Abstract
OBJECTIVE: This study evaluated the neurophysiological effects of ADAM-101, a game-based digital therapeutic, in children with attention-deficit/hyperactivity disorder (ADHD) using quantitative electroencephalography (qEEG). We focused on theta-gamma coupling (TGC), a neural synchrony marker linked to attentional control and executive function. METHODS: Eighteen children with ADHD were randomized to an intervention group (n = 9; pharmacotherapy + ADAM-101) or a control group (n = 9; pharmacotherapy only). qEEG was recorded at baseline and after 4 weeks. TGC in the prefrontal cortex was quantified using the synchronization index method with gamma frequencies subdivided into 3-Hz bins between 30 and 51 Hz. RESULTS: The intervention group showed increased prefrontal TGC following the 4-week program, while the control group demonstrated decreases. These findings suggest that gamified cognitive training via ADAM-101 may enhance cross-frequency coupling mechanisms underlying attention and cognitive regulation. CONCLUSION: ADAM-101, when combined with pharmacotherapy, improved neural synchrony in pediatric ADHD, as evidenced by increased prefrontal TGC. This exploratory trial supports the potential of digital therapeutics as adjunctive interventions targeting neurophysiological mechanisms of attentional control. Larger studies are needed to validate these preliminary results.