Verster Joris C, Roth Thomas
From the *Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; †Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Australia; and ‡Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI.
J Clin Psychopharmacol. 2014 Oct;34(5):633-6. doi: 10.1097/JCP.0000000000000174.
Lapses of attention are characteristic for attention-deficit/hyperactivity disorder (ADHD) and as such may impair performance of daily activities. Data from an on-road driving study were reanalyzed to determine lapses in patients with ADHD after treatment with methylphenidate and placebo.A total of 18 adult ADHD patients performed a 100-km on-road driving test and were instructed to drive with a steady lateral position and constant speed. The SD of lateral position (SDLP), that is, the weaving of the car, lapses, and alertness, was assessed.Driving was significantly better (P = 0.006) with methylphenidate (SDLP, 18.8 cm) when compared with placebo (SDLP, 21.2 cm). Both the reduction in SDLP and the number of lapses (P = 0.003) confirm this significant improvement, which is further supported by subjective assessments of perceived driving performance. Although lapses were common in the placebo condition (11/18 patients), they were much less frequently observed (5/18 patients) after treatment with methylphenidate. Postdriving assessments suggest that lapses often go unnoticed by drivers.In conclusion, methylphenidate significantly improves driving of patients with ADHD by significantly reducing the number of lapses.
注意力不集中是注意力缺陷多动障碍（ADHD）的特征，因此可能会影响日常活动的表现。对一项道路驾驶研究的数据进行重新分析，以确定使用哌甲酯和安慰剂治疗后ADHD患者的注意力不集中情况。共有18名成年ADHD患者进行了100公里的道路驾驶测试，并被要求保持稳定的横向位置和恒定的速度行驶。评估了横向位置的标准差（SDLP），即汽车的摆动、注意力不集中情况和警觉性。与安慰剂（SDLP为21.2厘米）相比，使用哌甲酯时驾驶情况明显更好（P = 0.006）（SDLP为18.8厘米）。SDLP的降低和注意力不集中的次数（P = 0.003）都证实了这一显著改善，对驾驶表现的主观评估进一步支持了这一点。尽管在安慰剂组中注意力不集中很常见（11/18患者），但在使用哌甲酯治疗后观察到的情况要少得多（5/18患者）。驾驶后评估表明，驾驶员往往没有注意到注意力不集中的情况。总之，哌甲酯通过显著减少注意力不集中的次数，显著改善了ADHD患者的驾驶情况。
