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成人注意力缺陷多动障碍亚型与盐酸哌甲酯治疗反应的关联:一项磁共振波谱研究。

Association of adult attention deficit hyperactivity disorder subtypes and response to methylphenidate HCL treatment: A magnetic resonance spectroscopy study.

作者信息

Unal Gonca Ayse, Kenar Ayse Nur Inci, Herken Hasan, Kiroglu Yilmaz

机构信息

Psychiatry Clinic, Kozan State Hospital, Adana, Turkey.

Dept. of Psychiatry, School of Medicine, Pamukkale University, Denizli, Turkey.

出版信息

Neurosci Lett. 2015 Sep 14;604:188-92. doi: 10.1016/j.neulet.2015.08.006. Epub 2015 Aug 6.

Abstract

The effects of methylphenidate (MPH) treatment on N-acetyl aspartate (NAA), choline and creatine are being examined in individuals with different subtypes of attention deficit hyperactivity disorder (ADHD). Sixty ADHD subjects were included into the study aging between 18 and 60 years. Levels of NAA, creatine and choline in anterior cingulate cortex, cerebellum, striatum and dorsolateral prefrontal cortex were measured with magnetic resonance spectroscopy. Then, 10mg oral MPH was given to the subjects and the same metabolite levels were measured after an interval of 30min. Distribution of the patients according to the ADHD subtypes was as follows: 21 of them (35.0%) were in the inattentive type, 11 of them (18.3%) were in the hyperactive type and 28 of them were (46.7%) in the combined type. Changes of brain metabolite levels after MPH were found not to be statistically significantly different between the subtypes. The increase of choline levels after MPH compared to the levels of choline before MPH in striatum in the combined type patients were statistically significant. No clear association was found between ADHD subtypes and changes of brain metabolites with use of MPH in adult ADHD.

摘要

正在研究哌甲酯(MPH)治疗对不同亚型注意力缺陷多动障碍(ADHD)患者N-乙酰天门冬氨酸(NAA)、胆碱和肌酸的影响。60名年龄在18至60岁之间的ADHD受试者被纳入该研究。采用磁共振波谱法测量前扣带回皮质、小脑、纹状体和背外侧前额叶皮质中NAA、肌酸和胆碱的水平。然后,给受试者口服10mg MPH,并在30分钟后测量相同的代谢物水平。根据ADHD亚型对患者的分布如下:其中21例(35.0%)为注意力不集中型,11例(18.3%)为多动型,28例(46.7%)为混合型。发现MPH治疗后各亚型之间脑代谢物水平的变化无统计学显著差异。混合型患者纹状体中MPH治疗后胆碱水平相对于MPH治疗前胆碱水平的升高具有统计学意义。在成人ADHD中,未发现ADHD亚型与使用MPH后脑代谢物变化之间存在明确关联。

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