Cognitive Flexibility Improved by ADHD Medications: An fMRI Study of Children

August 11, 2022

The use of stimulant medications can significantly improve learning and executive functioning abilities in children with ADHD, who typically have limited cognitive flexibility compared to their peers. This result comes from a study published in Molecular psychiatry who found regional neural flexibility may be predictive of ADHD and symptom severity.1

Neural flexibility refers to brain dynamics thought to underlie cognitive flexibility, or “the ability to selectively switch between mental processes.” The researchers studied the neural flexibility of 180 children with ADHD and 180 typically developing children (TDC) using fMRI and machine learning methods. Compared to the DCT group, decreased neural flexibility was observed in the ADHD group at both whole-brain and subnet levels, suggesting “a system-wide dynamic reconfiguration in ADHD rather than a disruption limited to specific subsystems,” according to the researchers.

“Neural flexibility is not only potentially related to cognitive flexibility, but has also been reported to predict learning outcomes and executive functions in healthy subjects,” the researchers wrote. “Therefore, neural flexibility might be a useful measure to reflect impaired cognitive flexibility in ADHD subjects.”

The effects of stimulant medications on children with ADHD indicated significant improvement in cognitive functioning. Of the 180 children with ADHD, 46 were identified as using stimulant medications. Whole-brain neural flexibility was significantly higher for the medicated ADHD group compared to the unmedicated ADHD group. No statistical difference was found between the DCT group and the ADHD medication group, suggesting that neural flexibility can be used as a sensitive measure “revealing alterations in intrinsic brain function in response to stimulant drugs.”

“Since the psychostimulant drugs were withheld 24 to 48 hours prior to the examination, the observed ‘recovery’ of neural flexibility in the drug group may reflect the long-term benefits of the stimulant drugs for brain function.”

Finally, the researchers compared regional neuronal flexibility between the ADHD and DCD groups. They were able to identify key brain regions “capable of distinguishing DCD from ADHD and predicting the severity of ADHD symptoms”.

The data comes from a publicly available multi-site ADHD dataset. Due to the limited availability of female subjects, only males were considered in the machine learning models.

“Currently, the clinical diagnosis of ADHD relies primarily on behavioral assessments after symptom onset and presents potential rater bias during implementation. Our findings could potentially inform early detection efforts of vulnerable youth.

View article sources

About Michael Bill

Check Also

Maltese Fibromyalgia and M/E Activist Shows How Much Medication She Needs to Function

Ruth Debono, Malta’s fibromyalgia leader and M/E campaigner, showed people how much medicine she needs …