Does neurocognitive functioning predict future or persistence of ADHD? A systematic review

• We reviewed the predictive value of neurocognitive functions for ADHD persistence.
• Persisters and remitters did not differ on higher nor lower level neurocognitive functions.
• Both persisters and remitters were different from controls on neurocognitive functions.
• In young children, future ADHD was predicted based on neurocognitive functions.
• Neurocognitive dysfunctions might be seen as epiphenomena in the course of ADHD.

Many children with ADHD remain symptomatic in (young) adulthood. It is important to understand what characterizes this persistent ADHD group. Since ADHD has been associated with neurocognitive dysfunctioning on a variety of neurocognitive domains, and many of these domains are influenced by the same risk genes that influence ADHD, neurocognitive functions are a potential predictor for ADHD persistence. We carried out a systematic literature review on the predictive value of neurocognitive functioning for future ADHD. Based on eighteen studies there was no evidence that either automatically controlled (requiring little mental effort; lower level), or more consciously controlled (requiring high levels of mental effort; higher level) neurocognitive functions differentiated ADHD persistence from remittance. In general, both persisters and remitters showed weaker performance than typically developing controls, although the effect was smaller for remitters. Neurocognitive functions measured in childhood predicted ADHD a few years later, regardless of the type of neurocognitive function. Our findings do not support the model of Halperin and Schulz (2006), which suggests a maturation of more consciously controlled neurocognitive functions in ADHD remitters.