Azami Saeed, Moghadas Alireza, Sohrabi-Esmrood Faramarz, Nazifi Morteza, Mirmohamad Mahdieh, Hemmati Fatemeh, Ahmadi Ameneh, Hamzeh-Poor Pariya, Khari Saeedeh, Lakes Kimberley
Department of Clinical and General Psychology, Allameh Tabatabai University, Tehran, Iran.
Department of Psychology, University of Bojnord, Bojnord, 9453155111, Iran.
Child Adolesc Ment Health. 2016 Nov;21(4):217-224. doi: 10.1111/camh.12157. Epub 2016 Apr 7.
This research aimed to compare computer-assisted cognitive rehabilitation (CACR) psychostimulants (MED) and placebo CACR (PCACR) in the treatment of ADHD using a multiarm parallel design.
Thirty-four boys with ADHD, aged 7-12, were randomly assigned to either CACR (n = 12), MED (n = 11), or PCACR (n = 11). However, the study was not blinded and medication doses might be suboptimal given the lack of titration. Continuous performance test, Tower-of-London, forward/backward digit span, span board, Raven's progressive matrices, and SNAP-IV were completed at baseline, posttest, and follow-up.
Computer-assisted cognitive rehabilitation outperformed both MED and PCACR on backward digit span at posttest and PCACR at follow-up. CACR outperformed PCACR and MED on forward digit span at posttest and PCACR at follow-up. CACR outperformed MED on span board at posttest. CACR outperformed PCACR and MED on Raven's matrices at posttest. CACR and PCACR scored lower than MED on ADHD-PHI at posttest. CACR scored lower than MED on ADHD-C at posttest.
Immediately after interventions, CACR improved certain simple executive functions (EFs) as much as active stimulant medication. On complex EFs, CACR was superior to active stimulant medication and PCACR. CACR reduced behavioral symptoms of ADHD more than active stimulant medication. However, at 3-month follow-up, maintenance of the CACR gains was weak.
本研究旨在采用多组平行设计比较计算机辅助认知康复（CACR）、精神兴奋剂（MED）和安慰剂计算机辅助认知康复（PCACR）对注意力缺陷多动障碍（ADHD）的治疗效果。
34名7至12岁患有ADHD的男孩被随机分配至CACR组（n = 12）、MED组（n = 11）或PCACR组（n = 11）。然而，该研究未设盲，且由于缺乏滴定，药物剂量可能未达最佳。在基线、测试后和随访时完成连续性能测试、伦敦塔测试、顺/倒背数字广度测试、跨度板测试、瑞文渐进性矩阵测试和SNAP-IV测试。
在测试后倒背数字广度以及随访时，计算机辅助认知康复的表现优于MED组和PCACR组。在测试后顺背数字广度以及随访时，CACR组的表现优于PCACR组和MED组。在测试后跨度板测试中，CACR组的表现优于MED组。在测试后瑞文矩阵测试中，CACR组的表现优于PCACR组和MED组。在测试后ADHD-PHI量表上，CACR组和PCACR组的得分低于MED组。在测试后ADHD-C量表上，CACR组的得分低于MED组。
干预后即刻，CACR在改善某些简单执行功能（EFs）方面与活性兴奋剂药物效果相当。在复杂执行功能方面，CACR优于活性兴奋剂药物和PCACR。CACR比活性兴奋剂药物更能有效减轻ADHD的行为症状。然而，在3个月的随访中，CACR所取得的改善效果维持不佳。
