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注意缺陷多动障碍男孩的自主神经活动低下及哌甲酯的影响。

Autonomic hypoactivity in boys with attention-deficit/hyperactivity disorder and the influence of methylphenidate.

机构信息

Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg , Germany.

出版信息

World J Biol Psychiatry. 2014 Jan;15(1):56-65. doi: 10.3109/15622975.2013.829584. Epub 2013 Sep 9.

Abstract

OBJECTIVES

This study investigates an overall autonomic hypoactivity reflecting hypoarousal as important aetiological factor in ADHD at baseline during rest and in response towards stimuli. In addition, effects of methylphenidate (MPH) are examined. We further assessed whether this hypoarousal is a stable characteristic or ameliorated by arousing emotional stimuli.

METHODS

Boys with ADHD were examined with (n = 35) or without MPH (n = 45) and compared with healthy boys (n = 22) regarding skin conductance level (SCL) during rest and skin conductance responses (SCRs) as well as valence and arousal ratings in response to positive, neutral, and negative pictures.

RESULTS

ADHD children without MPH were characterized by reduced baseline SCL and overall reduced SCRs. ADHD children with MPH never differed from control children. All groups displayed normal valence and arousal ratings of the stimuli and enhanced SCRs to emotional in comparison to neutral pictures.

CONCLUSIONS

This is the first study to unravel (1) a general autonomic hypoactivity in ADHD children at baseline and in response to low arousing neutral and highly arousing emotional stimuli, and (2) hints that MPH normalizes this hypoactivity. Results contribute to the understanding of ADHD aetiology and MPH functionality, and are consistent with the cognitive-energetic model of ADHD.

摘要

目的

本研究旨在探讨 ADHD 患者在静息状态和对刺激反应时自主神经活动低下(反映唤醒不足)这一潜在病理生理机制,及其作为 ADHD 重要病因学因素的作用。此外,还对哌醋甲酯(MPH)的作用进行了研究。我们进一步评估了这种唤醒不足是否是一种稳定的特征,或者是否可以通过唤起情绪刺激来改善。

方法

本研究共纳入 35 名未服用 MPH 的 ADHD 患儿、45 名服用 MPH 的 ADHD 患儿和 22 名健康对照儿童,分别评估他们在静息状态下的皮肤电导率(SCL)、皮肤电反应(SCR)以及对正性、中性和负性图片的效价和唤醒评分。

结果

未服用 MPH 的 ADHD 患儿基线 SCL 降低,整体 SCR 降低。服用 MPH 的 ADHD 患儿与对照组儿童从未表现出差异。所有组的刺激效价和唤醒评分均正常,与中性图片相比,情绪图片的 SCR 增强。

结论

这是第一项研究揭示了(1)ADHD 患儿在基线和对低唤醒中性和高唤醒情绪刺激时存在自主神经活动低下,以及(2)提示 MPH 可使这种活动低下正常化。这些结果有助于理解 ADHD 的发病机制和 MPH 的作用机制,与 ADHD 的认知能量模型一致。

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