translated from Spanish: Scientists propose digital therapy as a treatment for hyperactive children

ADHD is a disorder that affects behavior, and is mainly characterized by a lack of attention of those who suffer from it, added to impulsivity and, in some cases, also mixed with hyperactivity. In the vast majority, the diagnosis is at an early age and, both nationally and internationally, it has been described as the main reason for consultation in the Neurology and Child Psychiatry Services, with a prevalence of 5% worldwide and 10% at the national level. All these characteristics indicate that this disorder impacts the development of millions of children in today’s society, which could potentially lead to some degrees of social disability if not treated properly.
ADHD, brain disorders and their treatment.
People with ADHD have alterations in the parts of the brain that control attention and cognition. These modifications are related to less activation in the frontal, frontoparietal and ventral areas of the brain.  This means that these children have trouble concentrating on certain tasks.
It is currently considered that treatments should be multimodal. This means that psychosocial intervention with the patient, intervention with parents, school community and, finally, pharmacological treatment must be included. However, all these pathways have been shown to have low efficacy. In addition, pharmacotherapy often causes concern due to the susceptibility to the abuse of these drugs, since most are psychostimulants derived from amphetamines such as Adderall, Focalin and Ritalin. Society has also been guilty of the misuse of these drugs, as some of these drugs are used recreationally at parties. Even governments have had to legislate laws to regulate the over-administration of these medicines to children (Ritalin Act).
For this reason, finding an alternative and easily accessible therapy is crucial to be able to improve a little the quality of life of these people and their families. In this sense, it has been proposed that a digital therapy could address these limitations with better access, minimal side effects and, decrease the disproportionate use of drugs. Some research on video games has shown that they are capable of altering brain structures and functions. Therefore, this suggests that it could be used advantageously for the game to selectively improve the brain circuits that are affected.
This caught the attention of a group of researchers led by Scott Kollins, from duke university medical center in the United States, who set out to study the possible therapeutic effect of a video game on children suffering from ADHD. The game was called AKL-T01 and specifically aims for people to control their attention to handle competing tasks in order to efficiently change the attention between them.
Something tangled, isn’t it? Don’t worry, I leave you the video link to see how the game works. Even if you’ve ever played Subway surfers from your cell phone, you could say it’s something similar. That is, the player has a specific task, which is to squeeze the tablet screen when a ball of an assigned color appears, while balls of other colors appear. The player then has a second task, in which he must move the tablet to dodge obstacles. Later the game gets a little more complicated, leveling up to a multitasking stage. In this period, the player must press the screen at the right time while dodging obstacles. And this is not all, since the game has 12 levels in total, therefore, it could become quite complicated.
Testing AKL-T01 as therapy for ADHD
To determine if this video game has effects specifically on people diagnosed with ADHD, the researchers conducted a clinical study with 348 individuals (70% boys and 30% girls), who had an average age of 10 years.
Of the total number of eligible children, 180 were randomly assigned treatment with AKL-T01 and 168 were given a control set, which did not have the same goals at concentration. The procedure had a total duration of 28 days and consisted of individuals having to use 5 times a week, for 25 minutes, the game that had been assigned to them on a tablet. The effects of the game were monkeythe tests and surveys that were carried out before and after the intervention. One of these was the TOVI API (Attention Variable Test and Attention Performance Index), which consists of a parameterized computational assay to evaluate the effects of interventions on ADHD. From the results of this test, researchers can conclude what the level of people’s attention is, how long it lasts over time, and how selective it is. Other measures they used were surveys of children to find out if they suffered side effects, and how their inattention, impulsivity and hyperactivity evolved.  Finally, this was complemented by a survey of parents to know from their perspective the improvement of their children.
The researchers found that after the intervention, children undergoing the use of AKL-T01 showed a substantial improvement in the TOVA API test, which translates into an improvement in the level of attention, selectivity, and duration of attention. While parents perceived that their children had a clear improvement in attention. It is important to note that these improvements were not observed in people who were subjected to control play. On the other hand, this treatment had virtually no side effects. However, in the qualitative surveys that were conducted with the children, these did not show improvements in attention, hyperactivity and impulsivity, contradicting the more quantitative results of the research.
Despite the positive results of this study, the researchers indicate that they should be treated with care, because the research has certain limitations. First, they used a range of boys and girls with fairly mild ADHD, therefore, they do not know how this treatment might work with more severe individuals. Second, only a 28-day intervention was used, so the effects of a more prolonged treatment are unknown. Finally, the researchers did not conducted studies to directly understand how the brain had been affected with this treatment. This is quite relevant, considering that, in this way, scientists can know if the video game is having effects in the desired areas, and in turn, they could have a more accurate explanation about which brain networks are participating.
Video games and their possible use as a digital treatment
We are currently immersed in a digital age in every way, where sports are no strangers. Esports is gaining more and more ground, generating millions of followers around the world with games such as League of Legends, DOTA 2, FIFA, Fortnite and Counter Strike. Don’t believe me? According to several studies, it is believed that there are about 500 million people around the world who are fans of eSports, and this is demonstrated in the world finals of these sports, where stadiums have been filled with 100 thousand spectators, and with more than 60 million individuals watching them on their computers (yes, crazy). Can you imagine that the game you have downloaded on your cell phone, PS4, or computer will serve to improve your attention and work as a treatment for millions of children with ADHD? Apparently, science could have a positive answer to this question very soon.
*This article arises from the agreement with the Interdisciplinary Center for Neuroscience of the University of Valparaíso.

Original source in Spanish

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