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Biomedical subjects

C Denney

Publications and source records attributed to C Denney.

4 recordsLinked to original sources

Titrating methylphenidate in children with attention-deficit/hyperactivity disorder: is body mass predictive of clinical response?

OBJECTIVE: To evaluate the hypothesis that gross body mass is functionally related to methylphenidate (MPH) response in children with attention deficit disorder/hyperactivity disorder (ADDH). METHOD: Seventy-six children with ADDH received each of five counterbalanced doses of MPH (placebo, 5 mg, 10 mg, 15 mg, 20 mg) in the context of a double-blind, placebo-controlled, within-subject (crossover) experimental design. Dependent measures included direct observations of attention, academic efficiency, and teacher ratings of behavior in the classroom. RESULTS: Dose-response profiles did not differ across children varying incrementally in body mass, nor were systematic variations in dose-response curve parameters observed across discrete groups of children differing in mean body mass. Neither did these groups differ with respect to gains from placebo at each dose. Finally, body mass failed to predict optimal dose or gains achieved at optimal dose and did not distinguish between drug responders and nonresponders. CONCLUSIONS: Collectively, the findings fail to support the practice of titrating MPH on the basis of body weight in children with ADDH.

Analysis of Variance↗

Methylphenidate and attentional training. Comparative effects on behavior and neurocognitive performance in twin girls with attention-deficit/hyperactivity disorder.

The effectiveness of four doses (5-mg, 10-mg, 15-mg, 20-mg) of methylphenidate (MPH) and attentional training (AT) were evaluated using neurocognitive instruments (Continuous Performance Test; Matching Unfamiliar Figures Test), narrow- and broad-band rating scales in the context of a double-blind, placebo-control, within-subject reversal design for dizygotic twin girls with Attention-Deficit/Hyperactivity Disorder (ADHD). Both interventions proved effective for improving neurocognitive test performance and behavior, although broad-band ratings revealed dose-response curves different from those obtained from the neurocognitive tests. Implications for clinical management of girls with ADHD are discussed.

Attention↗

The eye blink electro-oculogram.

An electro-oculogram (EOG) was derived from potentials recorded from electrodes placed above and below the eye during voluntary vertical eye movements. Concurrent measurement of the amplitude of eye blink potentials recorded from the same electrodes produced curves which were highly correlated with the EOG measured from stereotyped eye movements. Recordings from a patient with a missing globe, owing to trauma, revealed eye movement and blink responses only from the intact side. A patient with no light perception showed blink responses which were less variable than responses measured during attempts voluntarily to move the eyes vertically in 60 degrees excursions. An EOG calculated by measurement of eye blink potentials may be possible in clinical situations where traditional electro-oculography techniques are not feasible.

Adaptation, Ocular↗

Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children.

OBJECTIVE: To evaluate the magnitude and clinical significance of methylphenidate (MPH) effects on the classroom behavior and academic performance of 76 children with attention deficit disorder/hyperactivity (ADDH). METHOD: A double-blind, placebo controlled, within-subject (crossover) experimental design was used to evaluate acute MPH effects at four dose levels (5 mg, 10 mg, 15 mg, and 20 mg) on children's attention, academic functioning, and behavior in regular classroom settings. Results were contrasted with a normal control sample. RESULTS: Standard statistical analysis revealed MPH effects on classroom functioning that were primarily linear. Analysis of the clinical significance of effects indicated that large proportions of treated children exhibited significantly improved or normalized classroom functioning; however, a large subset of them failed to show improved academic functioning. Overall, children failing to respond at lower dose levels have a high probability of improving or becoming normalized as a function of increasing dose. CONCLUSIONS: For a majority of children with ADDH, MPH results in significantly improved or normalized attention and classroom behavior. A significant subset, however, fail to realize gains in their academic functioning and will require supplemental interventions.

Achievement↗