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儿童创伤性脑损伤相关注意力缺陷:一项关于赖右苯丙胺二甲磺酸盐(维万思)的对照治疗试验

Traumatic Brain Injury-Related Attention Deficits in Children: A Controlled Treatment Trial with Lisdexamfetamine Dimesylate (Vyvanse).

作者信息

Tramontana Michael G, Prokop Jonathan W, Williamson Edwin, Duffie Tara, LaFever Hayden

机构信息

Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, The Village at Vanderbilt, Suite 2200, 1500 21st Avenue South, Nashville, TN 37212, USA.

出版信息

Brain Sci. 2021 Jan 16;11(1):117. doi: 10.3390/brainsci11010117.

Abstract

Attention deficits are among the most common and persistent impairments resulting from traumatic brain injury (TBI). This study was the first to examine the effects of lisdexamfetamine dimesylate (LDX, Vyvanse) in treating TBI-related attention deficits in children. It was an extension of a previous controlled trial with adults. This was a 12-week, randomized, double-blind, placebo-controlled, dose-titration, crossover trial. In addition to weekly safety monitoring, there were assessments on a broad range of neuropsychological and behavioral measures at baseline, 6-weeks, and 12-weeks. A total of 20 carefully selected children were enrolled, ranging from 10 to 16 years of age. The sample consisted of cases with mainly mild TBI (based on the known details regarding their injuries), but they had persisting attention deficits and other post-concussion symptoms lasting from 2 to 29 months by the time of enrollment. A total of 16 children completed the trial. One of the children withdrew due to a mild anxiety reaction while on LDX. There were no other adverse effects. Positive treatment results were found on both formal testing of sustained attention and in terms of parent ratings of attention, emotional status, behavioral controls, and various aspects of executive functioning. The findings also served to highlight broader insights into the nature of attention deficits and their treatment in children with TBI.

摘要

注意力缺陷是创伤性脑损伤(TBI)最常见且持续存在的损伤之一。本研究首次探讨了二甲磺酸赖右苯丙胺(LDX,商品名:维思通)治疗儿童TBI相关注意力缺陷的效果。它是之前一项针对成人的对照试验的扩展。这是一项为期12周的随机、双盲、安慰剂对照、剂量滴定、交叉试验。除了每周进行安全监测外,在基线、6周和12周时还对一系列广泛的神经心理学和行为指标进行了评估。总共招募了20名精心挑选的儿童,年龄在10至16岁之间。样本主要由轻度TBI病例组成(基于其损伤的已知细节),但在入组时他们存在持续的注意力缺陷和其他脑震荡后症状,持续时间为2至29个月。共有16名儿童完成了试验。其中一名儿童在服用LDX时因轻度焦虑反应退出。没有其他不良反应。在持续注意力的正式测试以及家长对注意力、情绪状态、行为控制和执行功能各个方面的评分方面均发现了积极的治疗结果。这些发现还有助于更深入地了解TBI儿童注意力缺陷的本质及其治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ff9/7830684/e285fb64a580/brainsci-11-00117-g001.jpg

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