Institute of Mental Health, Peking University, Beijing, China.
Neuropsychology and Applied Cognitive Neuroscience Laboratory; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Int J Neuropsychopharmacol. 2012 Feb;15(1):15-26. doi: 10.1017/S1461145711001490. Epub 2011 Oct 21.
This study aimed to compare the effects of osmotic release oral system-methylphenidate (OROS-MPH) and atomoxetine (ATX) on executive function in children and adolescents with attention deficit hyperactivity disorder (ADHD) by a randomized controlled trial. Subjects who met DSM-IV ADHD criteria were randomized to receive either OROS-MPH or ATX treatment. The doses were titrated to achieve optimal response and then maintained for 4-6 wk. A battery of executive function tests and the Behavior Rating Inventory of Executive Function (BRIEF) were administered to subjects who completed the dose titration (OROS-MPH, n=85; ATX, n=57) at the pre- and post-treatment periods. Forty-six children without ADHD were recruited as controls. Both OROS-MPH and ATX significantly improved scores in the Rey Complex Figure Test (RCFT), digit span, and Stroop color-word task. The scores in RCFT and the reverse digit span were not significantly different from the control group at post-treatment assessment (OROS-MPH=ATX=control, p>0.05), whereas the word interference time of the Stroop test was still more than that of the control group (OROS-MPH=ATX>control, p>0.05). OROS-MPH also significantly improved the total correct response in the verbal fluency test to normal level, and the shifting time in the trail-making test to subnormal level. The current findings suggest both OROS-MPH and ATX improved executive function generally in children and adolescents with ADHD, and could return working memory back to normative performance level.
本研究旨在通过随机对照试验比较渗透型控释哌甲酯（OROS-MPH）和托莫西汀（ATX）对注意缺陷多动障碍（ADHD）儿童和青少年执行功能的影响。符合 DSM-IV ADHD 标准的受试者被随机分配接受 OROS-MPH 或 ATX 治疗。剂量滴定以达到最佳反应，然后维持 4-6 周。在剂量滴定完成后（OROS-MPH，n=85；ATX，n=57），对受试者进行了一系列执行功能测试和行为评定量表的执行功能分量表（BRIEF）评估。招募了 46 名无 ADHD 的儿童作为对照组。OROS-MPH 和 ATX 均显著改善了 Rey 复杂图形测试（RCFT）、数字跨度和 Stroop 颜色-文字任务的分数。RCFT 和倒数数字跨度的分数在治疗后评估与对照组无显著差异（OROS-MPH=ATX=对照组，p>0.05），而 Stroop 测试的单词干扰时间仍高于对照组（OROS-MPH=ATX>对照组，p>0.05）。OROS-MPH 还显著改善了言语流畅性测试的总正确反应，使 trail-making 测试的转换时间恢复到亚正常水平。目前的研究结果表明，OROS-MPH 和 ATX 均可改善 ADHD 儿童和青少年的执行功能，使工作记忆恢复到正常水平。
