Neuropsychiatric Disease and Treatment (Jan 2021)
The Impact of Methylphenidate on QbTest Performance of Children with ADHD: A Retrospective Clinical Study
Abstract
Rajna Knez,1 Dejan Stevanovic,2 Salmir Nasic,3 Ana Doric,4 Elisabet Wentz5 1Department of Pediatrics, Skaraborgs Hospital, Skövde, Sweden; Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; 2Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia; 3Research & Development Centre, Skaraborgs Hospital, Skövde, Sweden; 4Department of Psychology, Faculty of Humanity and Social Sciences, University of Rijeka, Rijeka, Croatia; 5Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, SwedenCorrespondence: Dejan StevanovicPsychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Dr Subotic 6a, Belgrade 11 000, SerbiaTel +381 69 241 2006Fax +381 11 265 8355Email [email protected]: The Quantified behavior Test (QbTest), which combines a continuous performance task (CPT) and motion tracking, provides data for the core signs of attention-deficit/hyperactivity disorder (ADHD): attention, hyperactivity, and impulsivity. This study aimed to evaluate the performance of children and adolescents with ADHD on the QbTest before and after a single methylphenidate (MPH) dose.Subjects and Methods: This retrospective chart review study included data from 149 children and 215 adolescents who completed the QbTest. A summary index of the CPT and motion capture data on the QbTest is provided by three cardinal parameters: QbActivity, QbImpulsivity, and QbInattention. The test was performed twice on the same day, before and up to three hours after MPH intake. A decrease by ≥ 0.5 in a cardinal parameter score was considered an improvement, whereas an increase by ≥ 0.5 a deterioration.Results: QbActivity improvement after MPH intake was present in 71.7% and 76.2% of the children and adolescents, respectively. QbImpulsivity improvement was observed in 50.4% of the children and 44.7% of the adolescents, and QbInattention improvement in 85.1% and 91.1% of the children and adolescents, respectively. All three parameters improved simultaneously in 27.7% of the children and 28.7% of the adolescents. The likelihood that one parameter deteriorated after MPH use was greater if that parameter was within the normal range before medication. This was most pronounced for QbImpulsivity. Among male adolescents, QbInattention improvement was often accompanied by QbImpulsivity deterioration.Conclusion: The QbTest inattention and motor activity parameters improved markedly after a single MPH dose in children and adolescents with ADHD, while less so for impulsivity. Improvement of one parameter is not necessarily associated with improvement of the other two, and deterioration, especially regarding impulsivity, may occur. If confirmed, these results highlight the need for optimization and individualization of MPH treatment, while monitoring all aspects of the ADHD symptomatology based on the QbTest performance.Keywords: continuous performance task, inattention, impulsivity, motor activity, stimulants
