Potter Alexandra S, Newhouse Paul A
Clinical Neuroscience Research Unit, Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT 05401, United States.
Pharmacol Biochem Behav. 2008 Feb;88(4):407-17. doi: 10.1016/j.pbb.2007.09.014. Epub 2007 Sep 26.
The strong association between ADHD and cigarette smoking and the known effects of nicotine on cognition has lead to interest in the role of cholinergic function in ADHD cognitive deficits. We have previously demonstrated that acute nicotine improves behavioral inhibition in adolescents with ADHD. This study examined acute nicotine in young adults with ADHD-Combined type on cognitive domains including behavioral inhibition, delay aversion, and recognition memory.
15 non-smoking young adults (20+/-1.7 years) diagnosed with ADHD-C received acute nicotine (7 mg patch for 45 min) and placebo on separate days. Cognitive tasks included the Stop Signal Task, Choice Delay task, and the High-Low Imagery Task (a verbal recognition memory task). Three subjects experienced side effects and their data was excluded from analysis of cognitive measures.
There was a significant (p<.05) positive effect of nicotine on the Stop Signal Reaction Time measure of the Stop Signal Task. The SSRT was improved without changes in GO reaction time or accuracy. There was a trend (p=.09) for nicotine to increase tolerance for delay and a strong trend (p=.06) for nicotine to improve recognition memory.
Non-smoking young adults with ADHD-C showed improvements in cognitive performance following nicotine administration in several domains that are central to ADHD. The results from this study support the hypothesis that cholinergic system activity may be important in the cognitive deficits of ADHD and may be a useful therapeutic target.
注意缺陷多动障碍（ADHD）与吸烟之间存在密切关联，且已知尼古丁对认知有影响，这引发了人们对胆碱能功能在ADHD认知缺陷中所起作用的兴趣。我们之前已经证明，急性尼古丁可改善ADHD青少年的行为抑制能力。本研究考察了急性尼古丁对ADHD混合型年轻成年人在包括行为抑制、延迟厌恶和识别记忆等认知领域的影响。
15名被诊断为ADHD-C的不吸烟年轻成年人（20±1.7岁）在不同日期分别接受急性尼古丁（7毫克贴片，持续45分钟）和安慰剂。认知任务包括停止信号任务、选择延迟任务和高低意象任务（一种言语识别记忆任务）。三名受试者出现副作用，其数据被排除在认知测量分析之外。
尼古丁对停止信号任务的停止信号反应时间测量有显著（p<0.05）的积极影响。停止信号反应时间得到改善，而启动反应时间或准确性没有变化。尼古丁有增加延迟耐受性的趋势（p=0.09），且有改善识别记忆的强烈趋势（p=0.06）。
患有ADHD-C的不吸烟年轻成年人在服用尼古丁后，在ADHD的几个核心认知领域的表现有所改善。本研究结果支持以下假设：胆碱能系统活动在ADHD的认知缺陷中可能很重要，并且可能是一个有用的治疗靶点。
