Effect Of Computer-based Response Inhibitory Training In Children With Attention-Deficit/Hyperactivity Disorder(ADHD)

Objective 1.To explore the relationship between salivary cortisol level and clinical symptoms,response inhibition function and social function in children with Attention Deficit Hyperactivity Disorder(ADHD).2.By comparing the effects of Computer-based training and drug therapy on the clinical symptoms,response inhibition function and social function of ADHD children,to verify the effect of computer-based response inhibition training on ADHD children.Methods:1.A total of 178 children with ADHD were recruited from the children’s outpatient department of Mental Health Center of Ningxia Medical University general Hospital and children with ADHD tendency were recruited online,as well as 60 healthy school-age children recruited from the Internet.saliva samples were collected at 0,30,45,60 min after waking up in the morning,and the cortisol concentration was measured,stroop,Go/Nogo tasks assessed response inhibition,N-back,WCST tasks assessed Executive Functions,and Weiss social function rating scale for parents(WFIRS-P)assessed social function.2.Children with ADHD were randomly divided into three groups:Computer Intervention Group,drug treatment group and ADHD control group.SNAP-Ⅳand Conners were used to assess symptoms,Stroop and Go/Nogo tasks to assess response inhibition,N-back and WCST tasks to assess Executive Functions,and WFIRS-P to assess social function.Results : 1.The scores of factors in SNAP-IV in ADHD group were significantly higher than those in healthy control group(P<0.001),and the scores of oppositional defiant factors in the low salivary cortisol concentration group were significantly higher than those in the high cortisol concentration group(P<0.001).The scores of learning problems,anxiety,conduct problems,impulsive hyperactivity and hyperactivity index factors in Conners symptom questionnaire in ADHD group were significantly higher than those in healthy control group(P< 0.05),and the scores of anxiety factor in low salivary cortisol group were significantly higher than those in high salivary cortisol group(P< 0.001).There were significant differences between the ADHD group and the healthy control group in the correct rate of No Go response,correct Go response,wrong No Go response and inconsistent time of word and color(P<0.001),among which the low salivary cortisol group had longer response time in the correct Go response and wrong No Go response(P<0.001).There were significant differences between ADHD group and healthy control group in the number of persistent errors,the number of completed categories and the number of persistent responses in the WCST task(P<0.001).There was a significant difference in response time between the ADHD group and the healthy control group on the 1-back task(P<0.001).There were significant differences between ADHD group and healthy control group in WFIRS-P in learning and school,adventure activities and total score factors(P<0.001),and the low salivary cortisol group had significantly higher scores in WFIRS-P than the high salivary cortisol group(P<0.05).2.After 8 weeks of intervention,the scores of attention deficit,hyperactive impulsiveness,and oppositional defiant factors in SNAP-Ⅳ in both intervention groups were significantly reduced from baseline(P<0.001),and the computer intervention group was significantly greater than the drug treatment group in oppositional defiant factors(P<0.001).In Conners symptom questionnaire,the scores of conduct problems,learning problems,impulse hyperactivity and hyperactivity index factors were significantly improved from baseline(P<0.05),and the decrease of computer intervention group in hyperactivity index factor was significantly greater than that in drug treatment group(P<0.05).The No Go accuracy and correct Go response in the two intervention groups were significantly improved compared with baseline(P<0.001).In Stroop task,word color inconsistency time was significantly improved from baseline(P<0.001);The number of persistent errors in the WCST task decreased significantly from baseline in both intervention groups(P<0.01),and the decrease was more significant in the computer intervention training group than in the drug therapy group(P<0.01).Learning and school factors,self-management,and total scores in WFIRS-P were significantly improved in both intervention groups from baseline(P<0.01).Conclusion:1.Children with ADHD have symptoms of hyperactivity,impulsivity and inattention,as well as oppositional defiance,adventure behavior and anxiety.The low salivary cortisol group was more significant than the high salivary cortisol groupt.2.Children with ADHD in the low salivary cortisol group had longer reaction times during the Go/No Go task and 1-back task than those in the high salivary cortisol group.3.Both computer-based training group and drug therapy group can improve the children’s core symptoms,and computer-based response inhibition training can improve oppositional defiance better than drug therapy group.4.Computer-based intervention training can improve the response inhibition function of ADHD children,and also improve the Executive Functios of the part that has not been trained.