The effects of methylphenidate on neural systems of attention in attention deficit hyperactivity disorder
The effects of methylphenidate on neural systems of attention in attention deficit hyperactivity disorder
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DOI：
10.1176/appi.ajp.161.11.1990
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发表时间：
2004-11-01
影响因子：
17.7
通讯作者：
Shaywitz, BA
中科院分区：
文献类型：
--
作者：
Shafritz, KM;Marchione, KE;Shaywitz, BA
目的：最近的研究表明，注意缺陷多动障碍（ADHD）与基底神经节和前额叶皮质功能异常有关。然而，这些研究主要依赖于反映冲动控制而不是注意力机制的认知任务。方法：作者使用功能性磁共振成像，在15名ADHD青少年中进行了一项随机、双盲、安慰剂对照的哌甲酯药物激发试验，以研究选择性注意和分散注意的神经相关性（14-17岁）、8名患有阅读障碍的青少年（12-17岁）和4名患有阅读障碍和ADHD的青少年（14-18岁），这些青少年在哌醋甲酯和安慰剂治疗期间都接受了扫描。14名健康对照受试者（年龄12-20岁）谁没有给予哌醋甲酯担任主要comparison group.Results：在注意力分散task，unmedicated科目与ADHD或阅读障碍招募左腹侧基底神经节显著低于健康对照组。哌醋甲酯导致该区域的激活增加，但对任务表现没有影响。ADHD的受试者也招募颞中回显着低于比较科目，但哌醋甲酯没有直接影响激活在这个region.Conclusions：这些结果表明，ADHD与注意力网络的异常处理，在纹状体电路的特定功能障碍。哌醋甲酯可以使该网络内的活动正常化。
Objective: Recent studies have suggested that attention deficit hyperactivity disorder (ADHD) is associated with abnormalities in basal ganglia and prefrontal cortical functioning. However, these studies have primarily relied upon cognitive tasks that reflect impulse control rather than attentional mechanisms.Method: The authors used functional magnetic resonance imaging to investigate the neural correlates of selective and divided attention in a randomized, double-blind, placebo-controlled pharmacological challenge with methylphenidate in 15 adolescents with ADHD (ages 14-17), eight adolescents with reading disorder (ages 12-17), and four adolescents with both reading disorder and ADHD (ages 14-18) who were scanned during both a methylphenidate and a placebo session. Fourteen healthy comparison subjects (ages 12-20) who were not given methyl phenidate served as the primary comparison group.Results: During the divided attention task, unmedicated subjects with ADHD or reading disorder recruited the left ventral basal ganglia significantly less than the healthy comparison subjects. Methylphenidate led to an increase in activation in this region but had no effect on task performance. Subjects with ADHD also recruited the middle temporal gyrus significantly less than the comparison subjects, but methylphenidate did not have a direct effect on activation in this region.Conclusions: These results suggest that ADHD is associated with abnormal processing in attentional networks, with specific dysfunction in striatal circuitry. Methylphenidate may act to normalize activity within this network.