Methylphenidate, Guanfacine, and Combined Treatment Effects on Electroencephalography Correlates of Spatial Working Memory in Attention-Deficit/Hyperactivity Disorder.
Methylphenidate, Guanfacine, and Combined Treatment Effects on Electroencephalography Correlates of Spatial Working Memory in Attention-Deficit/Hyperactivity Disorder.
复制标题
哌醋甲酯、胍法辛和联合治疗对注意力缺陷/多动障碍中空间工作记忆的脑电图相关性的影响。
DOI：
10.1016/j.jaac.2022.06.017
复制
发表时间：
2023
影响因子：
13.3
通讯作者：
Loo,SandraK
中科院分区：
文献类型：
--
作者：
Michelini,Giorgia;Lenartowicz,Agatha;Diaz-Fong,JoelP;Bilder,RobertM;McGough,JamesJ;McCracken,JamesT;Loo,SandraK
d-哌甲酯和胍法辛（一种α-2A肾上腺素能激动剂）联合治疗注意缺陷多动障碍（ADHD）儿童可能是一种有效的替代药物。本研究探讨了神经机制的药物治疗效果，使用皮层源分析脑电图（EEG）data.MethodA共172名儿童多动症（7-14岁，118名男孩）完成了为期8周的随机，双盲，比较研究与3个治疗臂：d-哌甲酯，胍法辛，或其组合。EEG调制的脑振荡在基线和终点进行了测量，在空间工作记忆任务的皮质来源位于前扣带回（额中）和初级视觉皮层（midocipital），根据以前报道的ADHD和控制的差异。线性混合模型研究治疗效果EEG和性能measures.ResultsCombined治疗降低midocipital EEG功率在大多数频段和任务阶段。几个中脑EEG测量也显示联合治疗的变化显著大于单药治疗。D-哌甲酯显着增加中枕骨θ在检索过程中，而胍法辛只产生趋势水平的减少中枕骨α在维护和检索。任务准确性改善与联合治疗，与d-哌甲酯不变，与胍法辛恶化。治疗相关的变化midocipital权力与改善ADHD severity.ConclusionThese研究结果表明，联合治疗改善midocipital神经活动与治疗相关的行为改善和以前牵连在ADHD的视觉注意力缺陷。两种单药治疗对EEG测量的影响有限，胍法辛进一步显示出对性能的不利影响。临床试验注册信息注意缺陷多动障碍儿童的单一与联合药物治疗（项目1）; https：//clinicaltrials.gov/; NCT 00429273.多样性与包容性声明我们努力确保招募人类参与者时的种族、民族和/或其他类型的多样性。我们在招募人类参与者时努力确保性别和性别平衡。本文的一位或多位作者自我认同为一个或多个历史上在科学领域代表性不足的种族和/或族裔群体的成员。在引用与这项工作科学相关的参考资料的同时，我们还积极努力在我们的参考资料清单中促进性别和性别平衡。我们积极致力于促进历史上代表性不足的种族和/或民族群体在我们的作者群体中的科学包容性。我们积极致力于促进作者群体的性别平衡。
ObjectiveThe combination of d-methylphenidate and guanfacine (an α-2A adrenergic agonist) may be an effective alternative to either agent as monotherapy in children with attention-deficit/hyperactivity disorder (ADHD). This study investigated the neural mechanisms underlying medication effects using cortical source analysis of electroencephalography (EEG) data.MethodA total of 172 children with ADHD (aged 7-14; 118 boys) completed an 8-week randomized, double-blind, comparative study with 3 treatment arms: d-methylphenidate, guanfacine, or their combination. EEG modulations of brain oscillations at baseline and end point were measured during a spatial working memory task from cortical sources localized within the anterior cingulate (midfrontal) and primary visual cortex (midoccipital), based on previously reported ADHD and control differences. Linear mixed models examined treatment effects on EEG and performance measures.ResultsCombined treatment decreased midoccipital EEG power across most frequency bands and task phases. Several midoccipital EEG measures also showed significantly greater changes with combined treatment than with monotherapies. D-methylphenidate significantly increased midoccipital theta during retrieval, while guanfacine produced only trend-level reductions in midoccipital alpha during maintenance and retrieval. Task accuracy improved with combined treatment, was unchanged with d-methylphenidate, and worsened with guanfacine. Treatment-related changes in midoccipital power correlated with improvement in ADHD severity.ConclusionThese findings show that combined treatment ameliorates midoccipital neural activity associated with treatment-related behavioral improvements and previously implicated in visuo-attentional deficits in ADHD. Both monotherapies had limited effects on EEG measures, with guanfacine further showing detrimental effects on performance. The identified midoccipital EEG profile may aid future treatment monitoring for children with ADHD.Clinical trial registration informationSingle Versus Combination Medication Treatment for Children With Attention Deficit Hyperactivity Disorder (Project1); https://clinicaltrials.gov/; NCT00429273.Diversity & Inclusion StatementWe worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. We actively worked to promote sex and gender balance in our author group.