Attention Deficit Hyperactivity Disorder
Conditions
Keywords
ADHD, Inattention
Brief summary
This study is a single arm, open-label, pilot study to assess midline frontal theta (MFT) power as measured by stimulus-locked electroencephalogram (EEG) before and after treatment with AKL-T01 for improving attention in pediatric participants ages 8-12 years old with attention deficit hyperactivity disorder (ADHD).
Detailed description
All participants enrolled in this study will not be taking medications for attention deficit hyperactivity disorder (ADHD), including stimulants, for the duration of the study. Participants who are taking ADHD medications prior to Day 0 must have been stable off of medications for at least 30 days per parent report, or washout of medications at a Screening visit 3 - 7 days prior to Day 0. At Baseline / Day 0, all eligible participants will complete both resting-state electroencephalogram (EEG) and a perceptual discrimination task (PDT)-locked EEG. All participants will then play AKL-T01 for approximately 25 minutes per day, 5 days per week, for 4 weeks at home. At Follow-up / Day 28, participants will repeat both resting-state and PDT-locked EEG.
Interventions
DEVICEAKL-T01
AKL-T01 digital treatment is a state-of-the-art mobile video game-like platform, which deploys modern videogame graphics, engaging reward loops, and real-time adaptive mechanics to dynamically personalize difficulty based on the user's ability. AKL-T01 multitasking treatment employs perceptual discrimination attention/memory task as well as a continuous motor driving task. Performance on these tasks are assessed in isolation and when performed together to calculate a performance index for each individual user. A personalized multitask treatment regimen is automatically configured and delivered to the user and is optimized adaptively to increase multitask performance. As players proceed through the treatment periodic recalibration occurs to maintain an optimal difficulty level.
Sponsors
Akili Interactive Labs, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Intervention group will be compared to historical controls.
Eligibility
Sex/Gender
ALL
Age
8 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Confirmed Attention Deficit Hyperactivity Disorder (ADHD) diagnosis at screening/baseline visit based on Diagnostic Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) criteria and established via the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) administered by a trained clinician either in person or via teleconference * Wechsler Intelligence Scale for Children 5th Edition (WISC-V), Full Scale Intelligence Quotient ≥ 70 * Vanderbilt ADHD Diagnostic Parent Rating Scale: Must score a 2 or 3 on at least 6 items 1-9 AND must score a 4 on at least 2, or 5 on at least 1, of items 48-54 (performance questions). * Consistently off stimulant medication for ≥ 1 week. OR currently on stimulant medication and agree to stop taking the medication for a 1 week prior to the baseline visit and off through duration of training and post-training assessment (note: participants will only be allowed to washout of stimulant medication if in the opinion of the investigator they are currently inadequately managed on their medication and it is appropriate to stop taking their medication for the duration of the trial) * Consistently off Psychotropic drug for ≥ 1 month * Consistently off non-stimulant medication for ADHD (e.g. atomoxetine, clonidine, guanfacine) for ≥ 1 month * Able to follow written and verbal instructions (English) as assessed by the PI and/or study coordinator * Functioning at an age-appropriate level intellectually * Able to comply with all testing and requirements
Exclusion criteria
* Current controlled (requiring a restricted medication) or uncontrolled, comorbid psychiatric diagnosis, based on the Neurodevelopment Intake Form, Behavior Assessment System for Children (BASC), and subsequent clinical interviewing, with significant symptoms including but not limited to post-traumatic stress disorder, psychosis, bipolar illness, severe obsessive compulsive disorder, severe depressive or anxiety disorder, conduct disorder, or other symptomatic manifestations that in the opinion of the Investigator may confound study data/assessments. (Participants with clinical history of learning disorders will be allowed to participate as long as the disorder does not impact their ability to participate based on PI judgement). * Autism Spectrum Disorder concern as indicated from the Social Communication Questionnaire ≥ 15. * Current treatment with stimulant treatment for ADHD and unwilling or inappropriate (per investigator opinion) to washout. * Initiation or completion of behavioral therapy within the last 4 weeks. The participant should inform the Investigator if they intend to change their behavioral therapy during the 4 weeks of the study. Participants who have been in behavior therapy consistently for more than 4 weeks may participate if their routine is unchanged throughout the study. * Participant is currently considered at risk for attempting suicide by the Investigator, has previously made a suicide attempt, or has a prior history of, or is currently demonstrating active suicidal ideation or self-injurious behavior, as measured by MINI-KID Suicidality Module C. * Motor condition (e.g. physical deformity of the hands/arms) that prevents game playing as reported by the parent or observed by the Investigator. * Recent history or suspicion (within the past 6 months) of substance abuse or dependence. * History of seizures (excluding febrile seizures). * Participation in a clinical trial within 90 days prior to screening. * Color blindness as detected by Ishihara Color Blindness Test. * Regular use of psychoactive drugs that in the opinion of the Investigator may confound study data/assessments. * Any other medical condition that in the opinion of the Investigator may confound study data/assessments. * Previously received AKL-T01 (Project-EVO™) treatment in a previous clinical trial. * Concurrent brain training
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Midline Frontal Theta Power (MFT) | Day 0 to Day 28 | Change in midline frontal theta (MFT) power as measured by Perceptual Discrimination Task (PDT)-Locked Electroencephalogram (EEG). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Midline Frontal Theta Power (MFT) | Day 28 | MFT power as measured by Perceptual Discrimination Task (PDT)-Locked Electroencephalogram (EEG) of ADHD cohort post-treatment with AKL-T01 compared to that of neurotypical cohort at Day 0 (historical controls). |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| AKL-T01 AKL-T01: AKL-T01 digital treatment is a state-of-the-art mobile video game-like platform, which deploys modern videogame graphics, engaging reward loops, and real-time adaptive mechanics to dynamically personalize difficulty based on the user's ability. AKL-T01 multitasking treatment employs perceptual discrimination attention/memory task as well as a continuous motor driving task. Performance on these tasks are assessed in isolation and when performed together to calculate a performance index for each individual user. A personalized multitask treatment regimen is automatically configured and delivered to the user and is optimized adaptively to increase multitask performance. As players proceed through the treatment periodic recalibration occurs to maintain an optimal difficulty level. | 25 |
| Total | 25 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Did not complete the intervention | 2 |
| Overall Study | Withdrawal pre-intervention | 1 |
Baseline characteristics
| Characteristic | AKL-T01 | — |
|---|---|---|
| Age, Continuous | 10.44 years STANDARD_DEVIATION 1.23 | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment United States | 25 participants | — |
| Sex: Female, Male Female | 5 Participants | — |
| Sex: Female, Male Male | 20 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 28 |
| other Total, other adverse events | 0 / 28 |
| serious Total, serious adverse events | 0 / 28 |
Outcome results
Primary
Midline Frontal Theta Power (MFT)
Change in midline frontal theta (MFT) power as measured by Perceptual Discrimination Task (PDT)-Locked Electroencephalogram (EEG).
Time frame: Day 0 to Day 28
Population: Exclusions: data with excessive noise at the pre- or post-intervention assessment. Excessive noise was defined as rejection of more than 30% of target trials due to voltage fluctuations greater than ± 100 μV deflections within an epoch.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| AKL-T01 | Midline Frontal Theta Power (MFT) | Mean change in time window 0-120 ms | -0.31835 Hertz | Standard Deviation 0.54423 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Mean change in time window 160-280 ms | -0.15256 Hertz | Standard Deviation 0.79222 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Mean change in time window 760-875 ms | -0.29013 Hertz | Standard Deviation 0.64112 |
Comparison: EEG data excluded if excessive noise (rejection of more than 30% of target trials due to voltage fluctuations greater than ± 100 μV deflections within an epoch) at the pre- or post-intervention assessmentp-value: <0.05t-test, 2 sided
Secondary
Midline Frontal Theta Power (MFT)
MFT power as measured by Perceptual Discrimination Task (PDT)-Locked Electroencephalogram (EEG) of ADHD cohort post-treatment with AKL-T01 compared to that of neurotypical cohort at Day 0 (historical controls).
Time frame: Day 28
Population: Exclusions: data with excessive noise at the pre- or post-intervention assessment. Excessive noise was defined as rejection of more than 30% of target trials due to voltage fluctuations greater than ± 100 μV deflections within an epoch.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| AKL-T01 | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (680-800 ms) | .35505 Hertz | Standard Deviation 0.607502 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (0-120 ms) | .09047 Hertz | Standard Deviation 0.625799 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (0-120 ms) | .39812 Hertz | Standard Deviation 0.411608 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (200-320 ms) | .81225 Hertz | Standard Deviation 0.931336 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (200-320 ms) | 1.06766 Hertz | Standard Deviation 0.729074 |
| AKL-T01 | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (680-800 ms) | -.02013 Hertz | Standard Deviation 0.436377 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (200-320 ms) | 1.09948 Hertz | Standard Deviation 1.804712 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (680-800 ms) | -.58763 Hertz | Standard Deviation 1.678055 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (200-320 ms) | .54878 Hertz | Standard Deviation 2.391647 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (0-120 ms) | -.34779 Hertz | Standard Deviation 1.278674 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Pre-intervention Mean MFT power (680-800 ms) | -.05245 Hertz | Standard Deviation 2.444086 |
| Neurotypical Historical Control | Midline Frontal Theta Power (MFT) | Post-intervention Mean MFT power (0-120 ms) | -.11458 Hertz | Standard Deviation 1.1151529 |