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正念和心理教育对成人 ADHD 工作记忆的影响:一项随机对照 fMRI 研究。

Effects of mindfulness and psychoeducation on working memory in adult ADHD: A randomised, controlled fMRI study.

机构信息

Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy, University Hospital, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany.

Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy, University Hospital, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany; Biological Psychology Lab, Department of Psychology, European Medical School, Carl von Ossietzky Universität Oldenburg, Germany.

出版信息

Behav Res Ther. 2018 Jul;106:47-56. doi: 10.1016/j.brat.2018.05.002. Epub 2018 May 7.

Abstract

Adult attention-deficit/hyperactivity disorder (ADHD) is a serious mental disorder associated with impaired neurocognitive performance related to working memory function. Recent clinical trials have suggested that mindfulness is a promising intervention in adults with ADHD. We performed a randomised controlled clinical trial to investigate working memory (WM) with an n-back task in adults with ADHD during fMRI before and after an 8-week mindfulness intervention (MAP) compared with psychoeducation (PE). ADHD symptoms were assessed using the self- and observer-rated Conners Adult ADHD Rating Scales (CAARS). The complete pre-post data of 21 MAP and 19 PE participants were analysed. We found no group difference in ADHD symptoms or task performance at the pre-measurement, but there was a significant decrease in ADHD symptoms and significant improvement in task performance in both groups at the post-measurement. Furthermore, we found a significant increase in task-related activation in the right parietal lobe, with no difference between groups. Exploratory two-sample paired t-tests revealed significant increased brain activation after MAP in the bilateral inferior parietal lobule, right posterior insula and right precuneus. A decrease in self-rated 'Inattention/Memory Problems' after MAP compared to baseline was associated with stronger activation in parts of the left putamen, globus pallidus and thalamus.

摘要

成人注意缺陷多动障碍(ADHD)是一种严重的精神障碍,与工作记忆功能相关的神经认知表现受损有关。最近的临床试验表明,正念是一种有前途的 ADHD 成人干预措施。我们进行了一项随机对照临床试验,在 fMRI 中使用 n-back 任务来研究 ADHD 成人的工作记忆(WM),在 8 周的正念干预(MAP)和心理教育(PE)后进行比较。使用自我和观察者评定的 Conners 成人 ADHD 评定量表(CAARS)评估 ADHD 症状。对 21 名 MAP 和 19 名 PE 参与者的完整预-后数据进行了分析。我们发现,在预测量时,两组在 ADHD 症状或任务表现方面没有差异,但在测量后,两组的 ADHD 症状均显著下降,任务表现显著提高。此外,我们发现右顶叶的任务相关激活有显著增加,两组之间没有差异。探索性两样本配对 t 检验显示,MAP 后双侧顶下小叶、右后岛叶和右楔前叶的脑激活增加。与基线相比,MAP 后自我评定的“注意力不集中/记忆问题”减少与左壳核、苍白球和丘脑部分的更强激活相关。

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