Giramonti Karla M, Kogan Barry A, Halpern Leslie F
Division of Urology, The Urological Institute of Northeastern New York, Albany, New York 12208, USA.
Neurourol Urodyn. 2008;27(4):315-8. doi: 10.1002/nau.20507.
Studies have shown cognitive problems in adults treated with anticholinergics. It is unclear if children are also susceptible to anticholinergic adverse effects. This study evaluates the effects of long-acting oxybutynin and tolterodine on short-term memory and attention in children with urgency and urge incontinence.
Children with urgency or urge incontinence were recruited to take part in a prospective, randomized double-blinded placebo controlled trial using long-acting oxybutynin or tolterodine. Patients underwent a baseline test of their memory/recall ability and attention span using a standardized developmental/neuropsychological assessment tool. They were then randomized to either medication or placebo with retesting in 2 weeks, at which time they were crossed. They were retested after the second 2 weeks.
Fourteen children (9 boys and 5 girls), ranging in age from 5 to 11 (M = 7.7) participated in the study. Attention and memory scores increased over time in all children, however, the analyses showed no significant negative effects of anticholinergic medications on attention or memory. Indeed, though not statistically significant, trends were for improvement in test scores in both areas.
Our results in a double blinded cross-over trial suggest that long-acting oxybutynin and tolterodine do not have a deleterious effect on children's attention and memory. Other cognitive functions may be affected.
研究表明，接受抗胆碱能药物治疗的成年人存在认知问题。目前尚不清楚儿童是否也易受抗胆碱能药物不良反应的影响。本研究评估长效奥昔布宁和托特罗定对尿急和急迫性尿失禁儿童短期记忆和注意力的影响。
招募尿急或急迫性尿失禁儿童参与一项前瞻性、随机双盲安慰剂对照试验，使用长效奥昔布宁或托特罗定。患者使用标准化发育/神经心理学评估工具对其记忆/回忆能力和注意力广度进行基线测试。然后将他们随机分为药物组或安慰剂组，2周后重新测试，届时进行交叉。在第二个2周后再次进行测试。
14名年龄在5至11岁（中位数 = 7.7岁）之间的儿童（9名男孩和5名女孩）参与了该研究。所有儿童的注意力和记忆分数随时间增加，然而，分析表明抗胆碱能药物对注意力或记忆没有显著负面影响。事实上，虽然没有统计学意义，但两个领域的测试分数都有改善的趋势。
我们在双盲交叉试验中的结果表明，长效奥昔布宁和托特罗定对儿童的注意力和记忆没有有害影响。其他认知功能可能会受到影响。
