Tucha O, Mecklinger L, Laufkötter R, Klein H E, Walitza S, Lange K W
Department of Experimental Psychology, University of Regensburg, Regensburg, Germany.
J Neural Transm (Vienna). 2006 Oct;113(10):1575-92. doi: 10.1007/s00702-005-0437-7. Epub 2006 Aug 8.
The present study examined the effect of the stimulant medication methylphenidate (MPH) on attentional functioning of adults with ADHD. Sixteen adults with a diagnosed ADHD without comorbidity were assessed twice, at baseline off MPH and following MPH treatment. The assessment battery consisted of reaction time tasks of low complexity, including measures of alertness--subdivided into tonic and phasic alertness, vigilance, divided attention, flexibility and such aspects of selective attention as including focused attention, inhibition and integration of sensory information. In addition, 16 healthy participants who were matched to adults with ADHD according to sex, age, education level and intellectual functions were also assessed twice using the same test battery. The results of the present study suggest that adults with ADHD off stimulant medication are seriously impaired in various components of attention including vigilance, divided attention, selective attention and flexibility. These impairments of attention were observed primarily in regard to reaction time and its variability. Treatment of adults with ADHD using individually tailored doses of MPH has a positive effect on measures of alertness, vigilance, selective attention, divided attention and flexibility. However, even on MPH adults with ADHD displayed considerable deficits in vigilance and integration of sensory information. The present findings indicate that adults with ADHD are not differentially impaired in attentional processes but may suffer from a more global deficit of attention. Although MPH treatment has been found to be effective in the treatment of the attention deficit of adults with ADHD, additional treatment appears to be necessary.
本研究考察了兴奋性药物哌甲酯（MPH）对患有注意力缺陷多动障碍（ADHD）的成年人注意力功能的影响。16名被诊断患有ADHD且无合并症的成年人接受了两次评估，一次是在停用MPH的基线期，另一次是在接受MPH治疗之后。评估项目包括低复杂度的反应时间任务，其中包括警觉性测量——分为紧张性警觉和相位性警觉、警惕性、分散注意力、灵活性以及选择性注意力的各个方面，如集中注意力、抑制和感觉信息整合。此外，还使用相同的测试项目对16名在性别、年龄、教育水平和智力功能方面与患有ADHD的成年人相匹配的健康参与者进行了两次评估。本研究结果表明，停用兴奋性药物的患有ADHD的成年人在注意力的各个组成部分，包括警惕性、分散注意力、选择性注意力和灵活性方面严重受损。这些注意力损伤主要在反应时间及其变异性方面被观察到。使用个体化定制剂量的MPH对患有ADHD的成年人进行治疗，对警觉性、警惕性、选择性注意力、分散注意力和灵活性测量有积极影响。然而，即使在服用MPH的情况下，患有ADHD的成年人在警惕性和感觉信息整合方面仍表现出相当大的缺陷。本研究结果表明，患有ADHD的成年人在注意力过程中没有差异性损伤，但可能存在更全面的注意力缺陷。尽管已发现MPH治疗对患有ADHD的成年人的注意力缺陷有效，但似乎仍需要额外的治疗。
