Differential effects of methylphenidate on attentional functions in children with attention-deficit/hyperactivity disorder
Differential effects of methylphenidate on attentional functions in children with attention-deficit/hyperactivity disorder
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DOI：
10.1097/00004583-200402000-00015
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发表时间：
2004-02-01
影响因子：
13.3
通讯作者：
Herpertz-Dahlmann, B
中科院分区：
文献类型：
--
作者：
Konrad, K;Günther, T;Herpertz-Dahlmann, B
目的：探讨哌醋甲酯对注意缺陷多动障碍（ADHD）儿童不同注意功能和行为的影响。方法：共有60名年龄在8至12岁之间的ADHD儿童完成了一项随机、双盲、安慰剂对照、受试者内交叉试验，接受两种剂量的哌甲酯（0.25和0.5 mg/kg体重）和安慰剂。应用了一套全面的神经心理学测试，包括警觉性和持续、集中和分散注意力的测试，以及两项执行测试，即停止信号范式和视觉设置转换任务。结果如下：在警觉性和集中和持续注意力任务中，两种药物条件均发现线性改善，但在分散注意力中未发现显著改善。二次曲线的趋势，发现这两个执行任务。由行为评级定义的应答者与无应答者没有差异。结论：结果表明，注意功能的影响差异哌甲酯：强度维度功能的影响最好的高剂量，执行功能的中等剂量，和选择性维度功能的可变剂量。此外，行为评定量表和注意力范式的不同结果强调，临床医生必须决定什么是适当的临床反应。对注意力进行更全面的评估可能有助于找到治疗注意力障碍的个体最佳剂量。
Objective: To examine the effects of methylphenidate on different attentional functions and behavior in children with attention-deficit/hyperactivity disorder (ADHD). Method: A total of 60 ADHD children aged between 8 and 12 years completed a randomized, double-blind, placebo-controlled, within-subject crossover trial with two doses of methylphenidate (0.25 and 0.5 mg/kg body weight) and placebo. A comprehensive neuropsychological test battery was applied, including tests of alertness and sustained, focused, and divided attention as well as two executive tests, the stop-signal paradigm and a visual set-shifting task. Results: A linear improvement was identified for both medication conditions in the alertness and focused and sustained attention task, but no significant improvement was found for divided attention. Quadratic trends were found for both executive tasks. Responders defined by behavior ratings did not differ from nonresponders. Conclusions: Results indicate that attentional functions are influenced differentially by methylphenidate: intensity-dimension functions are best influenced by higher doses, executive functions by moderate doses, and selectivity-dimension functions by variable doses. In addition, divergent results from behavior rating scales and from attentional paradigms emphasize that clinicians have to decide what constitutes an appropriate clinical response. A more comprehensive assessment of attention may help to find an individually optimal dose for the treatment of attentional dysfunctions.