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成人注意缺陷多动障碍的基本和复杂认知功能。

Basic and complex cognitive functions in Adult ADHD.

机构信息

Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands.

Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.

出版信息

PLoS One. 2021 Sep 2;16(9):e0256228. doi: 10.1371/journal.pone.0256228. eCollection 2021.

Abstract

BACKGROUND

Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27-74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests.

METHODS

Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory.

RESULTS AND CONCLUSION

Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.

摘要

背景

许多临床研究报告称,注意力缺陷多动障碍(ADHD)成人存在基本认知功能和复杂认知功能缺陷。然而,基本功能(即加工速度和分心)对 ADHD 成人复杂认知障碍(即工作记忆、计划、认知灵活性、记忆功能)的影响程度尚未得到充分研究。到目前为止,文献仅显示了一项研究,表明基本功能解释了 27%-74%的执行功能障碍。然而,作者报告说,研究结果可能受到神经心理学测试选择的影响。本研究的目的是使用不同的样本和不同的神经心理学测试集来复制这一发现。

方法

48 名 ADHD 成年患者与 48 名健康对照者在基本认知功能(即加工速度和分心)和更复杂的认知功能(即选择性注意、认知灵活性、计划、工作记忆、言语流畅性和言语记忆)方面进行了比较。基本和复杂认知功能采用警觉性和持续性注意力、选择性注意力、N 回、伦敦塔、连续操作测试、词语流畅性和词语学习与记忆进行评估。

结果与结论

逻辑回归分析显示,复杂认知功能障碍解释了 ADHD 诊断的 25%的变异。考虑到加工速度和分心的基本功能后,解释的变异从 25%下降到 9%。这 64%的降幅突出了基本功能对 ADHD 患者复杂功能障碍的重要性。

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