学术论文

      注意缺陷型和混合型注意缺陷多动障碍儿童冲突监测功能事件相关电位的研究

      An event-related potentials study for conflict monitoring in two subtypes of attention deficit hyperactivity disorder in children

      摘要:
      目的 使用事件相关电位(ERP)对注意缺陷多动障碍注意缺陷型(ADHD-Ⅰ型)和混合型(ADHD-Ⅲ型)儿童冲突监测功能进行比较,探讨两种亚型认知受损程度及神经机制.方法 注意缺陷多动障碍50例(ADHD-Ⅰ型25例,ADHD-Ⅲ型25例),正常对照组30名.采用空间整合Simon-Stroop任务,比较分析ADHD-Ⅰ型、ADHD-Ⅲ型及正常对照组额冲央部N2波幅及潜伏期的差异.结果 ①波幅:Simon不一致(Siin)和Stroop不一致(Stin)条件,ADHD-Ⅰ型[Siin(-4.33 ±2.89)μV;Stin(-5.03 ±3.03)μV]和ADHD-Ⅲ型[Siin(-2.49 ±2.01)μV Stin(-3.33±1.44)μV]明显低于正常对照组[Siin(-6.13±2.93)μV; Stin(-6.58±2.80)μV],差异有统计学意义(P<0.05).ADHD-Ⅰ型的波幅高于ADHD-Ⅲ型,差异有统计学意义(P<0.05).②潜伏期:Siin和Stin条件,ADHD-Ⅰ型[Siin(339.80±31.96) ms;Stin(344.29±26.23) ms]和ADHD-Ⅲ型[Siin(358.70 ±22.10)ms;Stin(352.60±17.90)ms]较正常对照组[Siin(325.96±23.01) ms;Stin (331.15±24.62) ms]延长,差异有统计学意义(P<0.05).ADHD-Ⅰ型Siin条件的潜伏期短于ADHD-Ⅲ型,差异有统计学意义(P<0.05).结论 ADHD-Ⅲ的冲突监测功能的损伤程度较ADHD-Ⅰ更严重,对任务相关性刺激的辨别及抵制分心刺激的干扰做出反应或适时的自动做出反应的能力较弱,两种亚型儿童的认知和神经机制方面的缺损也可能不同.
      Abstract:
      Objective To exanfined differences of conflict monitor function between the inattentive and combined Attention deficit hyperactivity disorder(ADHD) subtypes using event-related potentials(ERP) to assess the degree of cognitive impairment and explore neural mechanisms.Methods ERPs elicited by performing the spatial Simon-Stroop task were recorded in 50 children with ADHD(ADHD/Inattentive,ADHD-Ⅰ(n =25) ;ADHD/Combined,ADHD-Ⅲ(n =25) and 30 normal children.The differences of N2 component of ERP results in three groups were compared and analysed.Results ①Amplitude:ERP data indicated that the amplitude of N2 of the children with ADHD-Ⅰ and ADHD-Ⅲ in Simon-incongruent trials (Siin (-4.33 ± 2.89) μV,(-2.49 ± 2.01)μV) and Stroop-inconsistent trials(Stin(-5.03 ± 3.03) μV,(-3.33 ± 1.44) μV) were lower than matched controls (Siin(-6.13 ± 2.93) μV; Stin (-6.58 ± 2.80) μV).ADHD-Ⅲ children were lower than ADHD-Ⅰ children,and the difference had statistic significance (P < 0.05).②Latency:the latency of both subtypes of ADHD were longer than controls in Siin(ADHD-Ⅰ (339.80 ± 31.96) ms,ADHD-Ⅲ(358.70 ± 22.10) ms,control(325.96 ± 23.01) ms) and Stin(ADHD-Ⅰ (344.29 ± 26.23) ms,ADHD-Ⅲ(352.60 ± 17.90) ms,control(331.15 ± 24.62)ms) condition,the difference had statistic significance (P < 0.05),ADHD-I children were shorter than ADHD-Ⅲ children in Siin and Stin condition,but only in Siin condition the difference had statistic significance(P < 0.05).Conclusion Conflict monitoring function defect of ADHD-Ⅲ are more serious than ADHD-Ⅰ,the ability of identify task relevant stimulus dimensions and resist irrelevant stiuutus dimensions or automatic response to task-related stimulus was weaker.The neural mechanisms and congnitive of two subtypes may be different.
      作者: 王单单 [1] 任艳玲 [1] 杨硕 [1] 王苏弘 [1] 蔡婧 [1] 马岭 [1] 高鹏 [1] 董选 [2]
      作者单位: 苏州大学附属三院(常州市第一人民医院)脑科研究中心,常州,213003 常州儿童医院
      年,卷(期): 2012, 21(12)
      在线出版日期: 2013年4月26日
      基金项目: 国家自然科学基金项目