Cited by 271Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologySchizophrenia research and treatment

Effects of methylphenidate on cognitive functions in children and adolescents with attention-deficit/hyperactivity disorder: evidence from a systematic review and a meta-analysis

Coghill, David R., Seth, Sarah, Pedroso, Sara, Usala, Tatiana, Currie, John, Gagliano, Antonella·2014·Biological Psychiatry

Abstract

Background Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of neuropsychological impairments. The relationship between these neuropsychological deficits and the defining symptoms of ADHD seems more complex than originally thought. Methylphenidate (MPH) is an effective treatment for ADHD symptoms, but its impact on cognition is less clearly understood.Methods With a common systematic search strategy and a rigorous coding and data extraction strategy across domains, we searched electronic databases to identify published placebo controlled trials that compared MPH and placebo on executive and nonexecutive memory, reaction time, reaction time variability and response inhibition in children and adolescents (5-18 years) with a formal diagnosis of ADHD.Results Sixty studies were included in the review, of which 36 contained sufficient data for meta-analysis. Methylphenidate was superior to placebo in all five meta-analyses: executive memory, standardized mean difference (SMD) .26, 95% confidence interval (CI): -.39 to -.13; non-executive memory, SMD .60, 95% CI: -.79 to -.41; reaction time, SMD .24, 95% CI: -.33 to -.15; reaction time variability, SMD .62, 95% CI: -.90 to -.34; response inhibition, SMD .41, 95% CI: -.55 to -.27.Conclusions These data support the potentially important effects of MPH on various aspects of cognition known to be associated with ADHD. Consideration should be given to adding cognitive outcomes to the assessment of treatment outcome in ADHD, considering the complexity of the relationship between ADHD symptoms and cognition.

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Crossref · 10.1016/j.biopsych.2013.10.005

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  • Stimulant medication for ADHD, e.g., MPH, is usually a first-choice treatment for ADHD, but it also has an effect on ANS functioning, for example increasing HR and blood pressure and giving rise to difficulties in sleeping.

    “Stimulant medication for ADHD, e.g., MPH, is usually a first-choice treatment for ADHD (NICE, 2018) but, together with well documented findings of improvement in cognitive performance (Coghill et al., 2014) and reduction of hyperactivity and impulsivity (Faraone and Buitelaar, 2010), it also has an effect on ANS functioning, for example increasing HR and blood pressure (Liang et al., 2018) and”
  • Stimulant medication improves cognitive functioning on laboratory tasks in children with ADHD.

    “Many studies have shown that stimulants improve cognitive functioning on laboratory tasks (Coghill et al., 2014; Pietrzak et al., 2006; Rapport & Kelly, 1991; Swanson et al., 2011; Vertessen et al., 2021)”
  • Four meta-analyses testing predominantly single dose effects of stimulants on cognitive performance in children and adults with ADHD have most consistently found effects on mean reaction time (MRT), attention, inhibition and working memory (WM).

    “Four meta-analyses testing predominantly single dose effects of stimulants on cognitive performance in children and adults with ADHD, have most consistently found effects on mean reaction time (MRT), attention, inhibition and WM (17, 22, 29, 30).”
  • The lisdexamfetamine effects on RT and CV extend findings that methylphenidate consistently improves RTV and RT in children with ADHD.

    “They extend findings of methylphenidate consistently improving RTV and RT in children with ADHD (22, 29–31), with meta-analytic fMRI evidence showing that this may be underpinned neurofunctionally by MPH-induced deactivation of frontal areas of the DMN which is associated with RTV in people with ADHD (75).”
  • Methylphenidate both in acute and longer-term dosage has been shown to improve inhibitory measures.

    “This was also unexpected as methylphenidate both in acute and longer-term dosage has been shown to improve inhibitory measures (17, 22, 29–31).”

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Authors
Coghill, D. R., Seth, S., Pedroso, S., Usala, T., Currie, J., & Gagliano, A.
Affiliations
  • University of Dundee (GB)
  • National Health Service (GB)
  • University of Messina (IT)
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2014-10
Volume
76
Issue
8
Pages
603-615
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2009766215
Cited by
271
References
100
Citations by year
2026: 14 · 2025: 16 · 2024: 15 · 2023: 18 · 2022: 19 · 2021: 29 · 2020: 21 · 2019: 24 · 2018: 28 · 2017: 23 · 2016: 21 · 2015: 25 · 2014: 18
FWCI
2.91
Type
journal article
Language
en
Open access
closed
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
  • UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
methylphenidate, attention deficit hyperactivity disorder, cognitive function, executive function, memory, reaction time, response inhibition, children and adolescents, stimulant medication, neuropsychological deficits, treatment outcome assessment
MeSH terms
Age Factors, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Cognition Disorders, Methylphenidate, Neuropsychological Tests

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