Novel Strategy for the Analysis of CPT Data Provides New Insight into the Effects of Methylphenidate on Attentional States in Children with ADHD
Abstract
Continuous performance tasks (CPTs) provide a method for studying some components of attention, but do not take into account that attention fluctuates from moment to moment. To address this issue, CPT performance was classified into one of four states (on-task, impulsive, distracted, or randomly responding) every 30 seconds, based on commission and omission error rates. We evaluated this method on 60 boys (10.6 +/- 1.1 years) with attention-deficit hyperactivity disorder (ADHD)-Combined subtype, tested before and after a dose of methylphenidate (MPH, 0.4 mg/kg), and 8 unmedicated healthy control boys (11.3 +/- 2.0 years of age). Healthy controls were on-task during 82.4% of the 30-second epochs, and made an average of 5.4 attention shifts. In contrast, children with ADHD were only on-task during 42.6% of the epochs (p = 0.0006), and they made an average of 12.8 attention shifts (p = 0.00004). These state measures provided more robust indicators of the difference between children with ADHD and controls than did traditional CPT measures of error rates, latency, and variability. The new state measures were also more significantly affected by MPH. MPH produced a 77% increase in the percent of time children with ADHD spent on-task (p < 10(12)). Conversely, MPH reduced time spent in the distracted, impulsive, and random response states by 79%, 44.5%, and 69.2%, respectively (all p values < 0.0002). Unlike errors of omission and commission, which are highly correlated (r = 0.722, n = 60, p < 10(-11)), the percent of epochs spent in impulsive, distracted, and random response states were uncorrelated, and loaded onto discrete independent factors on principal component analysis. The level of activity during the CPT correlated with the degree of distraction, but not with the degree of impulsivity. Children with ADHD could be subtyped according to the nature of their attention performance problems, and these subtypes differed in levels of hyperactivity and degrees of response to MPH.
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Other studies show that medication reduces tau and reduces the peak and skew of reaction time distributions.
“These results suggest that medication specifically reduces intermittent long RTs, which is consistent with other studies showing that medication reduces tau [100] and reduces the peak and skew of RT distributions [43].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [100]
These results suggest that medication specifically reduces intermittent long reaction times.
“These results suggest that medication specifically reduces intermittent long RTs, which is consistent with other studies showing that medication reduces tau [100] and reduces the peak and skew of RT distributions [43].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [100]
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- Authors
- Teicher, M. H., Lowen, S. B., Polcari, A., Foley, M., & McGreenery, C. E.
- Affiliations
- Harvard University (US)
- McLean Hospital (US)
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2004-06
- Volume
- 14
- Issue
- 2
- Pages
- 219-232
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- OpenAlex
- W1978165003
- Cited by
- 54
- References
- 19
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 1 · 2014: 5 · 2013: 4 · 2012: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, methylphenidate, continuous performance test, attentional state, attentional shift, impulsivity, distraction, hyperactivity, drug response, children
- MeSH terms
- Central Nervous System Stimulants, Attention, Attention Deficit Disorder with Hyperactivity, Child, Data Interpretation, Statistical, Humans, Male, Methylphenidate, Motor Activity, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychomotor Performance, Reaction Time
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