Discriminate Validity of ADHD Subtypes Using Neuropsychological Test
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 122
- 试验地点
- 1
研究概览
简要总结
Background: Attention-Deficit/Hyperactivity Disorder (ADHD), characterized by inattention, hyperactivity, and impulsivity, is among the most common neuropsychiatric disorders worldwide (5-10% at school age) and in Taiwan (7.5%). The DSM-IV ADHD consists of three subtypes: predominantly Inattentive (ADHD-I), predominantly Hyperactivity/Impulsivity (ADHD-H), and Combined subtypes (ADHD-C). Although the DSM-IV field trials indicate that the current subtypes differ significantly on variables such as age of onset, gender ratio, and level of social and academic impairment, little has been addressed whether the DSM-IV subtypes differ neuropsychologically. Numerous researches have proved that stimulants (methylphenidate is the only stimulant in Taiwan) are the most effective medication in treating ADHD. Although the efficacy of methylphenidate on behavioral measures has been established in Taiwan, there is no information about neuropsychological measures.
Specific Aims:
- to validate ADHD subtype by neuropsychological measures; and
- to investigate the efficacy of methylphenidate on the improvement of executive functioning among children with ADHD.
Subjects and Methods: Participants will consist of 20 children with ADHD-C, 20 with ADHD-I, 10 with ADHD-H and 50 controls without ADHD in the age range of 7 to 10. The measures include the psychiatric interviews (Chinese K-SADS-E), neuropsychological tests (WISC-III, Cancellation Test, Digit Span, Trail Making Test, CPT, Circle Tracing Test), self-administered rating scale (SNAP-IV), and investigator administered assessment (CGI and Behavior Observation Ratings).
Anticipated Results: We anticipated that children in the ADHD and non-ADHD group will perform differently on the neuropsychological tests with more deficits in neuropsychological functions in the ADHD group. Also, we expected that methylphenidate will improve the performance on the neuropsychological tests and reduce the behavioral symptoms of ADHD children. Subtypes difference in the neuropsychological functions is also expected.
详细描述
BACKGROUND AND SIGNIFICANCE Attention-Deficit/Hyperactivity Disorder (ADHD) is among the most common impairing neuropsychiatric disorder worldwide among children and adolescents with the prevalence of DSM-IV ADHD in the range of 5-10% in Western countries (Faraone et al., 2003) and 7.5% in Taiwan (Gau et al., 2005) with the ratio of boys to girls as 3-8:1. The significance of ADHD in clinical practice and research is not only in its high prevalence but also in the impairments it brings about in neurocognitive function, academic performance, and social adjustment.
The DSM-IV ADHD is comprised with three subtypes, predominantly Inattentive (ADHD-I), predominantly Hyperactivity/Impulsivity (ADHD-H), and Combined subtype (ADHD-C). The DSM-IV field trials indicate that the current subtypes differ significantly on variables such as age of onset, gender ratio, and level of social and academic impairment (Lahey et al., 1994). Although previous researches have suggested that neuropsychological deficits in ADHD are associated with frontal-subcortical regions (Castellanos, 1997), few studies have addressed whether the DSM-IV subtypes differ neuropsychologically with inconsistent results (Nigg et al, 2002).
Many studies have demonstrated the efficacy of stimulants in treating ADHD. Among them, methylphenidate (MPH) was the widely used and has been rigorously studied (eg. Spencer et al., 2005; Stein et al., 2005; Wilens et al., 2005). MPH is also the only stimulant medication for the treatment of ADHD in Taiwan; it has been proved to reduce significantly the symptoms of ADHD, and to increase self regulation, learning motivation, academic performance, and interpersonal ability. Meanwhile, its efficacy was also observed in the significant improvement of neuropsychological functioning (e.g., Konrad et al., 2004).
Given that there is no conclusive finding in the neuropsychological function among ADHD subtypes and little is known about the neuropsychological deficits in three ADHD subtypes in the Chinese population, the present study aims to validate ADHD diagnosis and ADHD subtypes by executive functioning measures. Although the efficacy of methylphenidate on behavioral measures has been established in Taiwan, there is no information about neuropsychological measures.
SPECIFIC AIMS:
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
入排标准
- 年龄范围
- 7 Years 至 10 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients who have clinically diagnosis of DSM-IV ADHD confirmed by the K-SADS-E, are aged 7-10, and have IQ > 80; and who and whose parents consent to this study
排除标准
- •if they have a history of brain injury or epilepsy, visual/auditory deficit or were diagnosed as having motor disorder, obsessive-compulsive disorder, mental retardation, mood disorders, pervasive developmental disorder, or schizophrenia