Ubururu bwa metilene mu kwibuka no kwibanda: ibyo amagerageza ku bantu yapimye

Inyandiko yo mu 2023 ku bururu bwa metilene n'ubwonko bw'umuntu muzima itangira isobanura ingingo yayo n'interuro ubu isubirwamo mu nyandiko zisesengura ubushakashatsi, videwo n'impapuro z'ibicuruzwa: iyi ngingo y'imiti “yanagaragajwe ko yongera ubushobozi bwo gutekereza, kwiga no kwibuka, bitewe n'ingano yatanzwe, haba mu bantu no mu nyamaswa zikoreshwa mu magerageza.”

Igice cy'iyo nteruro kireba inyamaswa kiroroshye gushyigikira n'ibimenyetso. Igice kireba abantu gishingiye ku magerageza make, kandi kuyasoma bituma usobanukirwa ibice bitandukanye by'imvugo “ubushobozi bwo gutekereza.” Ishakisha ryakozwe kuri iyi ngingo ryabonye ubushakashatsi butanu ku bantu bwari bufite igipimo cy'ubushobozi bwo gutekereza cyangwa cy'amashusho y'ubwonko, hiyongereyeho amagerageza atatu yo mu kubaga yari afite igisubizo kijyanye n'ubushobozi bwo gutekereza. Igerageza rimwe mu bantu bakuru bafite ubuzima bwiza ryagaragaje ko kwibuka byateye imbere, ariko iyo nyungu ntiyakomeje kugaragara mu igereranya hagati y'amatsinda.

Ubwoko bune bw'ibisubizo ku bantu akenshi bufatwa nk'ikintu kimwe

Urebye iyo mbonerahamwe kuva hejuru kugeza hasi, ubona icyerekezo. Ubushakashatsi bufite igipimo nyacyo cy'ubushobozi bwo gutekereza ni ubwakorewe mu kubaga, kandi bwakoresheje umuti utewe mu mutsi mu barwayi bari mu kinya. Ubushakashatsi ku bakorerabushake bafite ubuzima bwiza bwapimye ibimenyetso by'ubwonko aho gupima gutekereza.

Ibyo igerageza ryo mu 2016 ku bantu bakuru bafite ubuzima bwiza ryabonye

Ubushakashatsi ku bantu buvugwa cyane kurusha ubundi bwahaye abantu bakuru 26 bafite ubuzima bwiza ingano imwe ya 280 mg ifatwa mu kanwa, hafi 4 mg/kg, cyangwa capsule ya placebo yuzuyemo ibara ry'ubururu FD&C no. 2 kugira ngo byombi bisa. Abitabiriye bafatiwe amashusho mbere yo guhabwa iyo ngano, bongera kuyafotorwa nyuma y'isaha imwe bakora umurimo wo kugenzura kuba maso no gusubiza, upima uko umuntu abona vuba ikimenyetso cyoroshye agaragarijwe, n'umurimo wo guhuza ishusho n'urugero nyuma yo gutegereza, ari wo kizamini cyo kwibuka amashusho mu gihe gito.

Ibisubizo by'ubwonko byarahindutse. Ubururu bwa metilene bwongereye ikimenyetso mu gice cy'inyuma cy'ubwonko cyitwa insula ku mpande zombi mu murimo wo kwitondera (Z = 2.9 to 3.4, P = .01 to .008), no mu bice by'ubwonko byo imbere, byo hejuru no inyuma mu murimo wo kwibuka (Z = 2.9 to 4.2, P = .03 to .0003).

Ibisubizo by'imyitwarire ni byo bikunze kuvugwa mu buryo buhinnye igihe ubu bushakashatsi busubirwamo.

1. Igihe cyo gusubiza nticyateye imbere. Itsinda ryahawe placebo ryavuye kuri milisegonda 230 rijya kuri 220. Itsinda ryahawe ubururu bwa metilene ryavuye kuri milisegonda 230 riguma kuri 230. Igereranya hagati y'amatsinda ryatanze F = 0.65, P = .43.
2. Ibisubizo by'ukuri byo kwibuka byiyongereye hafi 7% mu itsinda ryahawe umuti, P = .01 mu igereranya ry'ibya mbere n'ibya nyuma muri iryo tsinda.
3. Iyo nyungu ya 7% ntiyakomeje kugaragara mu kizamini cyo kugereranya amatsinda. Igereranya ry'ibipimo byafashwe inshuro nyinshi ku ihinduka ry'ibisubizo by'ukuri ryatanze F = 2.96, P = .09.

Ihinduka ryo mu itsinda rimwe, rijyana n'itandukaniro ry'imihindukire hagati y'amatsinda ridafite uburemere mu mibare, riranga igisubizo gishobora kuba nyacyo cyangwa kikaba ihindagurika ritunguranye. Umwanzuro w'inyandiko ubwayo uritonda uko bikwiye: ibyo yabonye “bishyigikira igitekerezo cy'uko ubururu bwa metilene bwongera ubushobozi bwo kwibuka” kandi bigatanga umusingi w'amagerageza azakurikiraho. Umusingi si igisubizo cyemejwe. Isesengura ryacu ry'ibimenyetso byagutse ku bantu rikurikirana ibyubakiye kuri uwo musingi kuva icyo gihe.

Ibyo ibizamini bipima koko

Nta na kimwe muri ibi bikoresho gipima “kwibuka” cyangwa “kwibanda” mu buryo umusomyi aba abitekerezamo. Buri kimwe gisaba umuntu gukora ikintu cyihariye, kigaha amanota igisubizo cye, kandi imbibi z'icyo gikoresho ni zo zigena imbibi z'ibivugwa byose bishingiye kuri cyo.

Bityo igisubizo gishobora kugira ishingiro rikomeye mu mibare ariko kikaba kigufi mu byo gisobanura. Igihe cyo gusubiza kidahinduka cyerekana ko kubona ikimenyetso bitihuse kurushaho; ntikivuga ko kwibuka isomo bitashobora kuba byiza kurushaho. Amanota yiyongereye mu kizamini cyo guhuza ishusho n'urugero nyuma yo gutegereza asobanura ko umuntu yamenye ishusho inshuro nyinshi kurushaho; ntasobanura ko azibuka izina ejo. Inyandiko iyobora ku buryo ubushakashatsi ku nyamaswa bupima kwibuka ikurikirana iryo tandukaniro mu nzira zinyuranamo no mu bizamini byo kumenya ibintu bishingirwaho n'ibyinshi mu bivugwa.

Ubushakashatsi bwabuherekeje ntibwanditse amanota na rimwe

Iyo gahunda y'ubushakashatsi yasohoye isesengura rya kabiri ryavuye mu gihe kimwe cyo gushaka abitabira, kuri kaminuza imwe, rikoresha ingano imwe na placebo imwe, ariko noneho rireba imikoranire y'ibice by'ubwonko mu gihe cyo kuruhuka. Hinjijwe abitabiriye makumyabiri n'umunani; isesengura ry'amashusho ryakoresheje hafi 13 kugeza kuri 15 muri buri tsinda.

Ubururu bwa metilene bwajyanye no kugabanuka kw'amaraso atembera mu bwonko mu rusobe rufasha kubona no kumenya aho ibintu biherereye, ndetse n'imikoranire ikomeye kurushaho mu gihe cyo kuruhuka hagati y'ibice byinshi by'ubwonko, birimo hippocampus y'ibumoso na cerebellum y'iburyo. Byombi ni ibyo ubushakashatsi bwabonye bishishikaje ku mikorere y'urusobe rw'ubwonko. Nta na kimwe ari igisubizo cyo kwibuka, kandi inyandiko ubwayo irabivuga: “Kutagira amanota y'imyitwarire muri ubu bushakashatsi na byo ni imbogamizi.”

Raporo ebyiri zavuye mu itsinda rimwe, mu gihe kimwe cyo gushaka abitabira no ku ngano imwe ni igerageza rimwe, si abiri. Ibimenyetso by'amashusho y'ubwonko bw'abantu ku nyungu mu bushobozi bwo gutekereza ntibirongera kuboneka mu bushakashatsi bwigenga.

Ubushakashatsi bwigenga bwabonye icyerekezo kinyuranye

Igipimo cyigenga cyavuye mu rindi tsinda kandi gikoresha ubundi buryo bwo gutanga umuti. Singh na bagenzi be bahaye abagore umunani bafite ubuzima bwiza umuti unyuzwa mu mutsi wa placebo n'ubururu bwa metilene bwa 0.5 na 1 mg/kg ku minsi itandukanye, hanyuma bapima amaraso atembera mu bwonko, ogisijeni ubwonko bukura mu maraso n'umuvuduko ubwonko bukoresha ogisijeni.

Byose uko ari bitatu byaragabanutse. Amaraso atembera mu bwonko bwose yagabanutse hafi 8% kuri izo ngano zombi, kandi umuvuduko w'ikoreshwa rya ogisijeni wagabanutse ku buryo bufite uburemere mu mibare. Abanditsi bari biteze ukwiyongera, ariko batangaje neza ko habaye ibinyuranye, batanga ibisobanuro bibiri: izo ngano ziri aho ingaruka z'ubururu bwa metilene ziva ku gushishikaza imikorere zikajya ku kuyibuza, kandi ubwonko bufite ubuzima bwiza bushobora kuba budafite umwanya munini wo kurushaho kunoza imikorere.

Uku guhinduka ni ko gutuma gufata iyi ngingo y'imiti mu buryo bwa “nyinshi ni nziza kurushaho” bidakora. Inyandiko iyobora kuri hormesis isobanura imiterere y'umurongo w'izo ngaruka; ingano zivugwa ko zongera imikorere muri ubu bushakashatsi ni 0.5 kugeza kuri 4 mg/kg, kandi inyandiko zizikoresha zivuga ko hejuru ya 10 mg/kg icyerekezo cy'ingaruka gihinduka.

Igipimo cy'ubushobozi bwo gutekereza cyahindutse ni urujijo rukaze nyuma yo kubagwa

Urujijo rukaze, cyangwa delirium, ni imimerere yo kujijwa itangira mu masaha cyangwa mu minsi, ikunze kuba mu bantu bageze mu zabukuru nyuma yo kubagwa gukomeye. Si kimwe no kwibuka aho imfunguzo ziri, ariko rupimwa n'ibikoresho byemejwe ko bipima neza, kandi ni igisubizo kijyanye n'ubushobozi bwo gutekereza.

Amagerageza atatu agabanya abitabira mu matsinda ku buryo bwa tombola yapimye niba ingano y'umuti itangwa mu mutsi mu gihe cyo kubagwa igabanya urwo rujijo.

Igerageza ryo mu 2021 ryanatangaje ko imikorere mibi y'ubushobozi bwo gutekereza mu gihe cya mbere nyuma yo kubagwa, yapimwe ku munsi wa karindwi, yagabanutse kuva kuri 40.2% kugera kuri 16.1% (OR 0.30, 95% CI 0.16 to 0.57, P < .001). Isesengura rihuza ibisubizo by'ayo magerageza atatu ryo mu 2026, rireba abarwayi 779, ryahuje ikigereranyo cya odds cya 0.35 (95% CI 0.23 to 0.53), nta tandukaniro rifite uburemere mu mibare hagati y'ubushakashatsi.

Ingaruka ni nini ukurikije ibipimo by'ubuvuzi bwo mu gihe gikikije kubagwa, kandi ntizari nta ngaruka mbi. Mu igerageza ryo gusimbuza ingingo ihuza amagufwa, umuriro nyuma yo kubagwa wabaye kenshi kurushaho mu itsinda ryahawe umuti, 16.5% ugereranyije na 7.4% (P = .039). Nyuma yaho, amagerageza yo kubaga impindura no gusimbuza ingingo ihuza amagufwa yatumye hasohoka amabaruwa yandikiwe umwanditsi mukuru w'ikinyamakuru. Ibyo bibaho igihe igisubizo gitangiye guhindura imikorere y'ubuvuzi, kandi ni n'ikimenyetso cy'uko amakuru arambuye ari gusuzumwa.

Hari n'ibimenyetso bitanga indi shusho. Isesengura rihuza ubushakashatsi mu rusobe ryo mu 2026 muri The BMJ ryahuje amagerageza 158 n'abarwayi 41,084 kugira ngo rishyire imiti mu byiciro ku bushobozi bwo gukumira urujijo rukaze. Ryagaragaje dexmedetomidine nk'umuti ufite ibimenyetso byizewe kurusha ibindi, hamwe na corticosteroids, imiti ikangura utwakira melatonin, parecoxib, olanzapine na insuline itangwa mu mazuru. Ubururu bwa metilene ntibwari mu miti iryo sesengura ryavuze.

Impamvu intsinzi yo mu cyumba cyo kubagiramo itimurirwa mu kwiga

Itandukaniro rine ritandukanya iyo mimerere.

1. Abitabiriye. Amagerageza yashatse abantu barengeje imyaka 60 bari kubagwa bikomeye, itsinda risanzwe rifite ibyago byinshi byo kujijwa. Gukumira urujijo mu bwonko bworoshye kugirwaho ingaruka si kimwe no kunoza ubwonko busanzwe bukora neza.
2. Uburyo bwo gutanga umuti n'aho watangiwe. Buri gisubizo cyiza cyavuye ku muti unyuzwa mu mutsi watanzwe mu gihe cy'ikinya. Capsule ituma umubiri uhura n'umuti mu buryo butandukanye; igereranya ry'uburyo bwo gutanga umuti risobanura ingano y'ibifatwa mu kanwa igera mu bwonko.
3. Igisubizo gipimwa. Urujijo rukaze ni ikibazo cy'ubuvuzi gisuzumwa n'abaganga bakoresheje ibikoresho bifite uburyo bwagenwe. Gukomeza kwibanda mu gicamunsi cy'akazi si ko bimeze, kandi igerageza ridashobora guhisha neza abitabira umuti bahawe rizagira ingorane zo kubipima.
4. Uburyo buvugwa ko butuma habaho ingaruka. Inyandiko zo mu kubaga zivuga ko ingaruka ziterwa no kugabanuka kw'ububyimbirwe mu mubiri wose no kurindwa k'urukuta rutandukanya amaraso n'ubwonko, hamwe no kugabanuka kwa IL-6. Iyo ni ingingo itandukanye n'inkuru yo guhererekanya electron muri mitochondria ikoreshwa mu kwamamaza kwibanda, kandi ibimenyetso ku bantu bishyigikira iya mbere cyane kurusha iya kabiri.

Igerageza rimwe ku bantu ryabonye kwibuka kwiza kurushaho

Mu igerageza ryo mu 2014 muri American Journal of Psychiatry, abantu bakuru 42 bafite ubwoba bukomeye bwo kuba ahantu hafunganye bahawe 260 mg z'ubururu bwa metilene cyangwa placebo ako kanya nyuma y'ibihe bitandatu, buri kimwe kimara iminota itanu, byo guhangana n'ubwo bwoba mu cyumba gifunze. Kwibuka imimerere y'amahugurwa, byapimwe nyuma y'umunsi umwe na nyuma y'iminsi 30, byari byiza kurushaho mu itsinda ryahawe umuti.

Igisubizo ku bwoba cyaterwaga n'imimerere. Abitabiriye barangije igihe cyo guhangana n'ubwoba bafite ubwoba buke bagize ibisubizo byiza kurushaho nyuma y'ukwezi iyo bari bahawe ubururu bwa metilene; abarangije ibyo bihe nabi bakunze kugira ibisubizo bibi kurushaho. Bityo ikintu cyegereye cyane ingaruka zemejwe ku kwibuka mu bushakashatsi ku bantu ni ukwibuka igikorwa kimwe cyo kwiga muri laboratwari, kwongerewe igihe umuti watanzwe nyuma y'icyo gikorwa. Inyandiko iyobora ku buvuzi bwo guhangana n'ibiteye ubwoba isuzuma iyo miterere.

Aho byashatswe ariko ntibiboneke

Igerageza rirerire kurusha ayandi ku bururu bwa metilene n'ubushobozi bwo gutekereza mu bantu ryamaze amezi atandatu. Mu bushakashatsi ku ndwara ihinduranya ibihe by'umunezero ukabije n'iby'agahinda, bugabanya abitabira ku buryo bwa tombola kandi bukabahinduranya imiti, abarwayi 37 bari basanzwe bafata lamotrigine bahawe 15 mg nk'umuti wo kugereranya ugaragara nk'ukora, cyangwa 195 mg nk'ingano y'umuti ukora. Amanota y'agahinda gakabije n'ay'amaganya yarushijeho kuba meza ku ngano nini. Ibyo inyandiko ivuga ku bushobozi bwo gutekereza biri mu murongo umwe: “Ingaruka z'ubururu bwa metilene ku bimenyetso by'ubushobozi bwo gutekereza ntizari zifite uburemere mu mibare.”

Ubu buryo bwakoresheje umuti ukora wo kugereranya kuko ubururu bwa metilene buhindura ibara ry'inkari, kandi abanditsi basanze placebo idakora itashobora gutuma umuti watanzwe ukomeza kutamenyekana. Iyo ngorane yo guhisha umuti watanzwe igaruka kenshi muri uru rwego, kandi inyandiko iyobora ku mpamvu bigoye guhisha umuti watanzwe mu magerageza y'ubururu bwa metilene isobanura uko ibyo bigira ingaruka ku gusobanura ibisubizo bishingiye ku byo abantu ubwabo bavuga ko bumva.

Amagerageza manini kurusha ayandi ku kwibuka mu bantu yakoresheje indi ngingo y'imiti

Igerageza rinini kurusha ayandi ry'umuti wo mu muryango w'ubururu bwa metilene ku kwibuka ryari gahunda y'ubushakashatsi ku ndwara ya Alzheimer, kandi ntiryakoresheje ubururu bwa metilene. Ryakoresheje hydromethylthionine mesylate, uburyo bwagabanyijwe bw'ishingiro rimwe rya phenothiazine, butunganyijwe ngo budahinduka mu buryo bw'umunyu, kandi bwakozwe nk'umuti ubuza tau kwirundanya. Igerageza rya vuba ry'icyiciro cya 3 ryinjije abitabiriye 598 bafite igabanuka ryoroheje ry'ubushobozi bwo gutekereza cyangwa dementia ya Alzheimer yoroheje kugeza ku iringaniye mu bigo 82, kandi intego zaryo ebyiri z'ibanze ku byumweru 52 ntizagezweho. Impamvu yatanzwe iratanga isomo: itsinda ryo kugereranya ryateye imbere, ibyo abanditsi bavuga ko byatewe n'umuti wo kugereranya ubwawo, 4 mg za methylthioninium chloride kabiri mu cyumweru, watoranyijwe nk'ibara ry'inkari ridakora kugira ngo umuti watanzwe ukomeze kutamenyekana. Itandukaniro rifite uburemere mu mibare ryagaragaye gusa mu itsinda rito ry'abafite igabanuka ryoroheje ry'ubushobozi bwo gutekereza, ku byumweru 78 na 104, mu isesengura ryo gutangira umuti bitinze. Raporo ya mbere y'icyiciro cya 3 yo muri iyo gahunda yakuye ibisubizo byayo bifite uburemere mu mibare mu masesengura yahinduwe mbere yo kumenyekanisha umuti watanzwe, igereranya amatsinda mato afata umuti umwe gusa atari yaragabanyijwe ku buryo bwa tombola. Inyandiko iyobora ku magerageza ya Alzheimer isobanura ibyo ayo magerageza yemeza.

Uko ubushakashatsi bukwiye kwizerwa bwaba buteye

Igerageza ryashobora gushyigikira ibivugwa ku kwibuka cyangwa kwibanda ryakenera abantu bakuru bafite ubuzima bwiza badafite ikibazo cy'ubushobozi bwo gutekereza gisanzwe, ingano z'umuti zitangwa kenshi mu gihe cy'ibyumweru, igereranya rihisha capsule irimo buri muti, ibisubizo bizapimwa byagenwe mbere, n'itsinda ry'abashakashatsi ryigenga. Nta kintu kuri urwo rutonde kidashyize mu gaciro. Gusa ntibirakorwa.

Niba ukomeje gutekereza kuyikoresha

Ingingo ebyiri z'umutekano zibanziriza ikiganiro icyo ari cyo cyose ku nyungu. Ubururu bwa metilene bubuza monoamine oxidase A gukora, bityo bukagira ikibazo mu kubukoresha hamwe n'imiti yandikwa ivura agahinda gakabije n'indi miti igira ingaruka kuri serotonine; impungenge ni syndrome ya serotonine aho kuba imikoranire y'imiti yoroheje. Ntibunemewe gukoreshwa mu bafite ibura rya G6PD kubera anemiya iterwa no gusenyuka kw'insoro zitukura. Inyandiko yifashishwa ku mutekano n'inyandiko iyobora ku mikoranire y'imiti bishyira ibyo bibazo mu byiciro by'imiti.

Niba kwibuka cyangwa kwibanda byarahindutse koko, intambwe ya mbere si inyongera. Indwara za tiroyide, guhagarara guhumeka mu bitotsi, B12 nke, agahinda gakabije n'imiti myinshi yandikwa na muganga bitera neza neza ikimenyetso umuti ugamije kongera ubushobozi bwo gutekereza ugurirwa gukosora, kandi inyandiko iyobora ku bimenyetso bya tiroyide yerekana uko akenshi impamvu ishobora kuvurwa iba iri inyuma yabyo.

Ubwoko bw'ibikoresho ni ikintu gihinduka muri buri bushakashatsi bwo hejuru

Buri ngano yavuzwe hano yari ingano yapimwe y'ingingo y'imiti izwi neza, iva ku ruganda rukora imiti, ifite icyemezo cy'isesengura kiyiherekeza. Icupa riva ku mucuruzi utagenzuwe si ibyo. Guhuza n'inyandiko ngenderwaho ya USP ni cyo gipimo umuguzi ashobora kugenzura, kandi ibikoresho bitayujuje bishobora kuba ibyagenewe inganda z'imyenda. Ibyo bishobora kugira imyanda y'ingingo z'ibinyabuzima nka Azure B, ibisigazwa by'ibishongesha n'ibyuma biremereye ku ngano ibisabwa ku miti bigena ntarengwa. Icyo izina USP ryemeza n'icyo ritemeza gisobanura urwego rw'ubwiza ubwabwo.

Abacuruzi benshi bavuga ko igicuruzwa cyapimwe n'ikigo cyigenga bapima ibyuma biremereye gusa, maze bakerekana iryo tsinda rimwe ry'ibipimo nk'iyubahirizwa ry'ibisabwa byose. Blupreme ipima ibisabwa byose na USP: kumenya icyo ingingo y'imiti ari cyo, ubwiza, imyanda y'ingingo z'ibinyabuzima, ibisigazwa by'ibishongesha, imyanda y'ibintu shingiro, ibisigazwa nyuma yo gutwika, imipaka y'utunyabuzima n'uburozi bwo imbere muri bagiteri. Buri cyiciro cy'umusaruro cyoherezwa gifite icyemezo cy'isesengura, kandi kugisoma neza bisobanura guhuza nomero y'icyiciro cy'umusaruro na laboratwari n'icupa ufite. Nta na kimwe muri ibyo gitanga inyungu mu bushobozi bwo gutekereza, kandi igicuruzwa kidashobora kwerekana inyandiko zemeza icyo ari cyo si ahantu hakwiye ho gutangirira kugerageza ibyavuzwe.

Umwanzuro

Nta gerageza ryahaye ubururu bwa metilene abantu bakuru bafite ubuzima bwiza ngo ryerekane inyungu mu kwibuka cyangwa kwitondera ugereranyije na placebo. Igerageza ryo mu 2016 ryahinduye ibimenyetso by'ubwonko, risiga igihe cyo gusubiza kidahindutse, kandi ritanga inyungu mu kwibuka itari ifite uburemere mu mibare igihe amatsinda yagereranywaga. Inyandiko yaribuherekeje ntiyanditse amanota y'ikizamini na rimwe. Itsinda ryigenga ryabonye amaraso atembera n'ikoreshwa rya ogisijeni bigabanuka, aho kwiyongera.

Igisubizo ku bushobozi bwo gutekereza mu bantu gifite ishingiro gituruka mu kubaga, aho ingano itangwa mu mutsi mu barwayi bageze mu zabukuru yagabanyije hafi kabiri igipimo cy'urujijo rukaze nyuma yo kubagwa mu magerageza atatu n'isesengura rihuza ibisubizo. Icyo ni igisubizo nyacyo ku barwayi bafite ibibazo bikaze, kandi isesengura ryigenga rinini kurusha ayandi ku gukumira urujijo rukaze ntiryagaragaje uwo muti by'umwihariko. Ni imvugo ifite imbibi nto cyane kurusha ikoreshwa mu kwamamaza, kandi ikwiye kuguma mu bitaro.

Ikarita y'uburyo ingingo y'imiti ikora mu ngirabuzimafatizo isobanura ibyo ikora mu magerageza yo muri laboratwari, isesengura ry'ibimenyetso kuri ADHD rikurikirana ikibazo cyo kwitondera mu bantu basuzumwe bagasanganwa iyo ndwara, naho isomero ry'ubushakashatsi ritondeka ubushakashatsi bushingirwaho n'ibyavuzwe byose kuri uru rupapuro.