Ameliorating Attention Problems in Children With Sickle Cell Disease: A Pilot Study of Methylphenidate
Ameliorating Attention Problems in Children With Sickle Cell Disease: A Pilot Study of Methylphenidate
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DOI：
10.1097/dbp.0b013e31824ba1b5
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发表时间：
2012-04-01
影响因子：
2.4
通讯作者：
Jackson, Sherron
中科院分区：
文献类型：
--
作者：
Daly, Brian;Kral, Mary C.;Jackson, Sherron
目的：本初步研究探讨哌醋甲酯（MPH）是否能有效提高镰状细胞病（SCD）合并脑血管并发症患儿的认知能力和注意力。方法：在这项多地点的初步研究中，我们评估了两项独立的双盲对照临床试验，其中一项是关于MPH短期疗效的实验室试验，另一项是为期3周的家庭/学校交叉试验，评估MPH的疗效。实验室试验包括14名年龄在7到16岁之间的参与者。评估包括持续注意力、反应时间、执行功能和言语记忆。家庭/学校试验包括20名参与者。结果测量是家长和老师对注意力的评价。第一项研究比较了MPH与安慰剂，而第二项试验比较了安慰剂、低剂量MPH和中剂量MPH。结果：在实验室试验中，对记忆和抑制控制的测量显示显着效果。来自家庭/学校试验的家长和老师报告表明，相对于安慰剂和低剂量MPH，中等剂量MPH在注意力方面产生了更好的改善。结论：兴奋剂对一些SCD患儿的记忆和抑制控制的选择指标有积极影响。根据家长和老师的评价，相对于低剂量的MPH和安慰剂，服用高剂量MPH的儿童和青少年的注意力得到了改善。兴奋剂药物可能为一些患有SCD和脑血管并发症的儿童提供有效的干预，他们表现出注意力问题。（发展行为儿科杂志33:244-251,2012）
Objective: This pilot study examined whether methylphenidate (MPH) was effective in enhancing cognitive performance and attention for children with sickle cell disease (SCD) with cerebrovascular complications who evidence attention problems. Methods: In this multisite, pilot study, we evaluated 2 separate double-blind controlled clinical trials, including a laboratory trial of the short-term efficacy of MPH, with the second study a 3-week home/school crossover trial evaluating the efficacy of MPH. The laboratory trial included 14 participants between the age of 7 and 16 years. Assessments included measures of sustained attention, reaction time, executive functions, and verbal memory. The home/school trial included 20 participants. The outcome measures were parent and teacher ratings of attention. The first study compared MPH with placebo, while the second trial compared placebo, low-dose (LD) MPH, and moderate-dose MPH. Results: In the laboratory trial, significant effects were revealed for measures of memory and inhibitory control. Parent and teacher reports from the home/school trial indicate that moderate-dose MPH produced superior improvement in attention relative to the placebo and LD MPH. Conclusions: Stimulant medication positively impacted select measures of memory and inhibitory control in some children with SCD. Attention, as rated by parent and teachers, was improved for a greater number of children and adolescents on higher doses of MPH relative to LD MPH and placebo. Stimulant medication may provide an effective intervention for some children with SCD and cerebrovascular complications who demonstrate attention problems. (J Dev Behav Pediatr 33: 244-251, 2012)