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目的探讨中国文化背景下汉族注意缺陷多动障碍(ADHD)儿童在威斯康星卡片分类测验(WCST)中的反应特征。方法对2003-04—2004-03在中山大学附属三院儿童发育行为中心确诊的汉族ADHD儿童57例和63例正常儿童,采用修订版WCST进行了测试分析。结果WCST的13个指标中ADHD组儿童有7个指标成绩都显著比正常对照组儿童差(P<0·05,P<0·01)。ADHD儿童与正常儿童在WCST中持续性错误数(RPE)分别为(26·84±10·87)与(22·83±10·35),P<0·05,总错误数(RE)分别为(57·58±18·06)与(49·33±18·55),P<0·05,持续性反应数(RP)分别为(30·39±13·88)与(25·49±12·68),P<0·05,完成总应答数(RA)分别为(127·60±1·77)与(122·86±11·04),P<0·01,完成分类数(CC)分别为(2·86±1·46)与(3·78±1·81),P<0·01,正确应答数百分比(RCP)分别为(54·96±14·00)与(60·50±13·38),P<0·05,概念化水平(RFP)分别为(40·80±17·61)与(47·77±17·72),P<0·05。控制年龄的偏相关分析显示症状、诊断都分别与WCST的多个指标相关,其中完成分类数(CC)与症状、诊断均相关。结论汉族ADHD儿童的认知功能、认知转移能力、抽象概括能力、概念形成的洞察力不足。推测汉族ADHD儿童可能存在额叶功能缺陷。WCST可以考虑作为ADHD临床诊断的参考测验,其中较稳定的指标是完成分类数。     

注意缺陷多动障碍儿童冲动行为与执行功能的相关研究

研究注意缺陷多动障碍（ADHD）儿童冲动行为与其执行功能的相关关系。方法　对2005年1月至2007年7月在中南大学湘雅二医院精神卫生研究所、郑州市第九人民医院心理科、郑州市儿童医院保健部的187例ADHD儿童（均符合DSM-IV注意缺陷多动障碍的诊断标准）与126名对照组儿童分别进行Barratt冲动性量表中文版（BIS）和威斯康星（WCST）卡片分类测验。结果　ADHD冲动组、ADHD非冲动组和对照组组间WCST的评分差异无统计学意义（P > 0.05）,BIS的3个因子及冲动总分与WCST卡片分类测验的非持续性错误数呈显著的负相关（P < 0.05）。结论　ADHD儿童与对照组儿童的执行功能差异无统计学意义（P > 0.05）,但冲动行为越强烈,儿童出现随机错误的可能性越大。     

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目的研究注意缺陷多动障碍(ADHD)儿童冲动行为与其执行功能的相关关系。方法对2005年1月至2007年7月在中南大学湘雅二医院精神卫生研究所、郑州市第九人民医院心理科、郑州市儿童医院保健部的187例ADHD儿童(均符合DSM-IV注意缺陷多动障碍的诊断标准)与126名对照组儿童分别进行Barratt冲动性量表中文版(BIS)和威斯康星(WCST)卡片分类测验。结果ADHD冲动组、ADHD非冲动组和对照组组间WCST的评分差异无统计学意义(P>0.05),BIS的3个因子及冲动总分与WCST卡片分类测验的非持续性错误数呈显著的负相关(P<0.05)。结论ADHD儿童与对照组儿童的执行功能差异无统计学意义(P>0.05),但冲动行为越强烈,儿童出现随机错误的可能性越大。     

非言语型学习障碍儿童选择注意功能的神经心理特性

目的　探讨非言语型学习障碍 (NLD)儿童选择注意功能相关的大脑额叶注意调控、工作记忆、注意维持等神经心理功能特点。方法　采用听觉辨别实验 (ADT)、威斯康星卡片分类测验(WCST)及中国修订版韦氏学龄儿童智力量表 (C WISC)对 14例NLD儿童和 2 3名正常儿童进行测试 ,并对C WISC各类分测验成绩进行了因子分析。结果　NLD组儿童ADT测试中的正确反应率明显低于对照组 (P <0 0 1) ,错误反应数多于对照组 (P <0 0 1) ;在WCST测试中其 2次的分类完成数 (CA)和持续性错误次数 (PE)成绩均显著低于对照组 (P <0 0 5 ) ;因子分析表明 ,与视觉空间功能相关的知觉组织因子和与注意维持功能相关的不分心因子明显低于对照组 (P <0 0 1,P <0 0 5 )。结论NLD儿童存在额叶为主的注意调控功能和工作记忆障碍 ,推测以右侧额叶功能障碍为著     

Tourette综合征患儿的执行功能损害与症状特征的关系

目的探讨Tourette综合征(TS)的执行功能损害及其与症状严重程度的关系。方法对TS患儿53例采用威斯康星卡片分类测验(WCST)评估其执行功能,Yale整体抽动严重程度量表(YGTSS)评估抽动症状严重程度,Achenbach儿童行为评定量表(CBCL)评估社会能力和行为问题。结果TS患儿在WCST中的各项成绩均明显低于正常对照组(P均<0.01)。TS患儿在WCST中的错误、非持续错误应答次数及概念化水平数与运动抽动严重程度和整体功能受损程度的呈显著相关性(P均<0.01),与其他各项因子分数的相关性无显著性意义(P均>0.05)。结论TS患儿存在一定程度的执行功能损害,并与其运动抽动的严重程度和整体功能受损程度有关。     

注意缺陷多动障碍混合型和注意缺陷型的神经心理特征分析

目的探讨注意缺陷多动障碍混合型、注意缺陷型与正常儿童的神经心理特征的差异。方法采用视觉记忆、Stroop效应、倒背数字、词汇流畅性、威斯康辛卡片分类、Temporal discounting等测验、分别测试124例注意缺陷多动障碍儿童（包括85例混合型和39例注意缺陷型）和124例正常儿童的视觉工作记忆、反应抑制能力、语音工作记忆、执行功能和延迟满足能力。结果ADHD儿童完成字义与字色相矛盾的字色命名时间[注意缺陷型：84（20）,混合型：98（31）]较正常组[70（28）]延长,错误数[注意缺陷型：3（3）,混合型：6（19）]较正常儿童[2（5）]增多（P〈0．01）;ADHD儿童倒背数字分数[注意缺陷型：3（3）,混合型：3（4）]较正常儿童[4（4）]低（P〈0．01）;延迟视觉记忆[注意缺陷型：19（5）,混合型19（5）]也较正常儿童[20（5）]低（P〈0．01）;ADHD儿童视觉工作记忆得分[注意缺陷型：21（3）,混合型：20（5）]较正常儿童[20（3）]明显偏低（P〈0．01）;ADHD儿童词汇流畅性错误数[注意缺陷型：1（1）,混合型2（1）]显著高于正常儿童[0（0）]（P〈0．01）;ADHD儿童的威斯康辛卡片分类错误数[注意缺陷型：15（17）,混合型：15（15）]显著高于正常儿童[13（13）],分类数[注意缺陷型：5（4）,混合型：5（4）]低于正常儿童[5（3）]（P〈0．01）;ADHD儿童的延迟满足能力显著低于正常儿童（P〈0．01）。ADHD的两种亚型之间在部分测试的结果差异有统计学意义,混合型的ADHD儿童受损更为明显（P〈0．01）。结论ADHD儿童存在视觉工作记忆、语音工作记忆、延迟满足能力、反应抑制等多项认知功能缺陷,其中混合型的儿童受损更为明显。     

分心刺激对注意缺陷多动障碍患儿注意维持的影响

目的 探讨注意缺陷多动障碍(ADHD)患儿与正常儿童在注意维持能力上的差异,分心刺激在不同维持注意水平(高、低)上的作用,以及不同亚型ADHD患儿在维持注意能力上的异同。方法 通过认知行为实验,采用方差分析方法对27名ADHD患儿与29名正常儿童的维持注意能力以及分心刺激的干扰作用进行了探讨,并比较了11名混合型与11名注意缺陷型ADHD患儿的异同。结果 在非注意维持项目(优势反应)上,ADHD患儿的错误率与正常儿童相比差异无显著性;与无分心刺激时相比,分心刺激阻碍了ADHD患儿对靶子的正确反应。在注意维持任务上,ADHD患儿的错误率显著高于正常儿童;与无分心刺激时相比,分心刺激对ADHD患儿的反应起到了促进作用。注意缺陷型和混合型ADHD患儿结果表现基本一致。结论 ADHD患儿存在注意维持缺陷;高、低注意维持水平上分心刺激所起的作用存在分离现象,注意缺陷型和混合型ADHD患儿在注意维持能力上没有表现出显著的差异。     

注意缺陷多动障碍患儿空间忽视的研究

目的 研究注意缺陷多动障碍(ADHD)患儿空间忽视的现象.方法 对32例男性ADHD患儿和32例正常儿童进行划星试验、线等分试验,以及智能测验等非忽视测验.结果 (1)ADHD患儿线等分测试结果为(-9.37±6.57),与对照组(-5.46±4.69)相比,差异有统计学意义(t=-2.735,P<0.01);ADHD患儿左侧划星试验成绩(11.44±5.55)差于对照组(16.34±4.82)(t=-3.78,P<0.01),且左侧较右侧(17.13±6.36)差,差异均有统计学意义(t=-3.09,P<0.01).(2)两组儿童线等分测验成绩均偏向"0"值的右侧(ADHD组t=-8.064,P<0.01;对照组t=-6.585,P<0.01),两侧划星测验成绩也较"正常值""27/27"差(ADHD组:左侧t=15.85,P<0.01;右侧t=-8.78,P<0.01.对照组:左侧t=-12.52,P<0.01;右侧t=-7.39,P<0.01).结论 ADHD患儿较正常儿童存在明显左侧空间忽视现象.     

伴与不伴注意缺陷多动障碍的Tourette综合征患儿行为和抽动症状的对照研究

目的　探讨伴与不伴注意缺陷多动障碍 (ADHD)的Tourette综合征 (TS)患儿之间行为和抽动症状的差异。方法　采用儿童行为调查表 (CBCL)和耶鲁综合抽动严重程度量表 (YGTSS)对 30例单纯TS患儿和 38例伴ADHD的TS(TS ADHD)患儿进行评分、对比分析。结果　TS ADHD组社交情况评分低于单纯TS组 (P <0 0 5 ) ,TS ADHD组在违纪问题、攻击性问题、外向性问题和行为问题总分的评分高于单纯TS组 (P <0 0 5 ) ;TS ADHD组的注意问题评分显著高于单纯TS组 (P <0 0 1)。TS ADHD组YGTSS量表的运动抽动对正常行为干扰和总分比单纯TS组评分高 (P <0 0 5 )。结论　TS ADHD患儿与单纯TS患儿存在差异 ,TS ADHD患儿比单纯TS患儿存在更加严重的外向性行为问题和注意问题 ,两组的抽动症状差异不明显。     

注意缺陷多动障碍儿童工作记忆功能的脑近红外成像研究

探讨注意缺陷多动障碍（ADHD）患儿工作记忆特征及其相应的脑机制。方法　选取2008年4月至10月的39例为南京医科大学附属脑科医院儿童心理卫生研究中心就诊的ADHD患儿,其中注意缺陷型（ADHD-I）14例,多动-冲动型（ADHD-HI）11例,混合型（ADHD-C）14例,同时选取年龄、智商、性别匹配的19名正常儿童为对照组。运用视空间工作记忆范式（包括观察任务、反应任务以及比较任务）进行工作记忆测试,同时采用功能近红外光学成像技术（NIRS）检测两组儿童在执行工作记忆任务时大脑前额叶含氧血红蛋白的差异,运用多变量方差分析进行统计分析。结果　行为学研究发现：（1）ADHD患儿工作记忆任务的总错误数及比较任务错误均高于对照组,差异有统计学意义（P < 0.05）。（2）两组在执行工作记忆任务时的平均反应时差异无统计学意义,但ADHD患儿执行反应任务时平均反应时较执行比较任务时平均反应时短,差异有统计学意义（P < 0.05）。（3）ADHD-C型反应任务错误数显著高于ADHD-HI型（P < 0.05）;在比较任务错误数方面,ADHD-HI型明显高于ADHD-C型（P < 0.05）,ADHD-I也明显高于ADHD-C型（P < 0.05）,但ADHD-HI型与ADHD-I型之间差异无统计学意义。（4）ADHD-HI型执行反应任务和比较任务时的平均反应时均显著高于ADHD-I型（P < 0.05）。NIRS研究发现：（1）ADHD在执行两种工作记忆任务时前额叶含氧血红蛋白激活量与对照组差异无统计学意义;（2）ADHD-C型儿童在执行反应任务时左下侧前额叶含氧血红蛋白激活量较ADHD-I型降低［（-2.46±9.62）×10-4 au 对（10.47±14.18）×10-4 au］,差异具有统计学意义（P < 0.05）。结论　ADHD患儿存在工作记忆缺陷,且不同亚型ADHD患儿完成工作记忆任务时脑前额叶的功能存在差异。     

Methylphenidate and Cognitive Perseveration in Hyperactive Children

Effects of methylphenidate on cognitive flexibility were investigated in 26 children with Attention Deficit Hyperactivity Disorder (ADHD), by assessing perseverative errors on the Wisconsin Card Sorting Test (WCST) and the emergence of clinical symptoms indicative of cognitive perseveration. A double-blind, placebo-control, randomized crossover design was used in which each child was assessed twice in each drug condition (placebo, 0.3 and 1.0 mg/kg). Results indicated that methylphenidate increased perseverative errors on the first assessment but decreased them on the second; clinical symptoms of perseveration occurred at both assessments. Findings suggest that MPH may reduce cognitive flexibility temporarily in some ADHD children.     

The neural correlates of attention deficit hyperactivity disorder: an ALE meta-analysis

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent and commonly studied forms of psychopathology in children and adolescents. Causal models of ADHD have long implicated dysfunction in fronto-striatal and frontal-parietal networks supporting executive function, a hypothesis that can now be examined systematically using functional neuroimaging. The present work provides an objective, unbiased statistically-based meta-analysis of published functional neuroimaging studies of ADHD. METHODS: A recently developed voxel-wise quantitative meta-analytic technique known as activation likelihood estimation (ALE) was applied to 16 neuroimaging studies examining and contrasting patterns of neural activity in patients with ADHD and healthy controls. Voxel-wise results are reported using a statistical threshold of p < .05, corrected. Given the large number of studies examining response inhibition, additional meta-analyses focusing specifically on group differences in the neural correlates of inhibition were included. RESULTS: Across studies, significant patterns of frontal hypoactivity were detected in patients with ADHD, affecting anterior cingulate, dorsolateral prefrontal, and inferior prefrontal cortices, as well as related regions including basal ganglia, thalamus, and portions of parietal cortex. When focusing on studies of response inhibition alone, a more limited set of group differences were observed, including inferior prefrontal cortex, medial wall regions, and the precentral gyrus. In contrast, analyses focusing on studies of constructs other than response inhibition revealed a more extensive pattern of hypofunction in patients with ADHD than those of response inhibition. CONCLUSIONS: To date, the most consistent findings in the neuroimaging literature of ADHD are deficits in neural activity within fronto-striatal and fronto-parietal circuits. The distributed nature of these results fails to support models emphasizing dysfunction in any one frontal sub-region. While our findings are suggestive of the primacy of deficits in frontal-based neural circuitry underlying ADHD, we discuss potential biases in the literature that need to be addressed before such a conclusion can be fully embraced.     

Shared and disorder-specific prefrontal abnormalities in boys with pure attention-deficit/hyperactivity disorder compared to boys with pure CD during interference inhibition and attention allocation

Background: Inhibitory and attention deficits have been suggested to be shared problems of disruptive behaviour disorders. Patients with attention deficit hyperactivity disorder (ADHD) and patients with conduct disorder (CD) show deficits in tasks of attention allocation and interference inhibition. However, functional magnetic resonance imaging (fMRI) of inhibitory and attention control has only been investigated in patients with ADHD, including comorbidity with CD, finding fronto‐striatal and temporo‐parietal dysfunction. This study investigates differences and commonalities in functional neural networks mediating interference inhibition and attention allocation between medication‐naïve children and adolescents with pure CD and those with pure ADHD. Methods: Event‐related fMRI was used to compare brain activation of 13 boys with non‐comorbid CD, 20 boys with non‐comorbid ADHD and 20 healthy comparison boys during a Simon task that measures interference inhibition and controls for attention allocation, thus tapping into interference inhibition and selective attention networks. Results: During interference inhibition, both patient groups shared reduced activation compared to controls in right superior temporal lobe and in predominantly right precuneus. During the oddball condition, both patient groups showed reduced activation compared to healthy control children in right medial prefrontal lobe. However, only ADHD patients showed a disorder‐specific under‐activation compared to the other two groups in an extensive activation cluster in left inferior prefrontal cortex. Conclusions: This study shows shared dysfunction in both patients groups in right hemispheric temporal and parietal brain regions during interference inhibition and in right dorsolateral prefrontal cortex during attention allocation. Ventrolateral prefrontal dysfunction, however, was specific to ADHD and not observed in patients with CD in the context of attention allocation. The findings suggest that the typically reduced functional activation in patients with ADHD in ventrolateral prefrontal cortex may be specific to the disorder, at least when compared to patients with CD.     

Poor performance in physical education - a risk factor for bully victimization. A case-control study

Aim: Poor social skills are a risk factor for becoming bullied, which could explain why this frequently occurs to children with autism spectrum disorders (ASD) and attention‐deficit hyperactivity disorder (ADHD). Poor social skills tend to coexist with clumsiness. According to a pilot study, poor performance in physical education (PE) was correlated with bully victimization. Methods: Sixty‐nine healthy university students reported performance in PE and bully victimization in childhood. In addition, the participants responded to questionnaires for ADHD and ASDs to assess personality traits related to increased risk for bully victimization. Results: Below average performance in PE was a risk factor of being bullied in school with an odds ratio of 3.6 [95% confidence interval: 1.23–10.5; p = 0.017]. Strong correlations between poor performance in PE and long duration of victimization (p = 0.007) and poor performance in PE and high frequency of victimization (p = 0.008) were found. Autistic traits were related to performance below average in PE. Conclusion: Poor motor skills are a strong risk factor for becoming bullied. Prevention programmes that identify, protect and empower the clumsy children could be an important step to avoid bullying of the most vulnerable children.     

Executive functioning in high-functioning children with autism

Executive functioning was investigated in 34 children (24 boys and 10 girls) with developmental language disorder (DLD) and 21 children (18 boys and 3 girls) with high-functioning autistic disorder (HAD) matched on Full Scale IQ, Nonverbal IQ, age (mean age 9 year, 1 month), and SES. The DLD group had a Verbal IQ that was 10 points higher than the HAD group. These children were given the Wisconsin Card Sorting Test (WCST), the Mazes subtest from the WISC-R, the Underlining test, and the Rapid Automatized Naming test. In addition, these children were given the Vineland Scales of Adaptive Functioning and the Wing Diagnostic Symptom Checklist in order to assess severity of autistic symptomatology. Results indicated that the only significant difference between the two groups on the cognitive tasks was perseverative errors on the WCST; there was no significant difference on total number of categories achieved or total number of errors on the WCST or on the other executive function measures. There was also significant overlap in the scores between the two groups and the difference in perseverative errors was no longer significant when Verbal IQ was partialled out. Executive functioning was strongly related to all IQ variables in the DLD group and particularly related to Verbal IQ in the HAD group. Although there was a relationship in the HAD group between executive functioning and adaptive functioning, as well as between executive functioning and autistic symptomatology, these relationships were generally no longer significant in the HAD group after the variance due to Verbal IQ was accounted for. The results are interpreted to indicate that although impaired executive functioning is a commonly associated feature of autism, it is not universal in autism and is unlikely to cause autistic behaviors or deficits in adaptive function.     

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??Abstract??Objective??To study the GRPR polymorphisms in ADHD children and analyze the sequence of the second exon of GRPR. Methods??The DNA was taken from the periphery blood. The PCR of the second exon of 120 children with ADHD and 126 normal children was sequenced. We used Chi-square test to know difference of genotype and haplotype between ADHD and normal control group?? and among inattention?? hyperactivity and impulsivity compound group. Result??There were TT?? CC and TC polymorphisms in the second exon of GRPR in 661 and 450 sits. There was no difference between ADHD and normal control group??χ2 = 0.30??0.52??1.34??0.30??all P > 0.05??. There was no difference among inattention?? hyperactivity and impulsivity compound group??χ2 = 0.37??0.49??0.63??all P > 0.05??. Conclusion??The research has not proved the relationship between ADHD and the second exon of GRPR.     

Sleep quality in children and adolescents with attention-deficit and hyperactivity disorder

Sleep disturbances are associated with an increased risk of attention-deficit and hyperactivity disorder (ADHD), which can also lead to sleep problems. In this study we aimed to determine the variables that affect the relationship between ADHD and sleep quality. Moreover, we aimed to compare these variables in children and adolescents with ADHD and healthy controls. This cross-sectional study was conducted using a random sample of 122 ADHD patients and 100 healthy children in Turkey. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The risk of impairment in sleep quality was associated with the presence of ADHD (OR: 13.3; 95% CI: 6.1–29.1), the presence of somatic disease (OR: 4.9; 95% CI: 1.9–12.2), and a family history of the psychiatric disorder (OR: 4.2; 95% CI: 1.3–13.1). The PSQI total score was higher in children with parental separation compared to those without parental separation (p=0.006). As the economic level of the participants decreased, the PSQI total score increased significantly (p=0.006). It was determined that combined-type ADHD was associated with impairment in sleep quality more than the other subtypes (p<0.001 and p=0.031, respectively). Our findings show that children with ADHD have significantly more sleep problems than healthy controls and that sociodemographic variables and familial characteristics affect sleep quality in healthy children and children with ADHD.