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[哌甲酯对注意力缺陷多动障碍儿童执行功能的影响]

[Effect of methylphenidate on executive function for children with attention deficit hyperactivity disorder].

作者信息

Shuai Lan, Yang Li, Cao Qing-jiu, Wang Yu-feng

机构信息

Institute of Mental Health, Peking University, Beijing 100083,China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Jun 18;39(3):293-8.

Abstract

OBJECTIVE

To explore whether methylphenidate (MPH) can improve the executive function (EF) of attention deficit hyperactivity disorder (ADHD) children and the degree of the improvements.

METHOD

We conducted an open study of 29 children (25 boys and 4 girls) who met DSM-IV criteria for ADHD. The variations of their EF before and after methylphenidate extended-release tablets [osmotic release oral system(OROS) methylphenidate] treatment were evaluated, and the differences of EF between 24 ADHD boys before and after treatment and 24 age-matched typically developing control boys were compared. The research instruments included Stroop color-word task, Rey complex figure test, digit span test, trail making test, tower of Hanoi and verbal fluency test.

RESULTS

The performances of errors in Stroop 1, time and errors of Stroops 2 and 4; the immediate memory and delay recalling of structure and detail score of RCFT; time of number-letter trail making, shifting time; total time and steps, rule violation of tower of Hanoi improved significantly after OROS methylphenidate treatment as compared with those before treatment. They were no significant differences between ante- and post-treatment. The initiation planning time of tower of Hanoi was significantly shorter after treatment as compared with that before treatment .

CONCLUSION

This study suggests that methylphenidate can improve the executive function in the aspects of inhibition, visual working memory, set shifting and planning in ADHD children, and almost all aspects of EF can reach the normal level except the inhibition.

摘要

目的

探讨哌甲酯(MPH)能否改善注意缺陷多动障碍(ADHD)儿童的执行功能(EF)及其改善程度。

方法

对29名符合DSM-IV标准的ADHD儿童(25名男孩和4名女孩)进行开放性研究。评估其在哌甲酯缓释片[渗透泵控释口服系统(OROS)哌甲酯]治疗前后EF的变化,并比较24名ADHD男孩治疗前后与24名年龄匹配的正常发育对照男孩之间EF的差异。研究工具包括Stroop色词测验、Rey复杂图形测验、数字广度测验、连线测验、河内塔测验和言语流畅性测验。

结果

与治疗前相比,OROS哌甲酯治疗后,Stroop 1的错误数、Stroop 2和4的时间和错误数;RCFT结构和细节得分的即刻记忆和延迟回忆;数字-字母连线时间、转换时间;河内塔的总时间和步数、违反规则情况均有显著改善。治疗前后无显著差异。与治疗前相比,治疗后河内塔的起始计划时间显著缩短。

结论

本研究表明,哌甲酯可改善ADHD儿童在抑制、视觉工作记忆、转换和计划等方面的执行功能,除抑制外,EF的几乎所有方面均可达到正常水平。

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