ADHD Predominantly Inattentive Type Clinical Trial
Official title:
Cognitive Impairment in Pediatric Onset Multiple Sclerosis: Research of Biomarkers Predictive of Cognitive Impairment Progression
Computer-assisted rehabilitation of attention deficits in pediatric Multiple Sclerosis and ADHD patients recruited during the study "Cognitive impairment in Pediatric Onset Multiple Sclerosis: research of biomarkers predictive of cognitive impairment progression".
The presence of cognitive deficits of varied intensity is characteristic of psychiatric
disorders of childhood and adolescence such as Attention Deficit Hyperactivity Disorder
(ADHD), but also of neurological pathologies such as pediatric onset multiple sclerosis
(POMS).
ADHD is one of the most common neurodevelopmental disorders characterized by pervasive
patterns of inattention and/or impulsivity/hyperactivity and a range of cognitive
dysfunctions that often persist into adulthood.
POMS represent 5-10% of total MS population. Cognitive dysfunction is one of the most
remarkable features of MS, and, particularly in POMS, the percentage of patients with at
least a mild cognitive deficit ranges from 30 to 80%. The most affected cognitive domains in
POMS are complex attention, information processing speed, executive functions, verbal and
visual memory, reasoning and problem solving.
The functional consequences of cognitive impairment can be particularly striking in children
and adolescents since they occur during formative years in the academic career and may
affect their social activities. Cognitive training, during the developmental age, when brain
plasticity is at the highest expression, can induce a strengthening of the key brain
networks implicated in POMS and ADHD. To date the efficacy of specific cognitive
rehabilitation interventions has never been evaluated by a randomized controlled trials
(RCTS) in POMS. Conversely, in the last years, several RCTs assessed the efficacy of
cognitive training as a potential non-drug alternative treatment for ADHD disorder.Most of
the cognitive trainings focused on the working memory or attention dysfunctions. Preliminary
evidence suggests that cognitive remediation might be at least partially effective in the
ADHD treatment. It is argued that cognitive training can reduce ADHD symptoms and improve
functioning by targeting neuropsychological deficits thought to mediate ADHD
pathophysiology.
During the study project "Cognitive impairment in Pediatric Onset Multiple Sclerosis:
research of biomarkers predictive of cognitive impairment progression", which is aimed to
assess clinical, radiological and biological markers in pediatric subjects, POMS and ADHD
patients will be recruited to assess the efficacy of a home-based computerized program for
retraining attention dysfunction.
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