Meta AnalysisID 4679

色氨酸治疗注意缺陷多动障碍的系统评价

CRD42020188649

This review aims to determine the efficacy of tryptophan modulation as an intervention for individuals with ADHD.

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Record Fields

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Meta Analysis Id
4679
Evidence Id
13237
Core Evidence Id
13237
Source Meta Analysis Id
4647
Herb2 Meta Analysis Id
HBMA004647
Crd Id
CRD42020188649
Title
A systematic review of the use of tryptophan as a treatment for Attention Deficit Hyperactivity Disorder
Review Question
This review aims to determine the efficacy of tryptophan modulation as an intervention for individuals with ADHD.
Study Type Included
This review will include randomised controlled trials only (either single or double-blinded).
Condition Being Studied
Attention Deficit/Hyperactivity Disorder (ADHD) is characterised by poor attention, heightened impulsivity and hyperactivity (American Psychiatric Association, 2000). Consequences of the disorder include higher risk of other psychiatric and physical health conditions and poorer academic and occupational functioning (Doggett, 2004; Hodgkins, Montejano, Sasane, & Huse, 2011; National Institute for Health and Clinical Excellence, 2009).
Participant
Participants will have either an ADHD diagnosis (or equivalent) or will be above cut point on validated ADHD measure. All subtypes will be included. This review will include both children and adults with ADHD, aged between 3 and 35 years. The upper age limit of 35 years has been selected to avoid the risk of age-related cognitive decline (Salthouse, 2009). The review will include ADHD participants with common comorbidities (including anxiety, depression, autism or substance or conduct disorder). Comorbidity trials will only be excluded they include uncommon comorbid conditions.
Animal
Human Disease Modelled
Intervention
The review will include randomised controlled trials which have an experimental tryptophan intervention (either involving depletion or loading). Trials that combine tryptophan interventions with other lifestyle manipulations (such as dieting or exercising) will only be included if they provide sufficient information on the effects of tryptophan modulation alone.
Comparator Control
All trials with a control arm will be included. The experimental tryptophan intervention will be compared to the following: 1. no treatment condition (how does tryptophan modulation compare with no treatment at all?) 2. placebo (how does tryptophan modulation compare with placebo?) 3. ADHD medication, including psychostimulant (e.g methylphenidate) and non-stimulant medication (e.g. atomoxetine) (how does tryptophan modulation compare with ADHD medication alone?)
Main Outcome
This review will focus on two main outcome measures: 1. global functioning/quality of life, measured through validated scales before and after the intervention (i.e. Global Functioning Scale, validated parent questionnaires) 2. Cognitive or behavioural tests which measure the core symptoms (inattentiveness, impulsivity and hyperactivity), measured before and after the intervention (i.e. attention: continuous performance tests, such as TOVA; impulsivity: Iowa Gambling Task, Delay Discounting Task, TOVA; hyperactivity: any objective measure of motor activity, such as actigraphy). If these scores are reported separately for the sub-dimensions of ADHD (i.e. inattention and hyperactivity/impulsivity), then the effect size of each of these will be calculated separately and aggregated to estimate the overall effect. 3. Scale measures of core symptoms e.g. Connors, ASRS, Barrett Impulsivity Scale or any validated ADHD scale or ADHD core symptoms scale. Measures of effect Global functioning: change in global functioning from baseline to study completion (objective measurement, self-report or observer rate). Effect size of the change in scores will be used as the effect measure. ADHD core symptoms: change in ADHD symptoms score from baseline to study completion (objective measurement, self-report or observer rate). Effect size of the change in scores will be used as the effect measure.
Outcome Measure
Additional Outcome
Other ADHD-related symptoms, measured using standardised tests or scales before and after intervention (i.e. aggression, working memory, reward learning). For trials that include ADHD participants with comorbid conditions, standardised tests or scales used to measure symptoms related to the comorbid conditions will be used as additional outcome measures (before and after intervention). Dropouts due to adverse events, if applicable. Dropouts due to other causes, if applicable. Measures of effect Other ADHD-related symptoms: change in symptoms score from baseline to study completion (objective measurement, self-report or observer rate). Effect size of the change in scores will be used as the effect measure. Comorbid conditions: change in symptoms score from baseline to study completion (objective measurement, self-report or observer rate). Effect size of the change in scores will be used as the effect measure. Drop-outs due to adverse events: the proportion of randomised participants who drop out due to adverse events. Drop-outs due to other causes: the proportion of randomised participants who drop out due to other causes.
Study Method
Intervention, Meta-analysis, Synthesis of qualitative studies, Systematic review
Keyword
Attention Deficit Disorder with Hyperactivity; Diagnostic Tests, Routine; Humans; Tryptophan
Contact
Dr Eleanor Dommett [email protected]
Organisational Affiliation
King's College London www.kcl.ac.uk
Funding Source
This review is not funded. Grant number(s) <span style=font-size: 14px>State the funder, grant or award number and the date of award</span>
Other Selection Criteria
Final Publication
Dinu, L.M., Phattharakulnij, N. &amp; Dommett, E.J. Tryptophan modulation in individuals with attention deficit hyperactivity disorder: a systematic review. J Neural Transm (2022). https://doi.org/10.1007/s00702-022-02478-5 https://link.springer.com/article/10.1007/s00702-022-02478-5
Same Topic Review
Published Protocol
Review Type
Language
English
Country
England
Review Stage
Review Completed published
First Submission Date
2020-06-01
Registration Date
2020-06-30
Anticipated Start Date
2020-06-04
Anticipated Completion Date
2020-10-31
Title Cn
色氨酸治疗注意缺陷多动障碍的系统评价
Title En
A systematic review of the use of tryptophan as a treatment for Attention Deficit Hyperactivity Disorder
Bilingual Status
complete