Can the CANTAB identify adults with attention-deficit/hyperactivity disorder? A controlled study

Abstract

We examined the diagnostic utility of the Cambridge Neuropsychological Test Automated Battery (CANTAB) for identifying adults with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of clinically referred adults aged 18 to 60 years old, with (n = 474) and without (n = 163) DSM-IV diagnosis of ADHD. All subjects were administered seven subtests from the CANTAB that targeted domains of executive functioning and verbal memory. Data were analyzed to identify which CANTAB tasks would best predict ADHD status. Our results failed to show any diagnostic utility for the CANTAB in adults with ADHD, even when using the most robust tests (Affective Go/No-go [AGN] Total Commissions and [RTI] Simple Reaction Time) identified from stepwise logistic regression (forward selection; p > 0.05 for entry). However, the CANTAB was helpful in identifying executive functioning disorder (EFD) in adults with ADHD when compared with controls subjects. Even though the CANTAB lacked diagnostic utility for adults with ADHD, the findings provided further evidence that adult ADHD is strongly associated with EFD. This study represents the most comprehensive evaluation of the diagnostic utility of the CANTAB in a clinical sample of adults with ADHD.

Keywords:

• ADHD
• adults
• CANTAB
• diagnostics
• executive functioning

Disclosure statement

M. DiSalvo and C. Kelberman have no potential conflicts of interest to report.

Author contributions

Dr. Ronna Fried is currently receiving research support from Shire Pharmaceuticals and Roche Pharmaceuticals. In the past, Dr. Fried has received grant support from the Food & Drug Administration, Lundbeck AS, and the National Institutes of Health. Previously, she had been on the scientific advisory board for Johnson & Johnson and Lundbeck AS. She also had received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses.

Dr. Joseph Biederman is currently receiving research support from the following sources: AACAP, Feinstein Institute for Medical Research, Food & Drug Administration, Genentech, Headspace Inc., Lundbeck AS, Neurocentria Inc., NIDA, Pfizer Pharmaceuticals, Roche TCRC Inc., Shire Pharmaceuticals Inc., Sunovion Pharmaceuticals Inc., and NIH. Dr. Biederman has a financial interest in Avekshan LLC, a company that develops treatments for attention deficit hyperactivity disorder (ADHD). His interests were reviewed and are managed by Massachusetts General Hospital and Partners HealthCare in accordance with their conflict of interest policies. Dr. Biederman’s program has received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Bracket Global, Ingenix, Prophase, Shire, Sunovion, and Theravance; these royalties were paid to the Department of Psychiatry at MGH. In 2019, Dr. Biederman is a consultant for Akili, Jazz Pharma, and Shire. Through MGH corporate licensing, he has a US Patent (#14/027,676) for a non-stimulant treatment for ADHD, and a patent pending (#61/233,686) on a method to prevent stimulant abuse. In 2018, Dr. Biederman was a consultant for Akili and Shire. In 2017, Dr. Biederman received research support from the Department of Defense and PamLab. He was a consultant for Aevi Genomics, Akili, Guidepoint, Ironshore, Medgenics, and Piper Jaffray. He was on the scientific advisory board for Alcobra and Shire. He received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2016, Dr. Biederman received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses, and from Alcobra and APSARD. He was on the scientific advisory board for Arbor Pharmaceuticals. He was a consultant for Akili and Medgenics. He received research support from Merck and SPRITES. In previous years, Dr. Biederman received research support, consultation fees, or speaker’s fees for/from the following additional sources: AACAP, Abbott, Alcobra, Alza, APSARD, AstraZeneca, Avekshan, Boston University, Bristol Myers Squibb, Cambridge University Press, Celltech, Cephalon, The Children’s Hospital of Southwest Florida/Lee Memorial Health System, Cipher Pharmaceuticals Inc., Eli Lilly and Co., Esai, ElMindA, Forest Research Institute, Fundacion Areces (Spain), Forest, Fundación Dr.Manuel Camelo A.C., Glaxo, Gliatech, Hastings Center, Ironshore, Janssen, Juste Pharmaceutical Spain, Magceutics, McNeil, Medice Pharmaceuticals (Germany), Merck, MGH Psychiatry Academy, MMC Pediatric, NARSAD, NIDA, New River, NICHD, NIMH, Novartis, Noven, Neurosearch, Organon, Otsuka, Pfizer, Pharmacia, Phase V Communications, Physicians Academy, The Prechter Foundation, Quantia Communications, Reed Exhibitions, Shionogi Pharma Inc, Shire, the Spanish Child Psychiatry Association, The Stanley Foundation, UCB Pharma Inc., Vaya Pharma/Enzymotec, Veritas, and Wyeth.

Additional information

Funding

This research received no specific grant from any funding agency, commercial, or not-for-profit sectors. This research was indirectly supported by the MGH Pediatric Psychopharmacology Council Fund.