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哌甲酯对注意力缺陷/多动障碍儿童听力理解有益作用的初步证据。

Preliminary evidence of beneficial effects of methylphenidate on listening comprehension in children with attention-deficit/hyperactivity disorder.

作者信息

McInnes Alison, Bedard Anne-Claude, Hogg-Johnson Sheilah, Tannock Rosemary

机构信息

Faculty of Education, University of Windsor, Windsor, Ontario, Canada.

出版信息

J Child Adolesc Psychopharmacol. 2007 Feb;17(1):35-49. doi: 10.1089/cap.2006.0051.

DOI:10.1089/cap.2006.0051
PMID:17343552
Abstract

OBJECTIVE

The effect of methylphenidate (MPH) on listening comprehension for information passages, and on working memory, was examined in a clinical sample of 16 children with attention-deficit/hyperactivity disorder (ADHD).

METHOD

Drug effects on comprehension of spoken language at the levels of single sentences and passages, and on verbal and visual-spatial working memory (WM) skills were assessed over a 4-day placebo-controlled, double-blind, crossover treatment trial of MPH at low, medium, and high doses. Concurrent behavior ratings were also completed. Data were analyzed at both group and individual levels; individual improvements using average change scores were analyzed to explore interrelationships among comprehension, WM, and behavioral responses to MPH.

RESULTS

There was a significant effect of drug on comprehension of inferences from challenging listening passages (F = 3.1, p ,0.05), and on visual-spatial working memory performance (F = 3.3, p ,0.05), with significant linear dose-response relationships evident for both domains. Individual improvements in comprehension using averaged placebo-dose change scores were not related to improvements in behavior with MPH, or to improvements in WM in this sample.

CONCLUSIONS

Findings provide preliminary evidence that MPH affects higher-level language comprehension skills, which require sustained attention and mental effort. If generalizable to classroom listening skills, these findings have implications for clinicians and teachers involved with children with ADHD.

摘要

目的

在16名患有注意力缺陷多动障碍(ADHD)的儿童临床样本中,研究哌甲酯(MPH)对信息段落听力理解以及工作记忆的影响。

方法

在一项为期4天的安慰剂对照、双盲、交叉治疗试验中,评估低、中、高剂量MPH对单句和段落层面口语理解以及言语和视觉空间工作记忆(WM)技能的药物效果。同时完成行为评分。在组和个体层面进行数据分析;使用平均变化分数分析个体改善情况,以探索理解、WM和对MPH行为反应之间的相互关系。

结果

药物对具有挑战性听力段落的推理理解有显著影响(F = 3.1,p < 0.05),对视觉空间工作记忆表现有显著影响(F = 3.3,p < 0.05),两个领域均呈现显著的线性剂量反应关系。在该样本中,使用平均安慰剂剂量变化分数的个体理解改善与MPH治疗后的行为改善或WM改善无关。

结论

研究结果提供了初步证据,表明MPH会影响需要持续注意力和脑力的高级语言理解技能。如果这些结果可推广到课堂听力技能,那么这些发现对涉及ADHD儿童的临床医生和教师具有启示意义。

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