Objective: Although attention deficit hyperactivity disorder (ADHD) is associated with cognitive deficits, there is considerable heterogeneity and only a minority of individuals with the disorder demonstrate a deficit in any cognitive domain. Recent studies indicate that the relationships between ADHD symptoms and cognition are complex with a dissociation between medication responses across these two domains. Method: We examined whether methylphenidate (MPH) differentially impacts on cognition in those with and without pretreatment cognitive deficits in a 4-week randomized controlled crossover of high (0.6 mg/kg/dose) and low (0.3 mg/kg/dose) dose MPH and placebo in 75 medication-naive boys with ADHD. Cognition was assessed using tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Confirmatory factor analysis (CFA) was used to form latent cognitive factors of executive functioning, visual memory, and reaction time, as well as a general cognition factor. Results: Compared to placebo, both high and low MPH doses significantly improved performance on pattern recognition (PR), spatial recognition (SR), and simple reaction time. The low, but not the high, dose improved performance on the Stockings of Cambridge (SOC) and delayed matching-to-sample tasks. Both doses also significantly improved performance on the executive functioning, visual memory, reaction time skills, and general cognitive latent variables. There were however no differences in the effects of MPH on cognition between those with and without a baseline cognitive deficit, for either the observed task values or the latent cognitive factor scores. Conclusions: We conclude that MPH can enhance executive functioning, visual memory, reaction time, and general cognitive function in boys with ADHD. These improvements are not dependent on baseline cognitive performance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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哌甲酯对注意力缺陷多动障碍男孩认知功能的影响：基线表现重要吗？

目的：虽然注意力缺陷多动障碍 (ADHD) 与认知缺陷有关，但存在相当大的异质性，只有少数患有该障碍的个体在任何认知领域表现出缺陷。最近的研究表明，ADHD 症状和认知之间的关系很复杂，这两个领域的药物反应之间存在分离。方法：我们在高（0.6 毫克/公斤/剂量）和低（0.3 毫克/公斤/剂量）剂量的 4 周随机对照交叉中检查哌甲酯 (MPH) 是否对有和没有预处理认知缺陷的人的认知产生不同的影响MPH 和安慰剂治疗 75 名患有 ADHD 的未用药男孩。使用来自剑桥神经心理学测试自动电池 (CANTAB) 的任务评估认知。验证性因素分析（CFA）用于形成执行功能、视觉记忆和反应时间等潜在认知因素，以及一般认知因素。结果：与安慰剂相比，高和低 MPH 剂量均显着提高了模式识别 (PR)、空间识别 (SR) 和简单反应时间的性能。低剂量但不是高剂量提高了剑桥袜子 (SOC) 和延迟匹配样本任务的性能。两种剂量还显着改善了执行功能、视觉记忆、反应时间技能和一般认知潜在变量的表现。然而，无论是观察到的任务值还是潜在的认知因素评分，MPH 对有和没有基线认知缺陷的人的认知影响没有差异。结论：我们得出结论，MPH 可以增强 ADHD 男孩的执行功能、视觉记忆、反应时间和一般认知功能。这些改进不依赖于基线认知表现。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。