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一项试点研究:盐酸哌甲酯控释片对合并或不合并行为共病的注意力缺陷多动障碍儿童工作记忆和注意力功能的不同影响。

A pilot study: differential effects of methylphenidate-OROS on working memory and attention functions in children with attention-deficit/hyperactivity disorder with and without behavioural comorbidities.

作者信息

Rubio Belén, Hernández Sergio, Verche Emilio, Martín Raquel, González-Pérez Pedro

机构信息

Psychiatry Service, Child and Adolescent Unit, Hospital Universitario de Canarias, Tenerife, Spain.

出版信息

Atten Defic Hyperact Disord. 2011 Mar;3(1):13-20. doi: 10.1007/s12402-010-0035-x. Epub 2010 Oct 21.

Abstract

To examine the effects of methylphenidate-OROS (MPH-OROS) on working memory (WM) and attention functions in children with attention-deficit hyperactivity disorder (ADHD), and to investigate whether there is a differential effect in ADHD children with (ADHD+) and without (ADHD-) behavioural comorbidities. Participants included a clinic referred sample of 12 stimulant naïve school-aged children with a diagnosis of combined ADHD according to the DSM-IV criteria (6 ADHD+, 6 ADHD-), and 11 healthy children. A neuropsychological protocol was applied at three different moments: before treatment, after one those of MPH-OROS, and after one month of MPH-OROS daily treatment. The protocol was simultaneously administered to the control group. Initial differences in attention parameters between naïve children with ADHD and the control group disappeared after the first dose of MPH-OROS. For WM, one month of daily treatment was necessary to achieve this pattern of results. Both ADHD groups (ADHD+ and ADHD-) showed these differences, but there was a greater improvement in (ADHD-). MPH-OROS had an immediate effect on attention deficits, but long-term treatment was needed to improve WM to the level of healthy subjects. The presence of comorbid behavioural conditions determined a less robust response in neuropsychological performance to stimulant treatment.

摘要

为研究哌甲酯控释片(MPH-OROS)对注意力缺陷多动障碍(ADHD)儿童工作记忆(WM)和注意力功能的影响,并调查其对伴有(ADHD+)和不伴有(ADHD-)行为共病的ADHD儿童是否存在差异效应。研究对象包括一个来自门诊的样本,其中有12名未服用过兴奋剂的学龄儿童,根据《精神疾病诊断与统计手册》第四版(DSM-IV)标准被诊断为混合型ADHD(6名ADHD+,6名ADHD-),以及11名健康儿童。在三个不同时间点应用了一项神经心理学测试方案:治疗前、服用一次MPH-OROS后以及每日服用MPH-OROS一个月后。该方案同时应用于对照组。未服用过药物的ADHD儿童与对照组在注意力参数上的初始差异在首次服用MPH-OROS后消失。对于WM,需要一个月的每日治疗才能达到这种结果模式。两个ADHD组(ADHD+和ADHD-)均表现出这些差异,但(ADHD-)组的改善更大。MPH-OROS对注意力缺陷有即刻效应,但需要长期治疗才能将WM提高到健康受试者的水平。共病行为状况的存在决定了神经心理学表现对兴奋剂治疗的反应不那么强烈。

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