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二十二碳六烯酸对未经药物治疗的注意缺陷多动障碍儿童的行为和认知影响:一项随机、安慰剂对照的临床试验。

Behavioral and cognitive effects of docosahexaenoic acid in drug-naïve children with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled clinical trial.

机构信息

Scientific Institute, IRCCS E. Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy.

Department of Psychology, University of Milano-Bicocca, Milan, Italy.

出版信息

Eur Child Adolesc Psychiatry. 2019 Apr;28(4):571-583. doi: 10.1007/s00787-018-1223-z. Epub 2018 Sep 24.

Abstract

This study aimed to investigate the efficacy of docosahexaenoic acid (DHA) dietary supplementation on behavior and cognition in school-aged, drug-naïve children with attention-deficit/hyperactivity disorder (ADHD). A total of 50 participants with ADHD aged 7 to 14 were enrolled in a 6-month randomized, placebo-controlled clinical trial and received either DHA or placebo. The primary outcome measure was the change in the ADHD rating scale IV Parent Version-Investigator (ADHD-RS-IV) after 4 and 6 months. Secondary outcome measures included Conners Parent Rating Scale-revised, other behavioral rating scales including quality of life and global functioning, and computerized cognitive tasks. Baseline assessment also addressed the blood fatty acids profile. No superiority of DHA supplement to placebo was observed on ADHD-RS-IV, the a priori primary outcome. DHA supplementation showed a significant, nonetheless quite small, effect on children's psychosocial functioning, emotional problems, and focused attention. Neither major nor minor adverse events were reported throughout the trial. This study shows that 6-month DHA supplementation has no beneficial effect on the symptoms of ADHD in school-aged, drug-naïve children with an established diagnosis of ADHD. Nevertheless, the 6 months treatment with supplemental DHA appears to have small positive effects on other behavioral and cognitive difficulties, which, in light of the absence of side-effects, could be reasonably followed up in future intervention studies. ( https://clinicaltrials.gov/ct2/show/NCT01796262 : The Effects of DHA on Attention Deficit and Hyperactivity Disorder (DADA)).

摘要

本研究旨在探讨二十二碳六烯酸(DHA)膳食补充对学龄期、未经药物治疗的注意缺陷多动障碍(ADHD)儿童行为和认知的疗效。共有 50 名年龄在 7 至 14 岁的 ADHD 儿童参与了一项为期 6 个月的随机、安慰剂对照临床试验,分别接受 DHA 或安慰剂治疗。主要结局指标是 ADHD 评定量表第四版家长版-研究者(ADHD-RS-IV)在 4 个月和 6 个月后的变化。次要结局指标包括 Conners 父母评定量表修订版、其他行为评定量表,包括生活质量和总体功能,以及计算机认知任务。基线评估还包括血液脂肪酸谱。DHA 补充剂在 ADHD-RS-IV(预先设定的主要结局)上并未显示出优于安慰剂的优势。DHA 补充剂对儿童的心理社会功能、情绪问题和注意力集中有显著但相当小的影响。整个试验过程中均未报告重大或轻微不良事件。本研究表明,6 个月的 DHA 补充对学龄期、未经药物治疗的 ADHD 儿童的 ADHD 症状没有有益的影响。然而,6 个月的 DHA 补充治疗似乎对其他行为和认知困难有较小的积极影响,鉴于没有副作用,在未来的干预研究中可以合理地进行随访。([https://clinicaltrials.gov/ct2/show/NCT01796262:DHA 对注意缺陷和多动障碍(DADA)的影响](https://clinicaltrials.gov/ct2/show/NCT01796262:%E7%94%B5%E8%B4%A6%E7%A7%91%E5%AD%A6%E8%B0%83%E6%9F%A5%E8%AF%95%E5%AE%A4-%E8%AF%B7%E6%8F%90%E4%BE%9B%E5%9C%B0%E4%B9%8B%E6%B3%A8%E5%87%BA%E5%95%86%E6%A0%BC%E5%BC%8F%E5%A4%B4%E7%97%87-%E6%AD%A3%E5%AE%9A%E8%A7%84%E8%8C%83%E7%9A%84%E5%BD%B1%E5%93%8D%EF%BC%88DHA%EF%BC%89%E5%92%8C%E5%A4%9A%E5%8A%A8%E7%97%87%E9%97%AD%E7%BC%BA%EF%BC%89)。

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