Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
J Psychiatr Res. 2022 May;149:252-259. doi: 10.1016/j.jpsychires.2022.03.018. Epub 2022 Mar 11.
Attention-deficit/hyperactivity disorder (ADHD) is associated with a broad range of deficits in cognitive functions which has significant implications for quality of life. Psychostimulants are demonstrated to improve symptoms of inattention and hyperactivity/impulsivity, however, their impact on cognition remains incompletely characterized. Herein, the aim of this systematic review is to synthesize the extant literature reporting on the effects of psychostimulants on cognitive function in individuals with ADHD.
A systematic search of PubMed, Scopus, and Web of Science from inception to July 2021 was conducted. Additional studies were identified through Google Scholar and a manual search of the reference lists of relevant articles. Inclusion criteria were original studies that evaluated the cognitive function of individuals with ADHD taking psychostimulants drugs. We assessed the quality of the included papers using the Newcastle-Ottawa scale (NOS).
A total of 10 studies involving 753 subjects with ADHD and 194 healthy controls were identified and eligible for inclusion. Nine studies evaluated the impact of methylphenidate on cognitive function and one study investigated the use of lisdexamfetamine. Results indicated that attentional deficits such as memory, vigilance, divided attention, phasic and tonic alertness, and focused attention were improved in ADHD patients treated with psychostimulants. The efficacy of psychostimulants in improving other domains of cognition remains inconclusive due to conflicting evidence or insignificant findings (ie. academic performance and executive function). Overall, results indicate that psychostimulants may improve only select domains of cognition (ie. memory and attention).
Psychostimulants are reported to improve several disparate aspects of cognition among individuals with ADHD. Further research is needed to better understand the complex relationships between cognition and behavior in ADHD, as well as the impact of medication on these distinct aspects of functioning. Further research is also needed to determine whether the pro-cognitive effect of stimulants would be transferable to other mental disorders.
注意力缺陷多动障碍（ADHD）与认知功能的广泛缺陷相关，这对生活质量有重大影响。兴奋剂已被证明可改善注意力不集中和多动/冲动症状，但它们对认知的影响仍未完全描述。本文的目的是系统综述现有的文献，报告兴奋剂对 ADHD 患者认知功能的影响。
从成立到 2021 年 7 月，对 PubMed、Scopus 和 Web of Science 进行了系统搜索。通过 Google Scholar 和相关文章参考文献的手动搜索确定了其他研究。纳入标准是评估服用兴奋剂药物的 ADHD 患者认知功能的原始研究。我们使用纽卡斯尔-渥太华量表（NOS）评估纳入论文的质量。
共确定了 10 项研究，涉及 753 名 ADHD 患者和 194 名健康对照者，符合纳入标准。9 项研究评估了哌甲酯对认知功能的影响，1 项研究调查了 lisdexamfetamine 的使用。结果表明，ADHD 患者在接受兴奋剂治疗后，注意力缺陷如记忆、警觉、分散注意力、相位和紧张警觉以及集中注意力等得到改善。由于证据冲突或无显著发现（即学业成绩和执行功能），兴奋剂改善其他认知领域的疗效仍不确定。总体而言，结果表明兴奋剂可能仅改善某些认知领域（即记忆和注意力）。
兴奋剂被报道可改善 ADHD 个体认知的几个不同方面。需要进一步研究以更好地了解 ADHD 中认知与行为之间的复杂关系，以及药物对这些不同功能方面的影响。还需要进一步研究以确定兴奋剂的促认知作用是否可以转移到其他精神障碍。
