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Does Adhd Medication Improve Working Memory

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Why I Can’t Remember Things — How ADHD Affects Working Memory

A recent survey found that about 25% of adults over age 50 take a supplement to improve their brain health with the promise of enhanced memory and sharper attention and focus.

The problem? Thereâs no solid proof any of them work.

âThe main issue with all over-the-counter supplements is lack of regulation,â says Dr. Gad Marshall, associate medical director at the Center for Alzheimer Research and Treatment at Harvard-affiliated Brigham and Womenâs Hospital. âThe FDA doesnât oversee product testing or ingredient accuracy they just look out for supplements that make health claims related to the treatment of specific diseases.â

In terms of brain health, this means a supplement manufacturer can claim a product helps with mental alertness or memory loss but not that it protects against or improves dementia or Alzheimerâs disease. âThis way manufacturers donât have to back up any claim that their product is effective or even safe,â says Dr. Marshall.

Analyses Of Publication Bias

To address publication bias, we analyzed whether there were differences between published studies and the grey literature . Overall, there was a tendency for studies in the grey literature to have smaller effect sizes, but this was only significant for verbal working memory and visuospatial working memory .

Detailed rules for including studies in the p-curve analysis are shown in Table S10, in the Supplemental Material available online. For details of the studies that the p-curves are based on, as well as excluded studies, see Table S11 in the Supplemental Material available online. Unfortunately, there has been an extensive use of one-tailed significance tests in published studies in this field . In the p-curve analysis these p values were transformed into two-tailed values. Six of the studies that claimed significant far transfer when using a one-tailed test exceeded p = .05 when we used this more conventional two-tailed approach . Because a p-curve analysis only includes studies that report significant findings, these six studies were excluded from the p-curve analysis.

p-curve analysis of studies of working memory training for articles that have tested a hypothesis of transfer effects from training to other cognitive measures. A: p-curve analysis for studies with untreated controls. B: p-curve analysis for studies with treated controls.

Search Inclusion Criteria And Coding

The literature search, criteria for inclusion and exclusion and flow of studies are shown in . Only studies that had a control group and a training group with pretest and posttest measures before and after working memory training were included in the review. Our decision as to whether a study trained working memory was guided by previous research examining the factor structure of working memory measures . For a study to be included, the training had to involve tasks that typically have been found to load on working memory in latent-variable studies. Examples include visuospatial and verbal versions of simple span , complex span, running span, updating , and N-back . In cases where an intervention had multiple components, the working memory tasks had to constitute at least 50% of the intervention. Studies based purely on training task-switching, inhibition, or reasoning were excluded in an attempt to isolate the construct being trained as working memory and not other potentially related constructs . We included only studies of computerized working memory training.

We separated the measures into three different categories: near-transfer measures , intermediate-transfer measures , and far-transfer measures .

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A Review Of Working Memory Training In The Management Of Attention Deficit Hyperactivity Disorder

  • 1Faculty of Medicine, Department of Clinical Physiology, King Abdulaziz University, Jeddah, Saudi Arabia
  • 2Public Health Sector, General Directorate of Health Affairs in Najran, Ministry of Health, Najran, Saudi Arabia
  • 3Faculty of Medicine, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia

Attention deficit hyperactivity disorder is one of the most common neurodevelopmental disorders among children. Working memory deficits underlie many of the behavioural symptoms of ADHD. Alongside psychostimulant medications, strategies to improve working memory may play an important adjuvant role in the management of ADHD. In this study, we review the role of working memory deficits in ADHD, the evidence surrounding working memory training strategies in the management of the condition, and the factors affecting the success of these strategies in alleviating ADHD symptoms. More specifically, we review several non-pharmacological interventions that target working memory deficits in ADHD, with special emphasis on cognitive working memory training. We conclude that the development of evidence-based interventions such as computerised cognitive training could provide an alternative or adjunct to the use of psychostimulants, especially in cases where side effects are a major issue.

Immediate Effects Of Working Memory Training On Far

Pilot study suggests ADHD drugs do not improve cognition ...

shows a summary of the effects of working memory training on far-transfer measures. In studies with treated controls, the effects of training on nonverbal ability, verbal ability, word decoding, and arithmetic are close to zero and not significant . For reading comprehension, the effect size for studies with treated controls is small though significant . Closer inspection shows that 10 comparisons with treated controls give small to large positive effects . Of these, six comparisons across four studies show an odd pattern with the control group showing decreases in reading comprehension from pretest-posttest . This pattern of results makes these studies very difficult to interpret. Theoretically, there is no reason to expect decreases in a relatively stable construct such as reading comprehension ability between pretest and posttest in a control group such decreases presumably can only reflect error of measurement. Also, one of these studies showed large effects compared with the others . When the comparisons with the problematic pretest-to-posttest decline in the control group are excluded, the effects of working memory training compared with treated controls for reading comprehension becomes trivial and similar in magnitude to the other far-transfer outcomes.

Mean effects on the transfer measures for studies with treated and untreated controls

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Working Memory Vs Short

Many psychologists use the terms working memory and short-term memory interchangeably. Others define them in the same way we do: as distinct but related abilities.

In our view, short-term memory refers to a persons ability to temporarily activate a long-term memory in the short term. Working memory enables that person to put that memory into use by focusing on a subset or chunk of it and processing it in a specific way. In other words, its the ability to store and manipulate information in ones mind for a short period of time .

For example, someone with good short-term memory ability can remember and repeat a short sequence of numbers in the same order they originally learned them. Unless that person also has a strong working memory ability, however, they might not be able to manipulate the order of those numbers if asked to, for example, say them backward.

The processing component of working memory requires a person to focus on a specific chunk of recalled memory long enough to process or use it. A key difference, then, between short-term memory vs. working memory is that working memory requires someone to ignore superfluous information and tune out distractions. This distinction begins to explain why many people with ADHDincluding those with good short-term memoriesnevertheless struggle with working memory.

How Adhd Affects Working Memory In Adults

One of the hallmarks of ADHD is how it affects executive functioning. As we explain in this related post on how to improve executive function in ADHD adults, executive function is the set of processes that allow a person to manage themselves and their resources to achieve a goal. A person is said to suffer from executive dysfunction if they have poor working memory or lack other primary executive functioning skills.

Its possible to have working memory problems without having ADHD. Its also possible to have ADHD without any noticeable working memory problems. That said, researchers have identified strong links between ADHD and poor working memory. For example, a 2011 study of brain scans of children with ADHD consistently found reduced working memory task-specific brain activation compared to their non-ADHD peers. Since ADHD is a lifelong disorder, these deficiencies in working memory persist in adults.

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Comparing Working Memory Training & Medication Treatment For Adhd

August 26, 2009 by Dr. David Rabiner

Working memory is the cognitive system responsible for the temporary storage and manipulation of information and plays an important role in both learning and focusing attention. Considerable research has documented that many children and adults with ADHD have WM deficits and that this contributes to difficulties associated with the disorder. For an excellent introduction to the role of WM deficits in ADHD, click here.

A simple example illustrates the importance of WM for particular academic tasks. Try adding 3 and 9 in your head. That was probably easy for you. Now trying adding 33 and 99. That was probably more difficult. Finally, try adding 333 and 999. This is quite challenging for most adults even though each calculation required is trivially easy. The challenge occurred because you need to store information the sum of 3+9 in the ones column and then tens column as you process the remaining part of the problem, i.e., 3+9 in the hundreds column, and this taxed your WM. If your WM capacity was exceeded, you could not complete the problem successfully.

Because WM deficits play an important role in the struggles experienced by many individuals with ADHD, it is important to consider how different interventions address this aspect of the disorder. In this study, the authors were interested in comparing the impact of Working Memory Training and stimulant medication treatment on the WM performance of children diagnosed with ADHD.

Make Adequate Sleep Nutrition And Exercise A Priority

ADHD and Working Memory (English)

Most people struggle to find the time to exercise, prepare healthy meals, and get enough sleep. For those with ADHD, however, balancing commitments with self-care is especially difficult their impaired organization and planning skills can make each day feel like a juggling act.

Unsurprisingly, research shows that people with ADHD are more likely to suffer from insomnia and have poor eating habits than neurotypical individuals, and this can have a significant impact on memory function. Sleep deprivation in particular has been proven to have a detrimental effect on working memory. Emerging evidence also suggests that eating a diet high in processed foods can exacerbate ADHD symptoms. This is thought to be the case because processed foods cause blood sugar levels to fluctuate dramatically, leading to periods of fatigue and poor concentration. Some chemical additives, like artificial food coloring agents, may also trigger ADHD symptom flare-ups.

To help your memory work better, you should make a point of eating a diet rich in unprocessed whole foods, particularly fruits, vegetables, and whole grains. Eating fatty fish once or twice a week can also boost brain function and balance your moods. If you dont like the taste of fish, try taking an Omega 3 fatty acid supplement instead.

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Prescription Stimulants Do Not Improve Working Memory

If youre thinking about taking prescription stimulants to improve your memory and do better at work, heres something worth considering. Stimulants may help with your memory, but only when rote learning is involved. As far as working memoryour ability to simultaneously hold and manipulate different pieces of informationprescription stimulants dont do much for it, according to various studies.

Are you convinced that prescription stimulants do more harm than good?

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Ological Issues In The Studies Of Working Memory Training

One major methodological issue comes out strongly from our review: the problem of using untreated control groups. In our analyses, we separated studies with treated controls from those with untreated controls. It is clear from our analyses that the effects of working memory training on measures of far transfer are absent in studies using treated control groups. As noted in the Introduction, only studies using treated control groups provide a sound basis for claiming support for specific causal effects of working memory training. Just as new medications are compared against inert pills in clinical trials to control for placebo effects, working memory training interventions should be compared against treated control groups to provide evidence for specific effects of working memory training in causing gains in unpracticed abilities. We recommend that investigators stop conducting working memory training studies with untreated control groups and that journals stop publishing them. It should also be noted that the type of active control group used is also potentially important . For example, whether an active control group uses a nonadaptive training regime or a different, adaptive activity may have effects . Because many of the studies reviewed did not describe the active control group scheme in much detail, there were too few studies to do a more fine-grained analysis of this. However, this is potentially important to consider in future studies.

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Brain Activity In The N

The analysis across all participants and task loads showed expected activations in FPN, SN, inferior temporal/lateral occipital cortex, and several subcortical areas, including the cerebellum and striatum. The opposite contrast revealed deactivations in DMN areas in the PCC/precuneus, VMPFC, SMN, and inferior temporal, and lateral occipital/occipito-parietal cortices . Brain activity was largely similar between the visuospatial and digit n-back tasks, mirroring the behavioral data. The only significant stimulus-type effects across all participants were observed in the dorsal visual, mainly in the lateral occipital cortex , bilaterally. Due to the large overlap between the two single n-back tasks, we collapsed the data across both task variants for the subsequent analyses to increase power.

FIGURE 2

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Characteristics Of The Training Plan

Medications to Enhance Memory

Most commercially available CCT programs target a mix of different cognitive skills. While this was thought to lead to more transfer effects than targeting single skills, empirical evidence for this in the form of comprehensive direct comparisons between these strategies is lacking. The little evidence that is available in this regard suggests that programs that provide intensive practise of one aspect of a cognitive function like working memory are probably more effective at achieving transfer effects than those that involve multiple cognitive skills .

There is considerable heterogeneity in the CCT literature regarding the number and duration of training sessions . Importantly, few studies have attempted to directly determine the optimal length and intensity of CCT. Nonetheless, several studies have shown that the effect of such interventions is dose-dependent, meaning the length and intensity of these programs influence outcomes . Although many commercially available CCT products implement this, the influence of adapting to the individual trainees performance to maintain a level of difficulty that is challenging on performance gains is also controversial .

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Factors Potentially Influencing The Effect Of Working Memory Training

Several factors are known to influence the outcomes of CCT interventions, including characteristics of the training plan , as well as individual differences in age, cognitive abilities, biological factors, personality factors, motivational factors, and emotional factors . Awareness of the role of these factors may help optimise CCT strategies in the future.

The Relationship Between Measures Of Near And Far Transfer

Overall, these analyses fail to provide support for the idea that improvements on measures of far transfer are mediated by improvements in working memory capacity. The absence of such effects calls into question the theoretical rationale for the training studies reviewed here, because such studies are predicated on the notion of a mediated relationship . In contrast, the meta-regression results provided additional evidence that the type of control group used accounts for significant variance in the nonverbal ability outcomes.

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Treatment Of Adhd Through Working Memory Training: Mitra Encyclopedia Web Resources

Mitra Encyclopedia. Encyclopedia Resources On The Net. GMT:2012-03-11 00:56:08.

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Does Adhd Affect Processing Speed

Working Memory Deficits and ADHD , ADHD in Adults

âMany people with ADHD may also notice that they have difficulty processing information quickly and performing basic numbers-based tasks, such as telling time or dividing by 2. This can have a big impact on a person’s ability to work in many occupations, including those that involve math or computers. In certain jobs, being slow to process information can result in missed deadlines, mistakes, and delays.

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Be The Man With A Plan

In other words, if you know you have an important meeting at work, and a conference with your childs teacher in the afternoon and you are not sure how you are going to pull dinner together plan ahead!

Keep a planner with you at all times. Use your paper-based planner to help you form a muscle memory each time you write down a task/obligation. The physical act of writing will help to improve your working memory, as will the visual representation of your schedule on your calendar.

Then use a calendar app or Google Calendar to create a calendar for yourself. The key is to use something, anything, that will give you a visual and auditory reminder. We all know we need reminders.

Baseline Differences Between Adhd Versus Healthy Controls

4.1.1 Cognitive functions

As expected, as compared with healthy controls, participants with ADHD exhibited a range of deficits, ranging from self-rated clinical symptoms in inattention and impulsivity to related behavioral performance as indicated by CPT and digit span at baseline . Those effects are consistent with previous ADHD studies . Also consistent with other work is our observation that adults with ADHD performed relatively well on n-back tasks, showing similar behavioral performance levels as the healthy controls .

4.1.2 WM-related brain functioning

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