Wehmeier Peter M, Schacht Alexander, Wolff Christian, Otto Walter R, Dittmann Ralf W, Banaschewski Tobias
Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
J Child Adolesc Psychopharmacol. 2011 Oct;21(5):433-44. doi: 10.1089/cap.2010.0142.
The effect of atomoxetine (ATX) on executive function has been assessed by means of questionnaires only. The aim of this study was therefore to evaluate the efficacy of ATX using standard variables of a computer-based continuous performance test (cb-CPT) combined with an infra-red motion-tracking device at different times of the day. One hundred twenty-eight girls and boys aged 6 to 12 years with a diagnosis of ADHD according to DSM-IV-TR criteria were randomized in the study. The primary efficacy measures were the q-scores of the cb-CPT combined with an infra-red motion-tracking device. The test comprises 13 neuropsychological variables that can be taken to reflect hyperactivity, inattention, or impulsivity. One hundred five patients completed the study (ATX group: n=54; placebo group: n=51). ATX (target dose 1.2 mg/kg/day) over 8 weeks was significantly superior to placebo in reducing hyperactivity, inattention, and impulsivity as measured by q-scores of 10 primary variables of the cb-CPT. Both groups of patients showed a circadian pattern of neuropsychological outcomes across the day as reflected by the cb-CPT combined with an infra-red motion-tracking device. In summary, this study demonstrated a positive effect of ATX on some aspects of executive function, inhibitory control, and hyperactivity compared with placebo.
以往仅通过问卷来评估托莫西汀(ATX)对执行功能的影响。因此,本研究旨在结合基于计算机的连续性能测试(cb-CPT)的标准变量以及红外运动追踪设备,在一天中的不同时间点评估ATX的疗效。根据美国精神疾病诊断与统计手册第四版修订版(DSM-IV-TR)标准,128名年龄在6至12岁、诊断为注意力缺陷多动障碍(ADHD)的女孩和男孩被随机纳入本研究。主要疗效指标为结合了红外运动追踪设备的cb-CPT的q分数。该测试包含13个可用于反映多动、注意力不集中或冲动性的神经心理学变量。105名患者完成了研究(ATX组:n = 54;安慰剂组:n = 51)。在为期8周的时间里,按照cb-CPT的10个主要变量的q分数衡量,ATX(目标剂量为1.2mg/kg/天)在减少多动、注意力不集中和冲动性方面显著优于安慰剂。两组患者在一天中均呈现出由结合了红外运动追踪设备的cb-CPT所反映的神经心理学结果的昼夜模式。总之,本研究表明与安慰剂相比,ATX对执行功能、抑制控制和多动的某些方面具有积极作用。