The effect of a skipped dose (placebo) of methylphenidate on the learning and retention of a motor skill in adolescents with Attention Deficit Hyperactivity Disorder

Individuals with Attention Deficit Hyperactivity Disorder (ADHD) have difficulties in achieving optimal performance in many everyday and academic tasks, deficits attributed to impaired skill acquisition and procedural memory consolidation. We tested the effect of a skipped dose of methylphenidate (MPH) on learning a movement sequence and its subsequent consolidation into procedural memory in adolescents with ADHD. A crossover double-blind design with placebo was used. Sixteen male adolescents, 16–18 years-old, with ADHD and taking MPH formulations on a daily basis, were trained on performing a 5-element sequence of finger-to-thumb opposition movements. Participants took part in two study conditions, 2 months apart. In each condition a different movement sequence was trained and tested. Participants trained on the task either with active medication or placebo on the day of training, crossed-over between study conditions. Learning effects, speed and accuracy, were assessed within-session, during a 24-h memory consolidation phase. Retention was tested by 2 weeks post-training. There were robust gains in performance both within-session and during the 24-h consolidation phase, in both conditions. However, the discontinuation of MPH on the day of training significantly reduced performance speed, with no loss of accuracy. By 2 weeks, post-training performance was comparable. Adolescents with ADHD who are treated daily but skip a dose of MPH show significant slowing of performance relative to their own performance on medication. However, on a background of daily treatment a skipped dose has no deleterious effect on memory consolidation and retention.     

Visual Perception of ADHD Children with Sensory Processing Disorder

Objective

The aim of the present study was to investigate the visual perception difference between ADHD children with and without sensory processing disorder, and the relationship between sensory processing and visual perception of the children with ADHD.

Methods

Participants were 47 outpatients, aged 6-8 years, diagnosed with ADHD. After excluding those who met exclusion criteria, 38 subjects were clustered into two groups, ADHD children with and without sensory processing disorder (SPD), using SSP reported by their parents, then subjects completed K-DTVP-2. Spearman correlation analysis was run to determine the relationship between sensory processing and visual perception, and Mann-Whitney-U test was conducted to compare the K-DTVP-2 score of two groups respectively.

Results

The ADHD children with SPD performed inferiorly to ADHD children without SPD in the on 3 quotients of K-DTVP-2. The GVP of K-DTVP-2 score was related to Movement Sensitivity section (r=0.368^*) and Low Energy/Weak section of SSP (r=0.369*).

Conclusion

The result of the present study suggests that among children with ADHD, the visual perception is lower in those children with co-morbid SPD. Also, visual perception may be related to sensory processing, especially in the reactions of vestibular and proprioceptive senses. Regarding academic performance, it is necessary to consider how sensory processing issues affect visual perception in children with ADHD.     

Brief and extended abstinence from chronic oral methylphenidate treatment produces reversible behavioral and physiological effects

Methylphenidate (MP) is a commonly prescribed psychostimulant to individuals with Attention Deficit Hyperactivity Disorder, and is often used illicitly among healthy individuals with intermittent breaks to coincide with breaks from school. This study examined how intermittent abstinence periods impact the physiological and behavioral effects of chronic oral MP self-administration in rats, and whether these effects persist following prolonged abstinence from the drug. Rats were treated orally with water, low-dose (LD), or high-dose (HD) MP, beginning at PND 28. This daily access continued for three consecutive weeks followed by a 1-week abstinence; after three repeats of this cycle, there was a 5-week abstinence period. Throughout the study, we examined body weight, food intake, locomotor activity, and anxiety- and depressive-like behaviors. During the treatment phase, HD MP decreased body weight, food intake, and depressive- and anxiety-like behaviors, while it increased locomotor activity. During intermittent abstinence, the effects of MP on locomotor activity were eliminated. During prolonged abstinence, most of the effects of HD MP were ameliorated to control levels, with the exception of weight loss and anxiolytic effects. These findings suggest that intermittent exposure to chronic MP causes physiological and behavioral effects that are mostly reversible following prolonged abstinence.     

Relationship between mentalis muscle hyperactivity and mandibular symphysis morphology in skeletal Class I and II patients

PurposeTo investigate the relationship between mentalis muscle activity and mandibular symphysis morphology in patients with Class I or II skeletal patterns.Materials and methods123 female Thai patients (17 years old+) participated in the present study. Subject pretreatment lateral cephalometric radiographs were examined. All subjects were diagnosed as having a skeletal normal bite. Subjects were grouped according to their sagittal skeletal pattern (ANB angle) into Class I (ANB 2–6) or Class II (ANB > 6). For each skeletal type, the subjects were divided into 2 groups, normal mentalis muscle activity (control group) and hyperactivity (experimental group). The skeletal Class I group comprised 37 subjects with mentalis muscle hyperactivity and 31 subjects with normal activity, while the skeletal Class II group comprised 30 hyperactive and 25 normal activity subjects. Eight cephalometric variables (angular, linear, and proportional measurements) were measured to evaluate mandibular symphysis morphology. The data were statistically analyzed using the Mann–Whitney U test or Independent-Sample t-test based on the normality of the data.ResultsIn the skeletal Class I type, the experimental group revealed a trend of narrower alveolar symphysis width and greater symphysis height compared to the control group, but this was not significant. However, in the skeletal Class II type, the experimental group demonstrated significantly narrower alveolar symphysis width and significantly greater symphysis height compared to the control group (p < 0.05).ConclusionAn increase in mandibular symphysis height and decrease in alveolar symphysis width may relate to mentalis muscle hyperactivity, and such relationship is more obvious in patients with Class II skeletal pattern.     

循证护理对中年女性膀胱过度活动症患者的影响

目的研究循证护理对中年女性膀胱过度活动症(BHD)患者症状改善及护理满意度的影响。方法选取2015年2月至2017年8月该院收治的中年女性BHD患者96例,以随机抽签法均分成研究组与对照组,各48例。对照组实施常规护理,研究组实施循证护理,两组均进行为期1年的干预。比较两组患者在症状改善、护理满意度、干预前后心理状态以及生活质量方面的差异。结果干预后3个月、6个月、12个月研究组患者的症状改善率均明显高于对照组,差异有统计学意义(均P<0.05)。干预后,研究组患者的护理满意度高于对照组,SAS、SDS评分明显低于对照组,各项SF-36评分明显高于对照组,差异均有统计学意义(均P<0.05)。结论循证护理可显著改善中年女性BHD患者的临床症状,提高患者的护理满意度,同时有利于缓解患者的不良心理情绪,提高其生活质量。     

Effect of electroacupuncture on the bladder function in rats with bladder hyperactivity

目的：观察电针对排尿频率、骶髓背角血管活性肠肽（VIP）表达的影响,探讨针刺抑制大鼠左旋多巴诱发的膀胱机能亢进的神经生物学机制。方法：将48只SD雌性大鼠按随机数字表分成正常组6只,对照组14只,模型组14只,电针组14只。全部动物均施行膀胱插管术,正常组不做腹腔注射;对照组腹腔注射生理盐水;模型组和电针组动物腹腔内先后注射卡比多巴和左旋多巴;应用连续膀胱测压技术动态观察电针中膂俞对大鼠排尿频率的影响;应用免疫组织化学的方法,观察电针后骶髓背角的vIP动态变化,并用图像分析技术进行定量分析。结果：模型组在腹腔注射左旋多巴后排尿频率较处理前迅速增加（P〈0．05）,电针组在腹腔注射左旋多巴后15～75min时段排尿频率较处理前增加（P〈0．05）,75～105min时段排尿频率接近处理前水平。在腹腔注射左旋多巴后3h时电针组骶髓背角的VIP阳性纤维和终末比模型组、正常组显著增加（P〈0．05）。在腹腔注射左旋多巴后8h时模型组骶髓背角的VIP阳性纤维和终末较正常组显著增加（P〈0．05）,而电针组与正常组则无统计学差异。结论：电针可促进左旋多巴引起的膀胱机能亢进大鼠的躯体传入神经释放VIP,从而降低排尿频率。     

Psychiatric symptoms in boys with fragile X syndrome: A comparison with nonsyndromic autism spectrum disorder

In the present study, we examined the profile of psychiatric symptoms in boys with fragile X syndrome (FXS) using a parent report instrument. In addition, by comparing boys with FXS to boys with nonsyndromic autism spectrum disorder (ASD) utilizing multiple matching strategies, we examined between-group differences in the types of psychiatric symptoms observed and in the strength of their concurrent associations. Across all matching strategies, symptoms of manic/hyperactive behaviors and general anxiety were more frequently reported for boys with FXS than for boys with nonsyndromic ASD. Results also indicated a positive association between social avoidance and general anxiety in FXS that was stronger than that observed in nonsyndromic ASD across all matching strategies. Theoretical and treatment implications are discussed.     

平肝定眩汤治疗肝阳上亢型后循环缺血性眩晕60例临床观察

目的:观察平肝定眩汤对肝阳上亢型后循环缺血性眩晕的疗效。方法:选取2017年6月-2018年10月烟台业达医院收治的后循环缺血性眩晕的患者120例,按随机数字表法分为治疗组和对照组。治疗组和对照组各60例,两组一般的资料经统计学方法,差异无统计学意义(P>0.05),具有可比性。两组均给予改善循环,控制血压、血糖,调节血脂,抗血小板聚集等基础治疗。治疗组给予平肝定眩汤,对照组给予平眩胶囊。两组疗程均为4周,观察两组患者治疗前后总体症状,脑血流速度、血脂、血糖等指标改善情况。采用SPSS 11.0统计学软件进行计算。结果:治疗组总有效率91.7%(55/60),对照组总有效率61.6%(37/60),两组疗效比较有统计学意义(P<0.05)。治疗组三酰甘油(Triglyceride,TG)、血清总胆固醇(Serum Total Cholesterol,TC)、HDL-C、LDL-C治疗后显著改善,与治疗前比较,差异有统计学意义(P<0.05);对照组TG及TC治疗前后差异有统计学意义(P<0.05),高密度脂蛋白胆固醇(High Density Liptein Cholesterol,HDL-C)及低密度脂蛋白胆固醇(Low Density Liptein Cholesterol,LDL-C)治疗前后比较,差异无统计学意义(P>0.05)。两组治疗后TC比较,差异有统计学意义(P<0.05)。两组治疗后空腹血糖(Fasting Plasma Glucose,GLU)明显降低(P<0.05),两组间的治疗后比较,差异无统计学意义(P>0.05)。治疗组治疗后椎动脉(Vertebral Artery,VA)、基底动脉(Basilarartery,BA)平均血流速度(Mean Blood Flow Velocity,VM)明显提高,与对照组治疗后相比较,差异具有统计学意义(P<0.05)。结论:平肝定眩汤治疗后循环缺血性眩晕在改善患者症状、降低血液黏稠度,改善脑血流状况方面疗效显著。     

肝阳上亢证患者情绪状态特征临床研究

目的：探讨肝阳上亢证患者的情绪状态特征．以指导临床进行心理干预。方法：选择226例高血压与偏头痛患者。分为肝阳上亢证组、肝郁气滞证组、肝肾阴虚证组．并设健康对照组16例，采用Beck焦虑量表（BAI）及Beck抑郁量表（BDI）对各组进行情绪测越。结果：肝阳上亢证、肝郁气滞证、肝肾阴虚证患者BAI、BDI各项积分均明显高于健康对照组（P〈0．01）。肝阳上亢证BAI积分明显高于肝郁气滞征、肝肾阴虚证（P〈0．01）；肝郁气滞证、肝肾阴虚证BDI积分明显高于肝阳上亢证（P〈0．05或P〈0．01）。结论：肝胆上亢证、肝郁气滞证及肝肾阴虚证患者均有不同程度的焦虑、抑郁情绪状态，肝阳上亢证患者以焦虑情绪状态为土。     

Sexual Function,Sexual Dysfunctions,and ADHD: A Systematic Literature Review

BackgroundThe scientific literature on sexuality among mentally ill patients clearly shows a higher prevalence of sexual disorders for many mental disorders, but little is known about sexuality in individuals suffering from ADHD. Clinicians will often assume that specific difficulties of ADHD are bound to affect sexual functioning.AimThe aim of this study was to provide a review of the literature to gain better knowledge about sexuality in subjects with ADHD and to discuss screening and management of their potential sexual problems.MethodsA systematic review of the literature was performed in Pubmed, PsychInfo, and Embase databases.Main Outcome MeasuresThe main outcome measures were sexual function and sexual dysfunctions.ResultsThe studies indicated that subjects with ADHD report more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population.Clinical ImplicationsClinicians working with subjects with ADHD should explore the quality of their sexual life.Strengths & LimitationsThis is the first systematic review of the sexuality of individuals with ADHD. However, the results are limited by the small number of studies, by the small sample size of many studies, and the potential for bias.ConclusionsADHD is a mental disorder affecting sexual health. Further studies are warranted to learn more about sexuality in subjects with ADHD.Soldati L, Bianchi-Demicheli F, Schockaert P, et al. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020;17:1653–1664.