Impact of Stimulants and In-Scanner Motion on Attentive Task Performance in ADHD (ADHD_NFB)

NCT ID: NCT06779825

Last Updated: 2025-01-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-28

Study Completion Date

2026-12-31

Brief Summary

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The goal of this interventional study is to learn the effects that stimulant medication prescribed to ADHD individuals has in their performance of attentive tasks, as measured by images and data collected through neuroimaging (fMRI) while also implementing new motion-correcting software. The main questions it aims to answer are:

1. How do the use of stimulants affect brain activity and motion in fMRI research in ADHD studies?
2. Can neurofeedback, an attentive task using real-time brain activity, engage the same brain circuits as seen with stimulant medication in individuals with ADHD?

Researchers will compare participant's brain activity from the completion of attentive tasks performed in the scanner while following their regular medication regimen and while abstaining to take medication. Researchers will also compare how the data collected using a more precise motion correction software differs to other previously reported data from ADHD studies who possibly employed more lenient measures of motion correction.

Participants will:

1. Be asked to complete at least 4 fMRI sessions, two of which will include neurofeedback
2. Be asked to abstain from taking stimulant medication on the day of two of these fMRI visits
3. Complete attentive tasks while in the scanner that will activate target brain regions of interest

Detailed Description

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Conditions

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ADHD

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Stimulant Medication for ADHD

Arm 1 will require that all participants refrain from taking their usual ADHD stimulant medication on the day of at least two of the study visits, one of which includes neurofeedback. Participants may resume their medication regimen upon completion of the study visit.

fMRI Neurofeedback attention task

Intervention Type COMBINATION_PRODUCT

Neurofeedback is an attentive task where participants are shown their real-time brain signals while in the scanner with the use of a representation, such as a rocket moving towards a portal. Participants are able to increase this brain signal by more purposefully engaging certain brain regions, and this is reflected in the representation that they see. Ultimately, this study is interested in whether neurofeedback can replicate the effects of stimulant medication in ADHD.

Interventions

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fMRI Neurofeedback attention task

Neurofeedback is an attentive task where participants are shown their real-time brain signals while in the scanner with the use of a representation, such as a rocket moving towards a portal. Participants are able to increase this brain signal by more purposefully engaging certain brain regions, and this is reflected in the representation that they see. Ultimately, this study is interested in whether neurofeedback can replicate the effects of stimulant medication in ADHD.

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

* Age 12 or older
* Able to follow verbal and written instructions in native language
* Pre-existing clinical ADHD diagnosis (with or without comorbid anxiety diagnoses)
* Pre-existing medication regimen of methylphenidate or amphetamine salt derivatives with no changes in the last month

Exclusion Criteria

* Known visual impairment preventing test administration
* Contraindication of inability to participate in fMRI scanning (per MRI screening form)
* Known, self-reported non-incidental structural brain abnormality
* Autism Spectrum Disorder or Obsessive-Compulsive Disorder
* Non-verbal
Minimum Eligible Age

12 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Alexander Cohen

Principal Investigator and Medical Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Boston Children's Hospital @2BP

Brookline, Massachusetts, United States

Site Status

Countries

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United States

Central Contacts

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Alexander Cohen, MD, PhD

Role: CONTACT

617-355-6000

Cohen Lab

Role: CONTACT

617-355-6388

Facility Contacts

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Alexander Cohen, MD, PhD

Role: primary

617-355-6000

Meghan Walsh, B.A.

Role: backup

Sofia Heras, B.S.

Role: backup

Alexander Cohen, MD, PhD

Role: backup

References

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Hein IM, De Vries MC, Troost PW, Meynen G, Van Goudoever JB, Lindauer RJ. Informed consent instead of assent is appropriate in children from the age of twelve: Policy implications of new findings on children's competence to consent to clinical research. BMC Med Ethics. 2015 Nov 9;16(1):76. doi: 10.1186/s12910-015-0067-z.

Reference Type BACKGROUND
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Isles AF. Understood consent versus informed consent: a new paradigm for obtaining consent for pediatric research studies. Front Pediatr. 2013 Nov 21;1:38. doi: 10.3389/fped.2013.00038.

Reference Type BACKGROUND
PMID: 24400284 (View on PubMed)

Sulzer J, Haller S, Scharnowski F, Weiskopf N, Birbaumer N, Blefari ML, Bruehl AB, Cohen LG, DeCharms RC, Gassert R, Goebel R, Herwig U, LaConte S, Linden D, Luft A, Seifritz E, Sitaram R. Real-time fMRI neurofeedback: progress and challenges. Neuroimage. 2013 Aug 1;76:386-99. doi: 10.1016/j.neuroimage.2013.03.033. Epub 2013 Mar 27.

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Wu ZM, Bralten J, An L, Cao QJ, Cao XH, Sun L, Liu L, Yang L, Mennes M, Zang YF, Franke B, Hoogman M, Wang YF. Verbal working memory-related functional connectivity alterations in boys with attention-deficit/hyperactivity disorder and the effects of methylphenidate. J Psychopharmacol. 2017 Aug;31(8):1061-1069. doi: 10.1177/0269881117715607. Epub 2017 Jun 28.

Reference Type BACKGROUND
PMID: 28656805 (View on PubMed)

Berberat J, Huggenberger R, Montali M, Gruber P, Pircher A, Lovblad KO, Killer HE, Remonda L. Brain activation patterns in medicated versus medication-naive adults with attention-deficit hyperactivity disorder during fMRI tasks of motor inhibition and cognitive switching. BMC Med Imaging. 2021 Mar 19;21(1):53. doi: 10.1186/s12880-021-00579-3.

Reference Type BACKGROUND
PMID: 33740903 (View on PubMed)

Rubia K, Alegria AA, Cubillo AI, Smith AB, Brammer MJ, Radua J. Effects of stimulants on brain function in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Biol Psychiatry. 2014 Oct 15;76(8):616-28. doi: 10.1016/j.biopsych.2013.10.016. Epub 2013 Oct 24.

Reference Type BACKGROUND
PMID: 24314347 (View on PubMed)

Sitaram R, Ros T, Stoeckel L, Haller S, Scharnowski F, Lewis-Peacock J, Weiskopf N, Blefari ML, Rana M, Oblak E, Birbaumer N, Sulzer J. Closed-loop brain training: the science of neurofeedback. Nat Rev Neurosci. 2017 Feb;18(2):86-100. doi: 10.1038/nrn.2016.164. Epub 2016 Dec 22.

Reference Type BACKGROUND
PMID: 28003656 (View on PubMed)

Fair DA, Nigg JT, Iyer S, Bathula D, Mills KL, Dosenbach NU, Schlaggar BL, Mennes M, Gutman D, Bangaru S, Buitelaar JK, Dickstein DP, Di Martino A, Kennedy DN, Kelly C, Luna B, Schweitzer JB, Velanova K, Wang YF, Mostofsky S, Castellanos FX, Milham MP. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data. Front Syst Neurosci. 2013 Feb 4;6:80. doi: 10.3389/fnsys.2012.00080. eCollection 2012.

Reference Type BACKGROUND
PMID: 23382713 (View on PubMed)

Dziemian S, Baranczuk-Turska Z, Langer N. Association between attention-deficit/hyperactivity disorder symptom severity and white matter integrity moderated by in-scanner head motion. Transl Psychiatry. 2022 Oct 6;12(1):434. doi: 10.1038/s41398-022-02117-3.

Reference Type BACKGROUND
PMID: 36202807 (View on PubMed)

Couvy-Duchesne B, Ebejer JL, Gillespie NA, Duffy DL, Hickie IB, Thompson PM, Martin NG, de Zubicaray GI, McMahon KL, Medland SE, Wright MJ. Head Motion and Inattention/Hyperactivity Share Common Genetic Influences: Implications for fMRI Studies of ADHD. PLoS One. 2016 Jan 8;11(1):e0146271. doi: 10.1371/journal.pone.0146271. eCollection 2016.

Reference Type BACKGROUND
PMID: 26745144 (View on PubMed)

Makowski C, Lepage M, Evans AC. Head motion: the dirty little secret of neuroimaging in psychiatry. J Psychiatry Neurosci. 2019 Jan 1;44(1):62-68. doi: 10.1503/jpn.180022.

Reference Type BACKGROUND
PMID: 30565907 (View on PubMed)

Yakupov R, Lei J, Hoffmann MB, Speck O. False fMRI activation after motion correction. Hum Brain Mapp. 2017 Sep;38(9):4497-4510. doi: 10.1002/hbm.23677. Epub 2017 Jun 5.

Reference Type BACKGROUND
PMID: 28580597 (View on PubMed)

Related Links

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https://bchcohenlab.com/participate/neurofeedback.html

Lab website giving a brief description of study protocol for those interested in participating.

Other Identifiers

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IRB-P00049401

Identifier Type: -

Identifier Source: org_study_id

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