Deparment of Psychology, University of Copenhagen, Copenhagen, Denmark.
Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), University of Copenhagen, Copenhagen, Denmark.
Psychol Med. 2019 Nov;49(15):2617-2625. doi: 10.1017/S0033291718003628. Epub 2018 Dec 18.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which frequently persists into adulthood. The primary goal of the current study was to (a) investigate attentional functions of stimulant medication-naïve adults with ADHD, and (b) investigate the effects of 6 weeks of methylphenidate treatment on these functions.
The study was a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 stimulant medication-naïve adult patients with ADHD, and 42 age and parental education-matched healthy controls. Assessments included measures of visual attention, based on Bundesen's Theory of Visual Attention (TVA), which yields five precise measures of aspects of visual attention; general psychopathology; ADHD symptoms; dyslexia screening; and estimates of IQ.
At baseline, significant differences were found between patients and controls on three attentional parameters: visual short-term memory capacity, threshold of conscious perception, and to a lesser extent visual processing speed. Secondary analyses revealed no significant correlations between TVA parameter estimates and severity of ADHD symptomatology. At follow-up, significant improvements were found specifically for visual processing speed; this improvement had a large effect size, and remained when controlling for re-test effects, IQ, and dyslexia screen performance. There were no significant correlations between changes in visual processing speed and changes in ADHD symptomatology.
ADHD in adults may be associated with deficits in three distinct aspects of visual attention. Improvements after 6 weeks of medication are seen specifically in visual processing speed, which could represent an improvement in alertness. Clinical symptoms and visual attentional deficits may represent separate aspects of ADHD in adults.
注意缺陷多动障碍（ADHD）是一种神经发育障碍，通常会持续到成年。本研究的主要目的是：（a）研究未经兴奋剂治疗的 ADHD 成年患者的注意力功能；（b）研究 6 周哌甲酯治疗对这些功能的影响。
这是一项前瞻性、非随机、非盲、6 周随访设计的研究，共纳入 42 名未经兴奋剂治疗的 ADHD 成年患者和 42 名年龄和父母教育程度匹配的健康对照者。评估包括基于 Bundesen 视觉注意理论（TVA）的视觉注意力测量，该理论提供了五种精确的视觉注意力方面的测量指标；一般精神病理学；ADHD 症状；诵读困难筛查；以及智商估计。
在基线时，患者和对照组在三个注意力参数上存在显著差异：视觉短期记忆容量、意识感知阈值，以及在较小程度上的视觉处理速度。二次分析显示，TVA 参数估计值与 ADHD 症状严重程度之间无显著相关性。随访时，仅发现视觉处理速度有显著改善；这种改善具有较大的效应量，并且在控制再测试效应、智商和诵读困难筛查表现后仍然存在。视觉处理速度的变化与 ADHD 症状的变化之间无显著相关性。
成人 ADHD 可能与三种不同的视觉注意力方面的缺陷有关。药物治疗 6 周后，仅观察到视觉处理速度的改善，这可能代表警觉性的提高。临床症状和视觉注意力缺陷可能代表成人 ADHD 的不同方面。
