Joaquín A. Ibáñez Alfonso

Background/Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and it tends to remain during adulthood. It not only affects cognitive abilities and behavior but also often presents emotional disturbances and alterations in the perceived quality of life. These symptoms are primarily related to dysfunctions in the ventromedial and dorsolateral prefrontal network. The main objective was to evaluate the feasibility and explore the initial outcomes of an integrated protocol combining neuropsychological treatment and transcranial direct current stimulation (tDCS). Methods: This study presents a single-case experimental A-B design of a 21-year-old woman, diagnosed with predominantly inattentive ADHD, treated at the University Psychology Clinic of Loyola Andalucía University. The treatment was carried out twice a week for 5 weeks (10 sessions in total), with 20 min of anodal tDCS at F3 and cathodal tDCS at F4 (2 mA), while digital neurorehabilitation exercises and psychotherapeutic support were provided. Results: An overall significant improvement was observed in cognitive functions (p = 0.008), with clinically significant gains in cognitive flexibility, visual working memory, and planning. Mixed results were found in inhibition, with improvement in interference control but no change in response inhibition. No significant changes were observed in sustained attention, auditory working memory, or processing speed. In terms of emotional state, an overall improvement was noted (p = 0.046), particularly in depression symptoms and perceived quality of life related to physical and psychological health. However, no significant changes were observed in anxiety symptoms or in areas related to the environment and social relationships. These findings reflect pilot-level evidence of clinical change within a feasibility framework. Conclusions: The combined treatment was found to be safe and feasible, showing promising preliminary improvements in cognitive and emotional domains. As a single-case study, these results serve as hypothesis-generating evidence for future controlled trials.

Introduction Several studies have highlighted the role of temperament as a relevant construct to understand the wide variability observed in neurodevelopmental disorders (NDDs) such as autism spectrum disorder and attention deficit hyperactivity disorder. Some studies have pointed to temperamental traits such as strained control as possible precursors to the development of these disorders. In addition, how temperament influences high-risk populations, as well as intervention programmes aimed at families, has been investigated. Methods and analysis This paper presents the protocol that will be followed to carry out a systematic review, the objective of which is to know how child temperament is related to the different domains of development in children with NDD or the risk of suffering from it. The search strategy will be implemented in Web of Science (WoS Core Collection), PubMed, ERIC, PsycINFO and Cochrane databases. The risk of bias will be measured by the Newcastle-Ottawa Scale to carry out the integration of the results obtained to synthesis without meta-analysis will be used. This systematic review aims to improve scientific evidence for institutions and professionals and enhance the effectiveness of early care programmes for children with NDD and their families. Ethics and dissemination No express approval has been sought from any ethics committee because there is no primary data involved and no access to confidential patient information. PROSPERO registration number CRD42023445173.

Introduction: Research shows how conditions in socio-economically disadvantaged environments can be a risk factor for children’s cognitive development. Consequently, children with neurodevelopmental disorders growing up in such environments face a double challenge. This study analyzed the effect of a comprehensive cognitive stimulation program on 4 single case studies comprising children with neurodevelopmental disorders from Guatemala.Methodology: A descriptive study was conducted, using a case series approach, consisting of four participants with neurodevelopmental disorders, and a neurotypical group of 126 children. Participants in the neurotypical group were randomly assigned to either a control or experimental reference group. Cognitive assessments were performed pre- and post-intervention for all participants. Children in the experimental group received a comprehensive cognitive stimulation program between assessments. Two participants with neurodevelopmental disorders also received the stimulation program while the other two children with neurodevelopmental disorders performed the same task as the control group, specifically, regular reading activities.Results: The experimental group exhibited a significant improvement in executive functions (inhibition, flexibility, and planning). The two experimental group children with neurodevelopmental disorders exhibited improved social cognition, showing a larger improvement compared to neurotypical children in their group, as well as compared to the two control children. However, although the reading program improved the language skills of the neurotypical control group, the children with neurodevelopmental disorders did not show as much improvement.Conclusion: These results suggest that specialized interventions are beneficial for children from socio-economically disadvantaged backgrounds, but importantly, may have a larger impact on children with neurodevelopmental disorders.

Background: Guatemala remains one of the poorest countries in Central America and suffers from high rates of social inequality and violence. In addition to the negative impact that two years without attending school has had on Guatemalan children due to the consequences of the COVID-19 pandemic, this unfavourable socioeconomic context poses a risk to children’s emotional and cognitive development. This work presents a protocol for implementing a cognitive and emotional stimulation program aimed at increasing the academic performance of these children and consequently improving their quality of life. Methods: The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It targets the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to an Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles. Results will be compared for the first and second years, looking for differences in academic and cognitive performance between groups. Discussion: Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances.

The prevalence of attention deficit hyperactivity disorder (ADHD) in the population is currently 4%. It is usually associated with problems related to executive functions, attention and emotional regulation. Non-invasive brain stimulation, such as transcranial direct current stimulation (tDCS), may compensate for cognitive impairment, thereby benefiting neuroplasticity and long-term outcomes. The aim is to find evidence concerning the dual application of tDCS with cognitive stimulation activities in the treatment of ADHD in adults, in relation to attention, executive functions and emotional regulation. Two reviewers conducted a literature search of Web of Science and PubMed on 22.02.2023, and selected articles that included ADHD patients aged 17-65 years old. The results were analysed using synthesis without meta-analysis (SWiM). Seven of 956 articles were selected for the present review, and were all related to executive functions and attention. No article related to neuromodulation of emotional regulation in adults with ADHD was found. Significant results related to attention and executive functions, and specifically inhibitory control, were found. All studies followed the international 10-20 system developed for the electroencephalogram. Further research is required in view of the limited number of studies found on the symptomatological treatment of ADHD with tDCS in adult populations and the lack of awareness of emotional regulation. This research should use a treatment involving more than two sessions. These tasks do not involve learning and involve a stimulation of more than 1.5 mA.

Background: Guatemala remains one of the poorest countries in central America and suffers from high rates of social inequality and violence. Among other disadvantages, this unfavourable socioeconomic context poses a risk to children’s emotional and cognitive development. In addition to the negative impact that two years without attending school has had on Guatemalan children, the impact of the COVID-19 pandemic on the country’s economic stability has worsened the socioeconomic divide that these children face. This work presents a protocol for implementing a cognitive and emotional stimulation program with the goal of increasing the academic performance of these children and consequently improve their quality of life. Methods: The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It contains activities targeting the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to either the Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles. Discussion: Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances. Trial registration: This project has been registered in the Open Science Foundation data base on the 10th of February 2022 (https://doi.org/10.17605/OSF.IO/JVZ6W).

Diet directly affects children’s physical and mental development. Nonetheless, how food insecurity and household food consumption impact the cognitive performance of children at risk of social exclusion remains poorly understood. In this regard, children in Guatemala face various hazards, mainly related to the socioeconomic difficulties that thousands of families have in the country. The main objective of this study was to analyze the differences in cognitive performance considering food insecurity and household food consumption in a sample of rural and urban Guatemalan children and adolescents at risk of social exclusion. Child cognitive performance was assessed in 134 children and adolescents (age M = 11.37; SD = 3.54) from rural and urban settings. Language, attention, and executive functions were assessed using neuropsychological tasks. Differences in cognitive performance in each level of food insecurity and household diet consumption were compared using the Mann–Whitney U test. A stepwise multivariate regression analysis was conducted to determine which factors may influence cognitive scores. The results showed that rural and urban groups did not differ in terms of food insecurity. However, considering just rural areas, differences were found between groups with food security and insecurity in attention and executive function tasks. Moreover, differences were found in food consumption for certain groups of food (e.g., meat, U = 1,146, p < 0.001, g = 0.72). Regarding regressions, protein food consumption (e.g., meat and fish), which is related to having a more balanced diet, was a relevant factor in executive performance. Contrary to what we expected, performance in attentional tasks was not related to the consumption of any food group. These findings could help politicians and decision-makers to select actions focused on improving diet balance and food security in families at risk of social exclusion. It is necessary to carry out more specific studies on the factors related to diet that affect the cognitive development of minors at risk of social exclusion. In addition, it is necessary to study the implementation of alternative interventions that include low-cost nutrients, thus ensuring that minors have access to a more balanced diet.