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What did the project achieve?
“Our study shows, for the first time, that our potential drug-free treatment is feasible, safe and leads to short and longer-term benefits for young people with ADHD,” says Professor Katya Rubia of King’s College London.
Around one in 20 children worldwide are affected by Attention Deficit Hyperactivity Disorder (ADHD).1
Children with ADHD tend to have a poor attention span, find it hard to concentrate and are often restless and impulsive. While drugs can be helpful, they can have unwanted side-effects and it has been questioned whether they work in the longer-term. Unfortunately, there is a lack of effective alternatives.
Professor Rubia is investigating a potential new treatment involving training the brain in a magnetic resonance imaging (MRI) scanner with the help of a fun computer game.
In their study, a group of young people with ADHD were trained to control the area of the brain responsible for self-control while lying inside the scanner and getting feedback of their brain activity that was connected to a rocket in a videogame (the ‘active’ group). Others (the ‘control’ group) were asked to play the same game but instead focussed on controlling another area of the brain.
“While we saw improvements in all of the participants’ ADHD symptoms after training, only the active group became better at certain tasks involving attention and in their brain activity during tests of self-control,” says Dr Rubia.
The results were even more encouraging almost a year after training.
“While the control group showed slightly decreased improvements in their ADHD symptoms after 11 months, the active group showed even greater improvement than immediately after the training – with effects as good as those seen with medication,” says Dr Rubia.
“As well as having fewer side-effects, brain training also appears to offer longer-lasting benefits than medication, which stop working when the child stops taking it.”
“We now want to carry out larger studies of our brain training for ADHD. We hope it will lead to a long-lasting, drug-free alternative treatment that will be preferred by parents, patients and clinicians.”
References
- Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164 (6):942-8.
This research was completed on
Around one in 20 children worldwide have attention deficit hyperactivity disorder (ADHD) – a debilitating psychiatric disorder, which often persists into adulthood.1 Medication, although helpful, is associated with problematic side effects.2,3 Professor Katya Rubia, of King’s College London, is investigating a new drug-free treatment, involving a computer game that works by monitoring brain activity, with the aim of helping children gain better control of regions of the brain that are responsible for self-control. She believes this could offer longer-lasting benefits than medication without causing side effects.
What is the problem and who does it affect?
Children with ADHD tend to be hyperactive and impulsive, with a short attention span. They may seem restless, are easily distracted and can fidget constantly.
‘ADHD can have serious consequences in life, affecting children’s concentration in the classroom and their relationships with parents, teachers and peers,’ explains Professor Rubia. ‘Children can find their difficulties deeply disturbing. Negative effects on friendships and academic performance can lead to low self-esteem.’ Sadly, depression and anxiety are common in children with ADHD.
Medication helps around 70 per cent of children with the disorder, but it is far from perfect.2,3 ‘Medication is associated with side effects such as restricted growth, loss of appetite and disturbed sleep,’ explains Professor Rubia. ‘What’s more, while medication is often highly effective in the short term, there is little evidence that it helps in the longer term and benefits are immediately lost if children stop taking their medication.’
Two thirds of children find their ADHD persists into adulthood.4 The demand for a new treatment that offers longer-term benefits without causing side effects is high.
What is the project trying to achieve?
‘We are investigating the potential of a new drug-free treatment for ADHD, called neurofeedback, which we believe might bring lasting benefits over the long term without causing side effects,’ says Professor Rubia. ‘The new treatment involves playing a fun computer game that is connected to a modern brain scanner. Children with ADHD have problems activating particular regions of the brain that are responsible for self-control. The computer game allows children to ‘see’ their own brain activity in these regions on a computer screen. The children’s brain activity is disguised as a helicopter, which rises and falls on the screen as brain activity rises and falls. We hope that this computer game will help children through play to learn how to gain greater control of the regions of the brain that are responsible for self-control.’
Around 25 boys with ADHD aged 10 to 14 are taking part in a pilot study of the new treatment. During sixteen, 10-minute treatment sessions, the boys lie inside an MRI scanner watching the cartoon helicopter on a computer screen, while the scanner measures their brain activity. If brain activity increases in the regions responsible for self-control, the helicopter rises and the children gain points. Through trial and error, the children learn how to control their brain activity and move the helicopter.
‘We are testing whether this playful treatment could help children improve their self-control and overcome their ADHD problems,’ explains Professor Rubia.
What are the researchers’ credentials?
Professor Rubia is a world expert in using MRI to scan the brains of people with ADHD. Her team at King’s College London has successfully scanned hundreds of children and teenagers with ADHD and related disorders. Facilities at their centre are second to none.
References
- Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164 (6):942-8.
- Wilens TE. Effects of methylphenidate on the catecholaminergic system in attention-deficit/hyperactivity disorder. J Clin Psychopharmacol 2008; 28:S46-53.
- WebMD. Stimulant drugs for ADHD. http://www.webmd.com/add-adhd/guide/adhd-stimulant-therapy Website accessed 25 January 2012.
- Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006;36(2):159-65.
| Project Leader | Professor Katya Rubia PhD |
| Project Team | Professor Gareth Barker PhDDr Vincent Giampietro PhDProfessor Anthony David MB ChB FRCP FRCPsych MD MSc FMed Sc |
| Project Location | Department of Child Psychiatry, Institute of Psychiatry, King’s College London |
| Project Location Other | Department of Neuroimaging, Institute of Psychiatry, King’s College LondonDepartment of Psychosis, Institute of Psychiatry, King’s College London |
| Project duration | 2.5 years |
| Date awarded | 10 November 2011 |
| Project start date | 5 November 2012 |
| Project end date | 30 April 2017 |
| Grant amount | £197,365 |
| Grant code | GN1890 |
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