Methylphenidate normalizes emotional processing in adult patients with attention-deficit/hyperactivity disorder: Preliminary findings
Methylphenidate normalizes emotional processing in adult patients with attention-deficit/hyperactivity disorder: Preliminary findings
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DOI：
10.1016/j.brainres.2010.12.085
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发表时间：
2011-03-24
期刊：
影响因子：
2.9
通讯作者：
Pauli, Paul
中科院分区：
文献类型：
--
作者：
Conzelmann, Annette;Woidich, Eva;Pauli, Paul
注意力缺陷多动障碍（ADHD）的症状可能与运动-动机功能障碍有关。多动-冲动症状和感觉寻求可能是寻找刺激的结果，认知功能障碍可能是由于动机驱动力低下。运动-动机功能障碍也可以解释ADHD患者的社会功能障碍，因为它们可能导致对情感和社会线索的误解。由于哌甲酯（MPH）是ADHD药物治疗的首选，我们研究了其对功能失调的情绪过程的影响。对13例成人ADHD患者进行了两次检查，根据他们的个人用药方案，不服用MPH和服用MPH后。情绪调节惊吓范式被用来评估生理（情绪调节惊吓反应）和主观（效价和唤醒等级）的反应，愉快，中性和不愉快的视觉刺激。健康对照组显示情感惊吓调制与预期一样，惊吓衰减和增强，而观看愉快和不愉快的图片，分别。相比之下，未用药的ADHD患者表现出对愉快刺激的反应不足;在接触愉快的图片期间没有观察到惊吓衰减。然而，MPH恢复了正常的情感惊吓调制，如衰减和增强与愉快和不愉快的图片，分别表示。患者的效价和唤醒等级不受MPH的影响。这些数据表明，MPH作为ADHD的首选治疗方法对成人ADHD患者的情绪过程有积极的影响，并指出ADHD情绪功能障碍的临床相关性。(C)2011 Elsevier BM. All rights reserved.
Emotional-motivational dysfunctions may significantly contribute to symptoms of attention-deficit/hyperactivity disorder (ADHD). Hyperactive-impulsive symptoms and sensation seeking could be the result of a search for reinforcers, and cognitive dysfunctions might be due to a low motivational drive. Emotional-motivational dysfunctions could also explain social dysfunctions in ADHD patients because they may lead to misinterpretations of emotional and social clues. Since methylphenidate (MPH) is the first choice as a pharmacological treatment in ADHD, we examined its influence on dysfunctional emotional processes. 13 adult ADHD patients were examined twice, without and after intake of MPH according to their personal medication regimen. The affect-modulated startle paradigm was used to assess physiological (affect-modulated startle response) and subjective (valence and arousal ratings) responses to pleasant, neutral and unpleasant visual stimuli. Healthy controls displayed affective startle modulation as expected, with startle attenuation and potentiation while watching pleasant and unpleasant pictures, respectively. In contrast, unmedicated ADHD patients displayed deficient responses to pleasant stimuli; no startle attenuation during the exposure to pleasant pictures was observed. However, MPH reinstated a normal affective startle modulation, as indicated by attenuation and potentiation associated with pleasant and unpleasant pictures, respectively. Valence and arousal ratings of patients were not affected by MPH. The data suggest that MPH as first choice treatment in ADHD has a positive impact on emotional processes in adult ADHD patients and points to the clinical relevance of emotional-dysfunctions in ADHD. (C) 2011 Elsevier BM. All rights reserved.