Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands; Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe achtergracht 129, 1018 Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
Eur Neuropsychopharmacol. 2021 May;46:1-13. doi: 10.1016/j.euroneuro.2021.02.002. Epub 2021 Mar 15.
Methylphenidate (MPH) is the first-choice pharmacological treatment for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) across the lifespan. However, it is unclear whether MPH affects cognitive development, while recent (pre-) clinical studies suggest effects on the developing brain. The present randomized, placebo-controlled trial aims to determine whether MPH has short-term, age-dependent effects on cognitive performance in ADHD after a 1-week washout. Effects of 16 weeks MPH treatment were assessed after a one-week washout on cognitive functioning. Boys (age=10-12) and men (age=23-40) with ADHD were assigned to MPH treatment (boys n=25, men n=24) or placebo (boys n=25, men n=24). Outcome measures were working memory, response inhibition, response speed, episodic memory, and delay aversion. Differences in task performances over time (pre-, mid-, and post-treatment, following a 1-week wash-out) were compared between age and treatment conditions with mixed ANOVAs. MPH improved working memory and response speed, but only during treatment. No lasting age*treatment effects were observed post intervention. Overall, the results from the present randomized, placebo-controlled trial show that the effects of MPH on cognition do not extend past treatment in children or adults. While treatment with MPH improves cognition during treatment, these effects appear transient after 16-weeks of treatment. (Title trial: "Effects of methylphenidate on the developing brain"; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3103).
哌醋甲酯（MPH）是治疗全生命周期注意缺陷多动障碍（ADHD）的首选药物治疗方法。然而，目前尚不清楚 MPH 是否会影响认知发展，而最近的（临床前）研究表明其对发育中的大脑有影响。本随机、安慰剂对照试验旨在确定 MPH 在 ADHD 患者停药 1 周后的短期、年龄依赖性对认知表现的影响。在停药 1 周后，评估 16 周 MPH 治疗对认知功能的影响。将 ADHD 男孩（年龄 10-12 岁）和男性（年龄 23-40 岁）分为 MPH 治疗组（男孩 n=25，男性 n=24）或安慰剂组（男孩 n=25，男性 n=24）。使用工作记忆、反应抑制、反应速度、情景记忆和延迟厌恶作为评估认知功能的指标。采用混合方差分析比较不同年龄和治疗条件下，在治疗前、中期和治疗后（停药 1 周后），任务表现的差异。MPH 改善了工作记忆和反应速度，但仅在治疗期间。干预后未观察到持续的年龄*治疗效果。总之，这项随机、安慰剂对照试验的结果表明，MPH 对认知的影响不会超过儿童或成人的治疗期。虽然 MPH 治疗在治疗期间改善了认知，但在 16 周治疗后，这些影响似乎是短暂的。（试验标题：“哌醋甲酯对发育中大脑的影响”；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3103）。
