学龄早期注意缺陷多动障碍儿童事件相关电位和行为问题的相关性

Correlation between event-related potential and behavioral problems in early schoolage children with attention deficit hyperactivity disorder

摘要:

目的 采用事件相关电位 （ERP）技术和Achenbach儿童行为量表 （CBCL）研究学龄早期注意缺陷多动障碍 （ADHD）儿童的认知特征，探讨ERP与儿童行为问题的相关性。方法 22例6~7 岁ADHD患儿和年龄匹配的19例正常儿童纳入研究。ERP试验采用持续性操作测试 （CPT-AX）任务，对Go和Nogo的N2、P3成分进行波幅和潜伏期的比较分析。CBCL量表由患儿家长填写，分析行为因子与ERP成分的相关性。结果 ADHD组ERP遗漏数明显高于正常对照组 （10±8 vs 5±4，P<0.05），而两组反应时间和虚报数比较差异无统计学意义 （P>0.05）。ADHD 组ERP 的Go-N2 波幅明显低于正常对照组 （-8±5 μV vs -10±4 μV，P<0.05）。ADHD 组多动、攻击问题检出率均为27%，违纪问题检出率为9%。攻击及违纪因子得分与ERP的Go-N2波幅呈负相关 （分别r=-0.43、r=-0.48，均P<0.05），多动因子得分与Go-P3潜伏期呈正相关 （r=0.50，P<0.05）。结论 学龄早期ADHD儿童已出现注意执行功能受损趋势，但抑制功能缺陷尚不明显。学龄早期ADHD 儿童多动、攻击及违纪问题与ERP 相关。

Abstract:

Objective To investigate the cognitive characteristics in early school-age children with attention deficit hyperactivity disorder (ADHD) using event-related potential (ERP) and Achenbach Child Behavior Checklist (CBCL), as well as the correlation between ERP and behavioral problems. Methods A total of 22 children aged 6-7 years with ADHD and 19 healthy children matched by age were enrolled. Continue Performance Test-AX (CPT-AX) was performed for ERP test. The amplitude and latency of N2 and P3 of Go and Nogo were compared. The CBCL was completed by the parents, and the correlation between behavioral factors and ERP was analyzed. Results The ADHD group had a significantly higher number of ERP omissions than the normal control group (10±8 vs 5±4; P<0.05), while the reaction time and number of commission errors showed no significant differences between the two groups (P>0.05). The ADHD group showed a significantly lower Go-N2 amplitude than the normal control group (-8±5 μV vs -10±4 μV; P<0.05). In the ADHD group, the detection rates of hyperactivity, attack, and discipline violation were 27%, 27% and 9% respectively. The scores on attack and discipline violation subscales were negatively correlated with the Go-N2 amplitude of ERP (r=-0.43 and -0.48 respectively; P<0.05), while the score on hyperactivity subscale was positively correlated with the latency of Go-P3 (r=0.50, P<0.05). Conclusions The early school-age children with ADHD show the tendency to the impairment of attention/executive function, but the inhibition function defect has not been noted. In early school-age children with ADHD, the behavioral problems such as hyperactivity, attack, and discipline violation are associated with ERP.