Rubio-Morell B, Martín-González R, Herreros-Rodríguez O, González-Pérez P, Hernández-Exposito S, Quintero-Fuentes I, Gracia-Marco R
Universidad de La Laguna. Facultad de Psicologia, 38320 La Laguna, Espana.
Rev Neurol. 2008;46(10):602-8.
There is wide evidence about dopaminergic and noradrenergic mechanisms in fronto-striatal circuits which are thought to be related with attention deficit hyperactivity disorder (ADHD) neurobiology. That dysfunction may explain core symptoms and part of executive deficits in cognitive functioning. Methylphenidate is effective in alleviating core symptoms, enhancing dopaminergic and noradrenergic biodisponibility. Less evidence in improving executive functions, specially working memory is found.
To assess if methylphenidate-OROS has a potential effect increasing working memory and attention parameters in ADHD children, and to determine if initial working memory and attention differences between ADHD and control group disappear after one month of daily methylphenidate-OROS treatment.
Eleven children with ADHD were selected and as control group was chosen eleven children compared in age, intelligence quotient, school grade, and social-demographic status. Neuropsychological battery was administered in naive ADHD patients at three times, before treatment, after the first methylphenidate-OROS dose, and after one month of daily treatment. Simultaneously neuropsychological battery was administered to control group. RESULTS. Statistically significant differences were found in neuropsychological variables of working memory after one month daily treatment with methylphenidate-OROS and attention parameters after only one dose in ADHD group. Differences between naive ADHD and control group in terms of working memory were statistically significant before treatment but not after one month daily treatment.
Methylphenidate-OROS improves attention achievement after the first dose and working memory after one month of daily treatment.
有大量证据表明额叶-纹状体回路中的多巴胺能和去甲肾上腺素能机制与注意力缺陷多动障碍(ADHD)的神经生物学有关。这种功能障碍可能解释了核心症状以及认知功能中执行功能缺陷的部分原因。哌甲酯在减轻核心症状、提高多巴胺能和去甲肾上腺素能生物利用度方面是有效的。但在改善执行功能,特别是工作记忆方面的证据较少。
评估控释哌甲酯对ADHD儿童的工作记忆和注意力参数是否有潜在的提升作用,并确定ADHD组和对照组之间最初的工作记忆和注意力差异在每日服用控释哌甲酯治疗一个月后是否消失。
选取11名ADHD儿童,选择11名在年龄、智商、年级和社会人口统计学状况方面与之匹配的儿童作为对照组。在未经治疗的ADHD患者治疗前、首次服用控释哌甲酯后以及每日治疗一个月后三次进行神经心理测试。同时对对照组进行神经心理测试。结果:ADHD组在每日服用控释哌甲酯治疗一个月后,工作记忆的神经心理变量以及仅服用一剂后注意力参数出现统计学显著差异。未经治疗的ADHD组和对照组在工作记忆方面的差异在治疗前具有统计学显著性,但在每日治疗一个月后无显著性差异。
控释哌甲酯在首次给药后可改善注意力,在每日治疗一个月后可改善工作记忆。