不同入学年龄注意缺陷多动障碍儿童事件相关电位及行为学特征的比较

Event-related potential and behavioral characteristics in children with attention deficit hyperactivity disorder of different school entrance ages: a comparative study

摘要:

目的 通过数学事件相关电位(ERP)、行为学测试及Conners父母问卷(PSQ)探讨入学年龄对注意缺陷多动障碍(ADHD)儿童认知及行为的影响。方法 58例7~12岁ADHD儿童纳入研究,按照不同入学年龄分为大龄组和小龄组,每组各29例。大龄组为6岁6个月至6岁11个月入学,小龄组为6岁至6岁5个月入学。使用数学任务ERP检测两组ADHD患儿脑电活动差异,并比较其行为学测试结果。患儿父母填写PSQ问卷,比较两组PSQ量表各因子得分。结果 ERP检测显示大龄组错误答案任务P2波幅高于小龄组 (10.9±5.0 μv vs 8.5±3.6 μv,P < 0.05);小龄组对错误答案反应时间短于大龄组 (619±340 ms vs 870±418 ms,P < 0.05)。小龄组学习问题及冲动-多动PSQ量表因子分高于大龄组(P < 0.05)。结论 入学年龄对ADHD儿童的认知与行为均有影响,入学年龄较小的ADHD儿童执行功能缺陷明显,尤其是错误察觉功能,导致冲动-多动行为及学习问题更突出。

Abstract:

Objective To evaluate the effects of school entrance age on cognition and behaviors in children with attention deficit hyperactivity disorder (ADHD) using mathematical event-related potential (ERP), behavioral test, and Conners Parent Symptom Questionnaire (PSQ). Methods Fifty-eight ADHD children aged 7-12 years were enrolled and classified into older age and younger age groups according to the school entrance age (n = 29 each). The children in the older age group were admitted at an age of 6 years and 6 months to 6 years and 11 months, and those in the younger age group were admitted at an age of 6 years to 6 years and 5 months. The ERP with a mathematical task was used to detect the difference in brain electrical activity between the two groups, and the behavioral test results were compared. The children's parents were asked to complete the PSQ, and the scores on each subscale were compared. Results The ERP detection showed that the older age group had a significantly higher P2 amplitude for wrong answers than the younger age group (10.9±5.0 μv vs 8.5±3.6 μv; P < 0.05). The younger age group had a significantly shorter time of response to wrong answers than the older age group (619±340 ms vs 870±418 ms; P < 0.05). The scores on the subscales of learning problems and impulse-hyperactivity of PSQ were significantly higher in the younger age group than in the older age group (P < 0.05). Conclusions School entrance age can affect cognition and behaviors in children with ADHD, and the ADHD children with a younger school entrance age have an obvious defect in executive function, especially the function of error detection, which leads to the prominent problems in impulse-hyperactivity and learning.