Erişkin dikkat eksikliği hiperaktivite bozukluğunda tepki ketleme ve enterferans kontrolü
Küçük Resim Yok
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Nöropsikiyatri Derneği
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnhibitör kontrol, dikkat eksikliği hiperaktivite bozukluğunda (DEHB) yürütücü işlevlerde bozulmanın görüldüğü temel alanlardan biridir. İnhibitör kontrol tepki ketleme ve enterferans kontrolü gibi bileşenlerden oluşmaktadır. Dikkat eksikliği hiperaktivite bozukluğunda inhibitör kontrolün hangi bileşenlerinde bozulma olduğunun saptanması, ayırıcı tanı ve tedavi açısından faydalı olacaktır. Bu çalışmada erişkin DEHB’de tepki ketleme ve enterferans kontrolünün ne şekilde etkilendiğinin araştırılması amaçlanmıştır. Yöntem: Çalışmaya 42 erişkin DEHB tanılı birey ve 43 sağlıklı kontrol (SK) dâhil edilmiştir. Tepki ketleme ve enterferans kontrolünün değerlendirilmesi amacıyla Dur İşareti Testi (DİT) ve Stroop Test kullanılmıştır. Hasta ve SK grupların DİT ve Stroop test açısından karşılaştırılmasında, yaş ve eğitim düzeyi eş değişken olarak alınarak, MANCOVA kullanılmıştır. Dur İşareti Testi ve Stroop Test ile Barrat Dürtüsellik Ölçeği-11 (BDÖ-11) arasındaki ilişkiye Pearson korelasyon analizi ile bakılmıştır. Erişkin DEHB tanılı bireylerde psikostimülan kullanan ve kullanmayan bireyler arasında testlerin karşılaştırılması Mann Whitney-U testi ile yapılmıştır. Bulgular: Çalışmamızda DEHB tanılı bireylerde tepki ketlemenin SK’lere göre bozulduğu, enterferans kontrolünün ise SK’lerden farklılık göstermediği saptanmıştır. Dur işareti gecikmesi (DİG) ile BDÖ-11 dikkat, motor, plansızlık ve toplam puanları arasında zayıf ve orta düzeyde negatif yönde, dur işareti tepki süresi (DİTS) ile BDÖ-11 dikkat, motor, plansızlık ve toplam puanları arasında zayıf düzeyde pozitif yönde ilişki bulunmuştur. Metilfenidat tedavisi alan DEHB tanılı bireylerde, almayanlara göre tepki ketleme becerilerinde anlamlı düzelme olduğu, BDÖ-11 ile ölçülen dürtüsellik düzeylerinin de gerilediği saptanmıştır. Sonuç: İnhibitör kontrol çatısı altında ele alınan tepki ketleme ve enterferans kontrolünün erişkin DEHB tanılı bireylerde farklı özellikler gösterebileceği ve bunun ayırıcı tanı açısından önemli olduğu unutulmamalıdır. Psikostimülan tedaviyle tepki ketleme becerisinde düzelme olduğu, bu durumun hastanın da fark edeceği şekilde olumlu olarak hissedildiği söylenebilir. Hastalığın nörofizyopatolojik mekanizmalarını anlamak, buna uygun tedaviler geliştirmek açısından faydalı olacaktır.
Among the executive functions affected in attention deficit hyperactivity disorder (ADHD), inhibitory control is one of the primary areas of impairment, characterized by components that include response inhibition and interference control. Determining the impaired inhibitory control components will be useful in the differential diagnosis and treatment of ADHD. The present study aimed to investigate response inhibition and interference control abilities of adults with ADHD. The study included 42 adults diagnosed with ADHD and 43 healthy controls. The stop-signal task (SST) and Stroop test were used for assessing the response inhibition and interference control, respectively. Multivariate analysis of covariance was used for comparing the ADHD and healthy control groups in terms of their SST and Stroop test scores, wherein the age and education level of the participants were taken as covariables. The relationship between SST and Stroop Test and Barratt Impulsiveness Scale-11 (BIS-11) was tested by Pearson correlation analysis. Mann-Whitney U test was used for comparing the test scores between those who were administered with psychostimulants among the adults with ADHD and those who were not. Response inhibition was observed to be impaired in adults with ADHD compared with the healthy controls, whereas no difference regarding interference control was observed. As per the Barratt Impulsiveness Scale-11 (BIS-11), a weak and moderately negative relationship was found between the stop signal delay and the attentional, motor, non-planning scores, and total scores and a weak positive relationship was found between the stop-signal reaction time and the attentional, motor, non-planning scores, and total scores. A significant improvement was observed in the response inhibition skills of the adults with ADHD who had received methylphenidate treatment compared to those who had not, and the former also showed lower impulsivity levels as measured by the BIS-11. It should be noted that response inhibition and interference control, which are considered under the umbrella of inhibitory control, may exhibit different characteristics in adult individuals diagnosed with ADHD and this is important for differential diagnosis. An improvement was observed in the response inhibition of adults with ADHD caused by psychostimulant treatment, which was associated with positive outcomes that were also noticeable by the patients. Understanding the underlying neurophysiological mechanisms of the condition would further facilitate the development of appropriate treatments.
Among the executive functions affected in attention deficit hyperactivity disorder (ADHD), inhibitory control is one of the primary areas of impairment, characterized by components that include response inhibition and interference control. Determining the impaired inhibitory control components will be useful in the differential diagnosis and treatment of ADHD. The present study aimed to investigate response inhibition and interference control abilities of adults with ADHD. The study included 42 adults diagnosed with ADHD and 43 healthy controls. The stop-signal task (SST) and Stroop test were used for assessing the response inhibition and interference control, respectively. Multivariate analysis of covariance was used for comparing the ADHD and healthy control groups in terms of their SST and Stroop test scores, wherein the age and education level of the participants were taken as covariables. The relationship between SST and Stroop Test and Barratt Impulsiveness Scale-11 (BIS-11) was tested by Pearson correlation analysis. Mann-Whitney U test was used for comparing the test scores between those who were administered with psychostimulants among the adults with ADHD and those who were not. Response inhibition was observed to be impaired in adults with ADHD compared with the healthy controls, whereas no difference regarding interference control was observed. As per the Barratt Impulsiveness Scale-11 (BIS-11), a weak and moderately negative relationship was found between the stop signal delay and the attentional, motor, non-planning scores, and total scores and a weak positive relationship was found between the stop-signal reaction time and the attentional, motor, non-planning scores, and total scores. A significant improvement was observed in the response inhibition skills of the adults with ADHD who had received methylphenidate treatment compared to those who had not, and the former also showed lower impulsivity levels as measured by the BIS-11. It should be noted that response inhibition and interference control, which are considered under the umbrella of inhibitory control, may exhibit different characteristics in adult individuals diagnosed with ADHD and this is important for differential diagnosis. An improvement was observed in the response inhibition of adults with ADHD caused by psychostimulant treatment, which was associated with positive outcomes that were also noticeable by the patients. Understanding the underlying neurophysiological mechanisms of the condition would further facilitate the development of appropriate treatments.
Açıklama
Anahtar Kelimeler
Dikkat eksikliği hiperaktivite bozukluğu, dürtüsellik, enterferans kontrolü, inhibitör kontrol, tepki ketleme, Attention deficit hyperactivity disorder, inhibitory control, interference control, impulsivity, response inhibition
Kaynak
Nöropsikiyatri Arşivi
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
60
Sayı
1
Künye
Arat Çelik, H.E., Küçükgöncü, S., Erdoğan, A. ve Özerdem, A. (2023). Erişkin dikkat eksikliği hiperaktivite bozukluğunda tepki ketleme ve enterferans kontrolü / Response inhibition and interference control in adult attention deficit hyperactivity disorder. Nöropsikiyatri Arşivi, Türk Nöropsikiyatri Derneği. 60(1), s. 3-8.
