哌甲酯对注意缺陷多动障碍患儿QbTest测试表现的影响：一项回顾性临床研究。
The Impact of Methylphenidate on QbTest Performance of Children with ADHD: A Retrospective Clinical Study.
作者信息
Knez Rajna, Stevanovic Dejan, Nasic Salmir, Doric Ana, Wentz Elisabet
机构信息
Department of Pediatrics, Skaraborgs Hospital, Skövde, Sweden; Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia.
出版信息
Neuropsychiatr Dis Treat. 2021 Jan 6;17:19-32. doi: 10.2147/NDT.S277490. eCollection 2021.
INTRODUCTION
The Quantified behavior Test (QbTest), which combines a continuous performance task (CPT) and motion tracking, provides data for the core signs of attention-deficit/hyperactivity disorder (ADHD): attention, hyperactivity, and impulsivity. This study aimed to evaluate the performance of children and adolescents with ADHD on the QbTest before and after a single methylphenidate (MPH) dose.
SUBJECTS AND METHODS
This retrospective chart review study included data from 149 children and 215 adolescents who completed the QbTest. A summary index of the CPT and motion capture data on the QbTest is provided by three cardinal parameters: QbActivity, QbImpulsivity, and QbInattention. The test was performed twice on the same day, before and up to three hours after MPH intake. A decrease by ≥ 0.5 in a cardinal parameter score was considered an improvement, whereas an increase by ≥ 0.5 a deterioration.
RESULTS
QbActivity improvement after MPH intake was present in 71.7% and 76.2% of the children and adolescents, respectively. QbImpulsivity improvement was observed in 50.4% of the children and 44.7% of the adolescents, and QbInattention improvement in 85.1% and 91.1% of the children and adolescents, respectively. All three parameters improved simultaneously in 27.7% of the children and 28.7% of the adolescents. The likelihood that one parameter deteriorated after MPH use was greater if that parameter was within the normal range before medication. This was most pronounced for QbImpulsivity. Among male adolescents, QbInattention improvement was often accompanied by QbImpulsivity deterioration.
CONCLUSION
The QbTest inattention and motor activity parameters improved markedly after a single MPH dose in children and adolescents with ADHD, while less so for impulsivity. Improvement of one parameter is not necessarily associated with improvement of the other two, and deterioration, especially regarding impulsivity, may occur. If confirmed, these results highlight the need for optimization and individualization of MPH treatment, while monitoring all aspects of the ADHD symptomatology based on the QbTest performance.
引言
定量行为测试（QbTest）结合了持续性操作任务（CPT）和运动追踪，可为注意力缺陷多动障碍（ADHD）的核心症状：注意力、多动和冲动提供数据。本研究旨在评估单次服用哌甲酯（MPH）前后，患有ADHD的儿童和青少年在QbTest中的表现。
受试者与方法
这项回顾性图表审查研究纳入了149名儿童和215名青少年完成QbTest的数据。QbTest上CPT和运动捕捉数据的一个汇总指标由三个主要参数提供：Qb活动、Qb冲动性和Qb注意力不集中。测试在同一天进行两次，分别在服用MPH之前和之后长达三小时。主要参数得分下降≥0.5被视为改善，而增加≥0.5则视为恶化。
结果
服用MPH后，分别有71.7%的儿童和76.2%的青少年出现Qb活动改善。50.4%的儿童和44.7%的青少年出现Qb冲动性改善，85.1%的儿童和91.1%的青少年出现Qb注意力不集中改善。27.7%的儿童和28.7%的青少年中，所有三个参数同时得到改善。如果某个参数在用药前处于正常范围内，那么在使用MPH后该参数恶化的可能性更大。这在Qb冲动性方面最为明显。在男性青少年中，Qb注意力不集中改善往往伴随着Qb冲动性恶化。
结论
在患有ADHD的儿童和青少年中，单次服用MPH后，QbTest的注意力不集中和运动活动参数显著改善，而冲动性参数改善较少。一个参数的改善不一定与其他两个参数的改善相关，并且可能会出现恶化，尤其是在冲动性方面。如果得到证实，这些结果凸显了优化MPH治疗并使其个体化的必要性，同时根据QbTest表现监测ADHD症状的各个方面。
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