McLean A, Dowson J, Toone B, Young S, Bazanis E, Robbins T W, Sahakian B J
Department of Psychiatry, School of Clinical Medicine, University of Cambridge.
Psychol Med. 2004 May;34(4):681-92. doi: 10.1017/S0033291703001296.
It is now accepted that attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood. However, relative to the considerable literature concerning the profile of neurocognitive deficits associated with this disorder in childhood, equivalent investigations in adult populations have been less common. The current study examined cognitive function in adults diagnosed with ADHD employing well-validated neuropsychological tasks.
Nineteen adult patients who satisfied DSM-IV criteria for ADHD and 19 matched (gender, age and verbal IQ), non-clinical control subjects were recruited. Patients were either unmedicated or had abstained from a psychostimulant medication regime for at least 24 h prior to neurocognitive assessment. A functionally wide-ranging test battery was administered.
Relative to controls, ADHD adults performed significantly worse on spatial working memory, planning, and attentional-set shifting tests and were significantly slower to respond to target stimuli on the go/no-go task. In contrast, the two subject groups performed equivalently on decision-making and pattern/spatial recognition memory assessments.
The demonstration of neuropsychological dysfunction in the adult ADHD cohort provides some support for the validity of this diagnosis in adulthood. In particular, there is broad consistency between the cognitive profile revealed in the current investigation and that previously demonstrated in a study of medication-naïve ADHD children. There is evidence that frontostriatal function is especially disrupted.
目前人们公认注意力缺陷多动障碍(ADHD)常常会持续到成年期。然而,相对于大量有关该障碍在儿童期所伴随的神经认知缺陷特征的文献而言,针对成年人群的同等研究却较为少见。本研究采用经过充分验证的神经心理学任务,对被诊断为ADHD的成年人的认知功能进行了检查。
招募了19名符合DSM-IV标准的成年ADHD患者以及19名匹配的(性别、年龄和言语智商)非临床对照受试者。在进行神经认知评估之前,患者要么未服用药物,要么已停用精神刺激药物治疗方案至少24小时。实施了一套功能广泛的测试组合。
相对于对照组,成年ADHD患者在空间工作记忆、计划和注意力转换测试中的表现明显更差,并在“是/否”任务中对目标刺激的反应明显更慢。相比之下,两组受试者在决策以及模式/空间识别记忆评估中的表现相当。
在成年ADHD队列中所证实的神经心理功能障碍为该诊断在成年期的有效性提供了一定支持。特别是,本研究中所揭示的认知特征与先前在一项针对未用药的ADHD儿童的研究中所证实的特征具有广泛的一致性。有证据表明额纹状体功能尤其受到了破坏。