文拉法辛治疗注意缺陷与多动障碍对照观察

目的：观察文拉法辛和哌醋甲酯治疗注意缺陷与多动障碍的临床疗效。方法：将50例注意缺陷与多动障碍的患儿随机分为两组，分别采用文拉法辛和哌醋甲酯治疗2个月，采用儿童多动指数量表(CIH)评定。结果：文拉法辛起效较慢，但疗效持久；哌醋甲酯起效快，治疗结束后疗效迅速消失。结论：文拉法辛可用以治疗注意缺陷与多动障碍。     

哌醋甲酯治疗注意缺陷多动障碍的疗效研究

验证哌醋甲酯的治疗作用和Ｃｏｎｎｅｒｓ儿童行为问卷衡量注意缺陷多动障碍的药物治疗效果，比较了哌醋甲酯治疗前后Ｃｏｎｎｅｒｓ家长用症状问卷和老师用评定量表的得分情况，结果：哌醋甲酯治疗ＡＤＨＤ的总有效率达７０．５６％，Ｃｏｎｎｅｒｓ儿童行为问卷可有效地反映临床药物治疗效果。文中还对有关问题进行了讨论。     

脑电生物反馈治疗注意缺陷多动障碍疗效分析

目的评价脑电生物反馈治疗儿童注意缺陷多动障碍的疗效。方法对2008-03~2010-03在郑州市儿童医院心理科确诊注意缺陷多动障碍的36例儿童采用脑电生物反馈治疗40次,治疗前后分别进行视听整合连续执行测试,对比综合尺度控制商数、综合尺度注意力商数、多动商数,且治疗前后进行Conners简明症状问卷对比。同期在我科确诊ADHD但未接受任何治疗的30例ADHD儿童为对照组,研究组接受40次脑电生物反馈治疗后与对照组进行视听整合连续执行测试及Conners简明症状问卷对比。结果 36例ADHD儿童经脑电生物反馈治疗40次后,各项观察指标均有明显改善,经统计学处理,差异有统计学意义。且研究组与对照组对比,各项观察指标差异均有统计学意义。结论脑电生物反馈治疗是ADHD综合治疗中一种有效的治疗方法,值得临床推广。     

注意缺陷多动障碍的治疗

注意缺陷多动障碍 (ADHD)的治疗近来有不少进展 ,现综述如下 :1　药物治疗1 1　中枢兴奋剂　包括哌醋甲酯 (MPH)、右旋苯丙胺 (DEX)和苯异妥因。兴奋剂可防止儿茶酚胺的重吸收 ,并促使其释放 ,故对ADHD患者的儿茶酚胺不足有补偿作用 ,有资料显示中枢兴奋剂可改善额叶的功能不良。中枢兴奋剂中MPH和DEX是治疗ADHD的首选 ,二者改善ADHD的核心症状的作用是相同的 ,而且MPH可改善短期记忆。最近的研究肯定了中枢兴奋剂对治疗儿童ADHD的作用。成人ADHD ,尤其是在童年期发病的 ,中枢兴奋剂仍是首选。无论对学龄或学前儿童还是青少…     

注意缺陷多动障碍儿童气质特征的研究

目的探讨注意缺陷多动障碍(ADHD)儿童的气质特征.方法采用中国学龄儿童气质量表对50例8～12岁ADHD患儿进行测查,并与中国常模(n=4350)进行比较.结果ADHD组与常模组的气质类型分布有高度显著性差异(P＜0.01),患儿中麻烦型及中间近麻烦型的比例明显高.ADHD组的活动水平、节律性、适应性、反应强度、心境、持久性、注意转移、反应阈等气质维度的得分与常模组比较有显著性差异.结论ADHD儿童的气质可能有其独特性,应根据其气质特征制定相应的干预方案.     

注意缺陷多动障碍药物治疗的进展

注意缺陷多动障碍的处理包括药物治疗和社会心理干预两个方面。药物方面,精神兴奋剂的应用多数医生已比较熟悉。本重点介绍治疗该病的其它药物及对相关问题的研究进展。     

麦普替林治疗注意缺陷多动障碍的疗效研究

目的　探讨麦普替林治疗注意缺陷多动障碍 (ADHD)的疗效及安全性。方法　符合CCMD 3诊断标准的ADHD患儿 32例 ,单一用麦普替林 2 5～ 12 5mg/d治疗 ,6周后进行临床疗效评定 ,治疗前后采用Conners儿童行为问卷 4 8项家长用症状问卷 (PSQ)评估对照。结果　有效 2 2例 ,有效率 6 8 75 % ,PSQ评估 6项因子分明显下降 ,其中因子Ⅲ (心身问题 )P <0 0 5 ,其余 5项因子分P <0 0 0 1。服药第 1周出现轻度口干、镇静、视物模糊、心跳增快 ,2周后逐步消失。结论　麦普替林治疗ADHD疗效肯定 ,副反应相对较轻 ,可作为治疗ADHD的首选药物之一。     

注意缺陷多动障碍药物治疗进展

介绍治疗注意缺陷多动障碍(attention-deficit-hyperactivity disorder,ADHD)的药物临床应用。     

注意缺陷多动障碍的药物治疗进展

介绍注意缺陷多动障碍的药物治疗进展,以及各类药物的疗效及不良反应。     

Transferrin in korean children with attention deficit hyperactivity disorder

Objective

The aim of the present study was to investigate the relationship between iron, ferritin, transferrin, total iron binding capacity (TIBC), hemoglobin, mean corpuscular volume (MCV) mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) in children with ADHD.

Methods

MethodsaaThe sample consisted of 48 ADHD children and sex and age matched control children (a couple of 28 boys, 22 girls; age 6-8 years; mean±SD, 6.98±0.39). We diagnosed ADHD according to DSM-IV. ADHD symptoms were evaluated subjectively with Conners'' Parent Rating Scales, Dupaul Parent ADHD Rating Scales. Subjects with ADHD and control were evaluated the hematology test including the iron, transferrin, MCV etc. Paired t test were used to evaluate the relation of a lot of hematology findings between ADHD and control group.

Results

The serum iron, ferritin, transferrin, TIBC, hemoglobin, MCV, MCH, and MCHC of ADHD group were respectively 80.92±33.33 ug/dL, 35.81±16.59 ng/mL, 248.42±44.15 mg/dL, 351.69±102.13 ug/dL, 12.78±0.71 g/dL, 82.94±2.58 fL, 27.18±1.12 uug, 32.79±1.12%. Otherwise the serum iron, ferritin, transferrin, TIBC, hemoglobin, MCV, MCH, and MCHC of control group were respectively 82.04±28.14 ug/dL, 37.05±18.28 ng/mL, 266.27±25.40 mg/dL, 352.77±89.54 ug/dL, 12.77±0.70 g/dL, 81.81±2.96 fL, 26.69±0.99 uug, 32.66±0.96%. A significant difference were found in the transferrin(t=2.63, p=0.011), MCV (t=2.19, p=0.034), and MCH (t=2.18, p=0.034).

Conclusion

These results suggested that lower transferrin levels might be related with ADHD symptoms.     

Dexmethylphenidate hydrochloride in the treatment of attention deficit hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) affects a large number of children. For decades, the stimulants have been the mainstay of pharmacological treatment for ADHD. Dexmethylphenidate (d-MPH), the d-isomer of the traditional racemic mixtures of d,l-threo-(R,R)-MPH, was recently introduced as another potential option in the stimulant class of medications. This paper reviews and summarizes the available research literature on d-MPH regarding pharmacodynamic, pharmacokinetic, chemical structure, receptor binding, toxicology, and clinical perspectives. d-MPH potentially may offer some advantages in the realms of absorption and duration of action compared with its racemic counterpart. The differences in pharmacokinetics and clinical implications of the immediate-release and extended-release forms of d-MPH are also compared and contrasted.     

Gait in attention deficit hyperactivity disorder

Abstract Background Cognitive function and the loading of attention presumably play an important role in gait as well as in fall risk, but previous work has not demonstrated this in any cause-and-effect way. Objectives To gain insight into the relationship between gait and cognitive function, we sought: (1) To compare the gait rhythmicity (stride time variability) of children with attention deficit hyperactivity disorder (ADHD) to controls, (2) To test the hypothesis that dual tasking leads to increased stride-to-stride variability in ADHD, and (3) To test whether pharmacological treatment that relieves ADHD symptoms reduces stride-to-stride variability. Patients and Methods Gait was quantified in children with ADHD and in age-matched healthy controls under single task and dual task conditions on three occasions: off medications (both groups) and, in the ADHD group, after double blinded, randomized administration of methylphenidate (MPH) or placebo. Results At baseline, children with ADHD tended to walk with increased stride-to-stride variability compared to the controls during the single task condition (p = 0.09). During dual task walking, stride time variability was significantly reduced in the children with ADHD (p < 0.004), but not in the controls. In the children with ADHD, the placebo did not significantly affect stride-to-stride variability or the dual tasking response. In contrast, stride time variability was significantly reduced on MPH (p < 0.001) such that dual tasking no longer affected variability. Conclusions The present findings demonstrate alterations in the gait of children with ADHD, support a cause and effect link between cognitive function and gait, and suggest that enhancement of attention abilities may, in certain populations, improve gait rhythmicity.     

Hyperfocusing as a dimension of adult attention deficit hyperactivity disorder

Patients with Attention Deficit Hyperactivity Disorder (ADHD) suffer not only from inability to focus but also from inability to shift attention for events that trigger their interests. This phenomenon is called “hyperfocusing”. Previous literature about hyperfocusing is scarce and relies mainly on case reports. The study aimed to investigate and compare the severity of hyperfocusing in adult ADHD with and without psycho-stimulant use. ADHD (DSM-IV-TR) patients either psycho-stimulant naive (n = 53) or on psycho-stimulants (n = 79) from two ADHD clinics were recruited. The control group (n = 65) consisted of healthy university students. A socio-demographic form, the Beck Depression Inventory, the Wender-Utah Rating Scale, the Adult ADHD Self- Report Scale and the Hyperfocusing Scale were applied to the participants. There was no difference between total Hyperfocusing Scale and Adult ADHD Self- Report Scale scores of two patient groups, but both have higher scores than controls (p < 0.001). Hyperfocusing is higher in adult ADHD and there was no difference between stimulant-naive patients or patients on stimulants. Hyperfocusing can be defined as a separate dimension of adult ADHD.     

H-MR-spectroscopy of cerebellum in adult attention deficit/hyperactivity disorder

Introduction

Neurobiological research has implicated the cerebellum as one possible site of neurophysiological dysfunction in ADHD. Latest theoretical conceptualizations of the cerebellum as core site of the brain to model motor as well as cognitive behavior puts further weight to the assumption that it might play a key role in ADHD pathophysiology.

Methods

30 medication free adult ADHD patients and 30 group matched (gender, age and education) healthy controls were investigated using the method of chemical shift imaging (CSI) of the cerebellum. The vermis, left and right cerebellar hemispheres were processed separately.

Results

We found significantly increased glutamate-glutamine (Glx) to creatine (Cre) ratios in the left cerebellar hemisphere. No other differences in measured metabolite concentrations were observed.

Discussion

To our knowledge this is the first evidence for neurochemical alterations in cerebellar neurochemistry in adult ADHD. They relate well to recent hypotheses that the cerebellum might control mental activities by internal models.     

State-related electroencephalographic deviances in attention deficit hyperactivity disorder

This study investigated the stability and state-related characteristics of electroencephalographic (EEG) deviances in attention-deficit/hyperactivity disorder (ADHD). Three minutes resting EEG with eyes closed and eyes open were compared between 21 children with ADHD and 29 typically developing children. Across resting conditions, children with ADHD exhibited divergent topographic distribution for theta, alpha and beta power compared to typically developing children. In addition, less alpha and theta suppression to eye opening was found in children with ADHD, but only in those without comorbid ODD/CD. Findings of the present study refer to a consistent divergence in topographic distribution in ADHD across resting state conditions, yet demonstrate that state-related factors and comorbidity may also contribute to resting EEG deviances in ADHD. The state-related findings are in accord with several theoretical accounts emphasizing the role of contextual and state factors defining deficits in ADHD.     

Schizotypy, attention deficit hyperactivity disorder, and dopamine genes

Previous research has suggested that there may be overlap between schizophrenia and attention-deficit hyperactivity disorder (ADHD). The relationship between schizotypal personality traits, ADHD features and polymorphisms was evaluated in dopamine-related genes. Thirty-one healthy, Caucasian men completed the Rust Inventory of Schizotypal Cognitions (RISC) and the ADHD Self-Report Scale (ASRS). Catechol-O-methyltransferase (COMT) Val158Met, dopamine receptors of the D3 type (DRD3) Ser9Gly, DRD4 variable number of tandem repeats (VNTR), and SLC6A3 VNTR polymorphisms were analyzed. RISC score was correlated with ASRS score (r = 0.54, P = 0.003). COMT Met homozygotes had higher ASRS scores than Val homozygotes (P = 0.005). These findings are consistent with evidence of overlap between schizophrenia and ADHD and support an involvement of COMT genotype in ADHD features.     

Psychotherapy of attention deficit hyperactivity disorder in adults

In clinical practice many adult patients with attention deficit hyperactivity disorder (ADHD) ask for an additional psychotherapeutic intervention besides the medical therapy. In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan. It was modified to suit the special needs of adult patients with ADHD. In this exploratory pilot study we tested this program in a group setting. The following elements were presented: neurobiology of ADHD, mindfulness, chaos and control, behavior analysis, emotion regulation, depression, medication in ADHD, impulse control, stress management, dependency, ADHD in relationship and self respect. In an open study design patients were assessed clinically using psychometric scales (Attention Deficit Hyperactivity Disorder Checklist according to DSM-IV, 16 items of the SCL-90-R, Beck-Depression Inventory, visual analogue scale) prior to and following group therapy. This treatment resulted in positive outcomes in that patients improved on all psychometric scales. Received: 19 April 2002 / Accepted: 18 July 2002     

Smell identification function in children with attention deficit hyperactivity disorder

Objective

Deficits in olfactory function are common features in neurodegenerative and neuropsychiatric disorders. Olfactory processing is related to dopamine metabolism and orbitofrontal cortex functioning, both known to be involved in the neurobiology of ADHD. Some investigations suggested alterations in olfactory processing (identification and detection threshold) in patients with ADHD. Despite increasing knowledge, controversy about this topic still exists regarding children with ADHD. This study was conducted to help elucidate some of this controversy.

Methods

50 participants (8-15 years, mean=10.70±1.77) with ADHD were compared to 50 controls. The two groups were well matched for age, gender and Mean School Scores (MSS). We assessed odor identification and threshold through a smell test composed of two tests of identification and detection threshold. Odor detection threshold was assessed with the odorant phenyl ethyl alcohol solved in propylene glycol using a single staircase method. Odor identification was assessed with chemical essences of five common odorants.

Results

The mean Sensory Identification Score for children with ADHD and the control groups were 3.76 (1.06) and 4.46 (0.76), respectively (p<0.001). The mean for Sensory Threshold Score for ADHD and control group was 6.4 (3.35) and 9.75 (2.16), respectively (p<0.001).

Conclusion

This study replicated altered olfactory performance in ADHD. Substantial olfactory deficits across the two domains of identification and detection threshold are observed in children with ADHD. These deficits do not seem to be a result of olfactory task difficulty and are not influenced by age, gender and MSS. Further studies are required to investigate whether olfactory function can be used as a biological marker for early diagnosis, treatment and prognosis of ADHD.