Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD
Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD
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DOI：
10.1016/j.euroneuro.2010.11.005
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发表时间：
2011-07-01
影响因子：
5.6
通讯作者：
Faraone, Stephen V.
中科院分区：
文献类型：
--
作者：
Biederman, Joseph;Mick, Eric;Faraone, Stephen V.
本研究的目的是评估执行功能缺陷（EFD）和哌甲酯治疗成人ADHD的反应之间的关联。我们在患有DSM-IV ADHD的成人中进行了一项为期6周的平行设计、随机、安慰剂对照研究。我们的执行功能的心理测量指标采用标准化的神经心理学测试。我们使用执行功能行为评定量表-成人版（BRIEF-A）评估EFD的行为反应。纳入具有执行功能可用测量值的受试者（OROS-MPH N=40;安慰剂N=47）进行分析。完成6周急性疗效I期试验的受试者百分比无差异（100%（N=40）vs. 98%（N=46），p=0.4）。I期终点的平均日剂量为84.6 +/- 31.6 mg（1.04 +/- 0.29 mg/kg）OROS-MPH和100.5 +/- 21.9 mg（1.20 +/- 0.11 mg/kg）安慰剂（p=0.0007）。基于基线评估时的神经心理学测试，40%的ADHD受试者（N=35/87）被认为具有EFD，但93%（N=81）的受试者具有>= 2个BRIEF-A临床量表T评分>65。然而，无论使用何种定义，EFD均不影响OROS-MPH的临床应答。这项随机临床试验表明，执行功能缺陷不会缓和对哌醋甲酯的反应，执行功能缺陷的测量与对OROS-MPH的反应无关。(C)2010 Elsevier B.V.和ECNP。All rights reserved.
The objective of this study was to evaluate the association between executive function deficits (EFDs) and response to methylphenidate treatment in ADHD in adults. We conducted a 6-week, parallel design, randomized, placebo controlled study in adults with DSM-IV ADHD. Our psychometric index of executive function used standardized neuropsychological testing. We assessed behaviors reflective of EFDs using the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A). Subjects with available measures of executive functioning (OROS-MPH N=40; Placebo N=47) were included for analysis. There was no difference in the percent of subjects completing the 6-week acute efficacy Phase I of the trial (100% (N=40) vs. 98% (N=46), p=0.4). The mean daily dose at Phase I endpoint was 84.6 +/- 31.6 mg (1.04 +/- 0.29 mg/kg) OROS-MPH and 100.5 +/- 21.9 mg (1.20 +/- 0.11 mg/kg) placebo (p=0.0007). Based on the neuropsychological testing at the baseline assessment, 40% of the ADHD subjects (N=35/87) were considered to have EFDs but 93% (N=81) of subjects had >= 2 BRIEF-A clinical scale T-scores >65. Regardless of the definition used, however, EFDs did not impact the clinical response to OROS-MPH. This randomized clinical trial showed that executive function deficits do not moderate the response to methylphenidate and measures of executive function deficits are not associated with response to OROS-MPH. (C) 2010 Elsevier B.V. and ECNP. All rights reserved.