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注意缺陷多动障碍儿童和青少年中枢神经系统5-羟色胺神经传递减弱与情绪自评:色氨酸快速耗竭无明显影响。

Diminished central nervous 5-HT neurotransmission and mood self-ratings in children and adolescents with ADHD: no clear effect of rapid tryptophan depletion.

作者信息

Zepf Florian Daniel, Holtmann Martin, Stadler Christina, Magnus Sophie, Wöckel Lars, Poustka Fritz

机构信息

Department of Child and Adolescent Psychiatry and Psychotherapy, JW Goethe University of Frankfurt am Main, Frankfurt am Main, Germany.

出版信息

Hum Psychopharmacol. 2009 Mar;24(2):87-94. doi: 10.1002/hup.1002.

Abstract

INTRODUCTION

Research on 5-HT-functioning in adult patients and healthy subjects using rapid tryptophan depletion (RTD) has indicated weak but stable effects on mood ratings. Altered mood in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) can confound the differential diagnosis between severe ADHD and mood disorders such as pediatric bipolar disorder. The present study investigated the effects of RTD induced lowered central nervous 5-HT-levels on mood self-ratings in children with ADHD.

METHODS

Seventeen boys with ADHD participated in the study in a double-blind within-subject crossover-design. They were administered RTD within an amino acid drink lacking tryptophan, thus lowering central nervous 5-HT-synthesis. On another day they received a placebo. Self-rated mood was assessed on both days at baseline conditions and at three different post-drink time-points.

RESULTS

RTD had no clear effect on mood within the whole sample. Low scorers on venturesomeness were more strongly affected by RTD in terms of feelings of inactivity and negative feelings compared to high venture patients.

CONCLUSIONS

Our data did not show a significant effect of RTD on mood self-ratings. However, the findings must be considered as preliminary and require further replication, in particular as they could be due to sampling bias.

摘要

引言

利用快速色氨酸耗竭法(RTD)对成年患者和健康受试者的5-羟色胺功能进行的研究表明,该方法对情绪评分有微弱但稳定的影响。患有注意力缺陷多动障碍(ADHD)的儿童和青少年的情绪改变可能会混淆重度ADHD与情绪障碍(如儿童双相情感障碍)之间的鉴别诊断。本研究调查了RTD诱导的中枢神经系统5-羟色胺水平降低对ADHD儿童情绪自评的影响。

方法

17名患有ADHD的男孩参与了本研究,采用双盲受试者内交叉设计。他们在一种不含色氨酸的氨基酸饮料中接受RTD,从而降低中枢神经系统5-羟色胺的合成。另一天,他们接受安慰剂。在基线条件下以及饮用饮料后的三个不同时间点,对两天的情绪自评进行评估。

结果

RTD对整个样本的情绪没有明显影响。与冒险性得分高的患者相比,冒险性得分低的患者在RTD影响下,在无活动感和负面情绪方面受到的影响更大。

结论

我们的数据未显示RTD对情绪自评有显著影响。然而,这些发现必须被视为初步结果,需要进一步重复验证,特别是因为它们可能是由于抽样偏差导致的。

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