Evidence map›Paper›PMID 27453080›Full record

Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2016

Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder.

Robert M Bilder, Sandra K Loo, James J McGough, Fiona Whelan, Gerhard Hellemann, Catherine Sugar, Melissa Del'Homme, Alexandra Sturm, Jennifer Cowen, Grant Hanada and 1 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00429273 (An Eight-Week, Randomized, Double-Blind Comparison of Guanfacine, Focalin XR, and the Combination, With a Twelve Month Open-Label Extension for the Treatment of ADHD in Pediatric Subjects Aged 7 to 14 Years), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00429273 phase4completednot on this map

An Eight-Week, Randomized, Double-Blind Comparison of Guanfacine, Focalin XR, and the Combination, With a Twelve Month Open-Label Extension for the Treatment of ADHD in Pediatric Subjects Aged 7 to 14 Years

TypeinterventionalSponsorUniversity of California, Los AngelesRan2007 to 2011Enrolled212ConditionsAttention Deficit Disorder With HyperactivityArmsGuanfacine, Methylphenidate (MPH)
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Concomitant activation of DResearch square · 2026
    Article
  8. Concomitant activation of DDiscover pharmaceutical sciences · 2026
    Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Review
  14. Alpha modulation during working memory encoding predicts neurocognitive impairment in ADHD.Journal of child psychology and psychiatry, and allied disciplines · 2019
    Article
  15. Article
  16. Linking ADHD to the Neural Circuitry of Attention.Trends in cognitive sciences · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Robert M BilderDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA; UCLA College of Letters and Science. Electronic address: rbilder@mednet.ucla.edu.
Sandra K LooDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
James J McGoughDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
Fiona WhelanDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
Gerhard HellemannDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
Catherine SugarDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA; UCLA School of Public Health.
Melissa Del'HommeDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
Alexandra SturmGraduate School of Education and Information Sciences at UCLA.
Jennifer CowenUCLA and the Semel Institute for Neuroscience and Human Behavior at UCLA.
Grant HanadaSchool of Engineering at the University of Michigan, Ann Arbor.
James T McCrackenDavid Geffen School of Medicine at University of California, Los Angeles (UCLA), and the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.
University of California, Los Angeles · USUCLA Health · USUniversity of Michigan–Ann Arbor · US

Funding

Translational Research to Enhance Cognitive ControlP50MH077248 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MCCRACKEN, JAMES T. · 2006 to 2011
$9.2M
NIMH NIH HHS P50 MH077248
6 · The paper itself

Abstract

objectivePsychostimulants are partially effective in reducing cognitive dysfunction associated with attention-deficit/hyperactivity disorder (ADHD). Cognitive effects of guanfacine, an alternative treatment, are poorly understood. Given its distinct action on α2A receptors, guanfacine may have different or complementary effects relative to stimulants. This study tested stimulant and guanfacine monotherapies relative to combined treatment on cognitive functions important in ADHD.

methodChildren with ADHD (n = 182; aged 7-14 years) completed an 8-week, double blind, randomized, controlled trial with 3 arms: d-methylphenidate (DMPH), guanfacine (GUAN), or combination treatment with DMPH and GUAN (COMB). A nonclinical comparison group (n = 93) had baseline testing, and a subset was retested 8 weeks later (n = 38). Analyses examined treatment effects in 4 cognitive domains (working memory, response inhibition, reaction time, and reaction time variability) constructed from 20 variables.

resultsThe ADHD group showed impaired working memory relative to the nonclinical comparison group (effect size = -0.53 SD unit). The treatments differed in effects on working memory but not other cognitive domains. Combination treatment improved working memory more than GUAN but was not significantly better than DMPH alone. Treatment did not fully normalize the initial deficit in ADHD relative to the comparison group.

conclusionCombined treatment with DMPH and GUAN yielded greater improvements in working memory than placebo or GUAN alone, but the combined treatment was not superior to DMPH alone and did not extend to other cognitive domains. Although GUAN may be a useful add-on treatment to psychostimulants, additional strategies appear to be necessary to achieve normalization of cognitive function in ADHD. CLINICAL TRIAL REGISTRATION INFORMATION: Single Versus Combination Medication Treatment for Children With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00429273.

Indexed as

Outcome Assessment, Health CareAdolescentAdrenergic alpha-2 Receptor AgonistsAttention Deficit Disorder with HyperactivityCentral Nervous System StimulantsChildCognitive DysfunctionDouble-Blind MethodDrug Therapy, CombinationFemaleGuanfacineHumansMaleMethylphenidateAdrenergic alpha-2 Receptor AgonistsCentral Nervous System StimulantsGuanfacineMethylphenidateattention-deficit/hyperactivity disordercognitionguanfacinestimulantworking memory

Identifiers

PMID27453080
PMCPMC4964604
OpenAlexW2418067944

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.