Araki Akiko, Ikegami Masanaga, Okayama Akie, Matsumoto Naoya, Takahashi Satoru, Azuma Hiroshi, Takahashi Masaharu
Department of Pediatrics, Asahikawa Medical University, Japan; Medical Research Center for Children's Development, Asahikawa Medical University, Japan.
Department of Psychology, Asahikawa Medical University, Japan.
Brain Dev. 2015 Jan;37(1):76-87. doi: 10.1016/j.braindev.2014.03.011. Epub 2014 Apr 22.
BACKGROUND/AIMS: Atomoxetine (ATX), a selective norepinephrine reuptake inhibitor, is the first approved non-stimulant drug for treatment of attention deficit/hyperactivity disorder (AD/HD). The present study examined the effects of long-term treatment with ATX on prefrontal hemodynamic activity in AD/HD children during a continuous performance task (CPT) using near-infrared spectroscopy (NIRS).
Prefrontal hemodynamic activity was measured in 12 children with AD/HD during experimental sessions conducted before and 6 months or more after starting ATX treatment. The average maintenance dose of ATX was 1.6 mg/kg/day. Fourteen age-matched typically developing children participated as a control group.
In the control group, the CPT induced a significant increase in oxygenated hemoglobin (oxy-Hb) concentration in the bilateral dorsolateral prefrontal cortex (DLPFC). In the AD/HD group in the pre-ATX condition, the CPT did not induce a significant increase in oxy-Hb concentration in any of the NIRS channels, but induced a significant decrease in oxy-Hb concentration in the left ventrolateral prefrontal cortex (VLPFC). In the AD/HD group in the post-ATX condition, significant activation was observed in the right DLPFC and the decrease in oxy-Hb concentration in the left VLPFC disappeared.
These results suggest that long-term treatment with ATX improved prefrontal hemodynamic activity in AD/HD children, and NIRS may be useful for assessment of the prefrontal hemodynamic response to ATX treatment.
背景/目的：托莫西汀（ATX）是一种选择性去甲肾上腺素再摄取抑制剂，是首个被批准用于治疗注意力缺陷/多动障碍（AD/HD）的非兴奋剂药物。本研究使用近红外光谱（NIRS），检测了AD/HD儿童在持续操作任务（CPT）期间，长期使用ATX治疗对前额叶血流动力学活动的影响。
在12名AD/HD儿童开始ATX治疗前及治疗6个月或更长时间后的实验环节中，测量其前额叶血流动力学活动。ATX的平均维持剂量为1.6mg/kg/天。14名年龄匹配的发育正常儿童作为对照组参与研究。
在对照组中，CPT诱导双侧背外侧前额叶皮质（DLPFC）的氧合血红蛋白（oxy-Hb）浓度显著增加。在ATX治疗前的AD/HD组中，CPT未在任何NIRS通道诱导oxy-Hb浓度显著增加，但在左侧腹外侧前额叶皮质（VLPFC）诱导oxy-Hb浓度显著降低。在ATX治疗后的AD/HD组中，右侧DLPFC观察到显著激活，且左侧VLPFC中oxy-Hb浓度的降低消失。
这些结果表明，长期使用ATX治疗可改善AD/HD儿童的前额叶血流动力学活动，且NIRS可能有助于评估对ATX治疗的前额叶血流动力学反应。
