Mahalick D M, Carmel P W, Greenberg J P, Molofsky W, Brown J A, Heary R F, Marks D, Zampella E, Hodosh R, von der Schmidt E
Department of Surgery (Section of Neurosurgery), UMDNJ-New Jersey Medical School, Newark, N.J., 07103-2499, USA.
Pediatr Neurosurg. 1998 Sep;29(3):121-6. doi: 10.1159/000028705.
This investigation examined the efficacy of psychostimulant therapy in alleviating neurobehavioral dysfunction attendant to pediatric brain injury. The most commonly reported neurobehavioral sequelae associated with head injury in the pediatric population involve deficits along the attentional matrix. This is also the most common objectively documented neurobehavioral finding among children as well as adults. There are several investigations in the adult literature which have employed the use of psychostimulants in treating both psychiatric and neuropsychological residua associated with head injury. Overall, the results of these studies are equivocal, but suggest a beneficial impact on general functioning. The present prospective investigation utilized a double-blind, placebo-controlled, cross-over experimental design to examine the efficacy of methylphenidate in treating children with acquired attentional disorders secondary to brain injury. A cohort of 14 children with varying degrees of head injury were recruited for participation. As expected, differences between drug and placebo conditions uniformly achieved statistical significance. Additionally, there were no differences in performance between baseline and placebo conditions on neurobehavioral tasks of attention and concentration. Current findings suggest that methylphenidate (and probably other psychostimulants such as Cylert, Adderal, Wellbutrin and dextroamphetamine sulfate) is an extremely effective agent in treating attentional disorders secondary to brain injury in children.
本研究考察了精神振奋剂疗法在缓解小儿脑损伤所致神经行为功能障碍方面的疗效。小儿人群中与头部损伤相关的最常报告的神经行为后遗症涉及注意力方面的缺陷。这也是儿童及成人中最常见的客观记录的神经行为表现。成人文献中有多项研究使用精神振奋剂治疗与头部损伤相关的精神和神经心理后遗症。总体而言，这些研究结果并不明确，但表明对整体功能有有益影响。本前瞻性研究采用双盲、安慰剂对照、交叉实验设计，以考察哌甲酯治疗继发于脑损伤的后天性注意力障碍儿童的疗效。招募了14名有不同程度头部损伤的儿童参与研究。不出所料，药物与安慰剂条件之间的差异均达到统计学显著性。此外，在注意力和专注力的神经行为任务上，基线与安慰剂条件下的表现没有差异。目前的研究结果表明，哌甲酯（可能还有其他精神振奋剂，如匹莫林、阿得拉、安非他酮和硫酸右苯丙胺）是治疗儿童继发于脑损伤的注意力障碍的极其有效的药物。
