Peled Julia, Cassuto Hanoch, Berger Itai
The Hebrew University-Hadassah Medical School, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Kaplan Medical Center, Rehovot, Israel.
Nord J Psychiatry. 2020 Apr;74(3):163-167. doi: 10.1080/08039488.2019.1686063. Epub 2019 Nov 5.
Patients with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) and ASD might benefit from stimulants. There is a progressive increase in prescribing ADHD aimed medications for children diagnosed with Autism Spectrum Disorder (ASD), despite scarce knowledge and no distinct clinical guidelines for that matter. This study aims to analyze the effect of stimulant on processing speed performance and attention indices in children with ASD and ADHD. Forty children aged 6-18 years diagnosed with ASD who also met the criteria for ADHD were recruited. All children performed a computerized performance test for the assessment of cognitive attention performance three times: twice while they are drug naïve and once an hour after taking a single dose of 10 mg. methylphenidate (MPH). This performance was compared to a group of children diagnosed with 'ADHD only' without ASD. A significant difference ( < 0.001) was found only in the parameter of measuring cognitive processing speed. This effect is significantly different from the response of the 'ADHD only' group. The reaction to MPH among ASD children is different than among ADHD children. In ASD, MPH significantly improved cognitive processing speed without changing other measured attention parameters. Improving processing speed, might improve every day functioning in children with ASD who also met the criteria for ADHD, in other means than expected. This unique response suggests new research targets for treatment with stimulants in ASD and ADHD children and its influence on cognitive parameters.
同时患有注意力缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）的患者可能会从兴奋剂中获益。尽管对此了解甚少且没有明确的临床指南，但为被诊断患有自闭症谱系障碍（ASD）的儿童开具治疗ADHD的药物的情况却在逐渐增加。本研究旨在分析兴奋剂对患有ASD和ADHD的儿童的处理速度表现和注意力指标的影响。招募了40名年龄在六岁至18岁之间、被诊断患有ASD且符合ADHD标准的儿童。所有儿童进行了三次用于评估认知注意力表现的计算机化性能测试：两次在未用药时，一次在服用10毫克单剂量哌甲酯（MPH）一小时后。将这一表现与一组仅被诊断患有“ADHD”而无ASD的儿童进行比较。仅在测量认知处理速度的参数中发现了显著差异（<0.001）。这种效应与“仅患有ADHD”组的反应显著不同。ASD儿童对MPH的反应与ADHD儿童不同。在ASD中，MPH显著提高了认知处理速度，而没有改变其他测量的注意力参数。提高处理速度可能会以意想不到的方式改善同时符合ADHD标准的ASD儿童的日常功能。这种独特的反应为ASD和ADHD儿童使用兴奋剂治疗及其对认知参数的影响提出了新的研究目标。
