托莫西汀对注意缺陷多动障碍和阅读障碍患者执行功能及词汇判断的不同影响。
Differential effects of atomoxetine on executive functioning and lexical decision in attention-deficit/hyperactivity disorder and reading disorder.
作者信息
de Jong Christien G W, Van De Voorde Séverine, Roeyers Herbert, Raymaekers Ruth, Allen Albert J, Knijff Simone, Verhelst Helene, Temmink Alfons H, Smit Leo M E, Rodriques-Pereira Rob, Vandenberghe Dirk, van Welsen Inge, ter Schuren Liesbeth, Al-Hakim Mazim, Amin Azad, Vlasveld Laurens, Oosterlaan Jaap, Sergeant Joseph A
机构信息
Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands.
出版信息
J Child Adolesc Psychopharmacol. 2009 Dec;19(6):699-707. doi: 10.1089/cap.2009.0029.
OBJECTIVE
The effects of a promising pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD), atomoxetine, were studied on executive functions in both ADHD and reading disorder (RD) because earlier research demonstrated an overlap in executive functioning deficits in both disorders. In addition, the effects of atomoxetine were explored on lexical decision.
METHODS
Sixteen children with ADHD, 20 children with ADHD + RD, 21 children with RD, and 26 normal controls were enrolled in a randomized placebo-controlled crossover study. Children were measured on visuospatial working memory, inhibition, and lexical decision on the day of randomization and following two 28-day medication periods.
RESULTS
Children with ADHD + RD showed improved visuospatial working memory performance and, to a lesser extent, improved inhibition following atomoxetine treatment compared to placebo. No differential effects of atomoxetine were found for lexical decision in comparison to placebo. In addition, no effects of atomoxetine were demonstrated in the ADHD and RD groups.
CONCLUSION
Atomoxetine improved visuospatial working memory and to a lesser degree inhibition in children with ADHD + RD, which suggests differential developmental pathways for co-morbid ADHD + RD as compared to ADHD and RD alone.
CLINICAL TRIAL REGISTRY
B4Z-MC-LYCK, NCT00191906; http://clinicaltrials.gov/ct2/show/NCT00191906.
目的
研究一种有前景的治疗注意缺陷多动障碍（ADHD）的药物托莫西汀，对ADHD和阅读障碍（RD）患儿执行功能的影响，因为早期研究表明这两种障碍在执行功能缺陷方面存在重叠。此外，还探讨了托莫西汀对词汇判断的影响。
方法
16名ADHD患儿、20名ADHD合并RD患儿、21名RD患儿和26名正常对照儿童参与了一项随机安慰剂对照交叉研究。在随机分组当天以及两个28天的药物治疗期后，对儿童进行视觉空间工作记忆、抑制能力和词汇判断的测试。
结果
与安慰剂相比，ADHD合并RD患儿在接受托莫西汀治疗后，视觉空间工作记忆表现有所改善，抑制能力也有一定程度的提高。与安慰剂相比，未发现托莫西汀对词汇判断有差异效应。此外，在ADHD组和RD组中未发现托莫西汀有效果。
结论
托莫西汀改善了ADHD合并RD患儿的视觉空间工作记忆，对抑制能力的改善程度较小，这表明与单独的ADHD和RD相比，共病的ADHD合并RD有不同的发育途径。
临床试验注册
B4Z-MC-LYCK，NCT00191906；http://clinicaltrials.gov/ct2/show/NCT00191906 。
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