脑电生物反馈治疗注意缺陷多动障碍疗效分析

目的评价脑电生物反馈治疗儿童注意缺陷多动障碍的疗效。方法对2008-03~2010-03在郑州市儿童医院心理科确诊注意缺陷多动障碍的36例儿童采用脑电生物反馈治疗40次,治疗前后分别进行视听整合连续执行测试,对比综合尺度控制商数、综合尺度注意力商数、多动商数,且治疗前后进行Conners简明症状问卷对比。同期在我科确诊ADHD但未接受任何治疗的30例ADHD儿童为对照组,研究组接受40次脑电生物反馈治疗后与对照组进行视听整合连续执行测试及Conners简明症状问卷对比。结果 36例ADHD儿童经脑电生物反馈治疗40次后,各项观察指标均有明显改善,经统计学处理,差异有统计学意义。且研究组与对照组对比,各项观察指标差异均有统计学意义。结论脑电生物反馈治疗是ADHD综合治疗中一种有效的治疗方法,值得临床推广。     

盐酸哌甲酯控释片联合生物反馈治疗注意缺陷多动障碍患儿对临床症状、脑电θ/β比值的影响

目的:探讨盐酸哌甲酯控释片联合生物反馈治疗注意缺陷多动障碍(ADHD)患儿对临床症状、脑电慢波(θ)/快波(β)比值的影响。方法:选取在我院诊治的ADHD患儿86例作为研究对象,以随机数字表法简单随机分组为对照组与研究组各43例,对照组给予脑电生物反馈治疗,研究组在同样治疗的基础上加予盐酸哌甲酯控释片。采用中文版注意缺陷多动障碍SNAP-Ⅳ评定量表(SNAP-Ⅳ)评估临床症状,比较两组临床症状、脑电θ/β比值以及临床治疗疗效。结果:研究组的临床治疗疗效优于对照组(Z=3.263,P=0.001),且研究组的总有效率为86.05%,明显高于对照组的65.12%(P0.05)。治疗后两组多动/冲动、注意力不集中、对立违抗评分均较治疗前降低(P均0.05),且研究组明显低于对照组(P均0.05)。研究组治疗2周、4周、6周、8周脑电θ/β比值均降低(P均0.05),对照组治疗4周、6周、8周脑电θ/β比值均降低(P均0.05),研究组在治疗2周、4周、6周、8周脑电θ/β比值明显低于对照组(P0.05或P0.01)。结论:盐酸哌甲酯控释片联合生物反馈治疗应用于治疗ADHD患儿,可有效改善临床症状、脑电波波形,治疗疗效显著。     

综合干预对注意缺陷多动障碍患儿的远期疗效分析

目的探讨综合干预和哌醋甲酯治疗注意缺陷多动障碍患儿(ADHD)的远期疗效。方法将门诊90例ADHD患儿随机分为观察组(药物治疗联合生物反馈、感觉统合训练)与对照组(单用药物组),多动症状控制后停止治疗,半年后评估。结果观察组10例(22.2%)患儿重现多动症状,对照组21例(46.7%)患儿重现多动症状;两组学习成绩、评分因子冲动-多动、焦虑、多动指数、瑞文智商(IQ)、记忆商(WMS)、知觉组织因子商(PoIQ)、记忆/注意力因子商(M/CIQ)比较有显著性差异。结论综合干预对ADHD的远期疗效较好。     

注意力缺陷多动障碍儿童脑神经特点及生物反馈 干预的研究进展

注意力缺陷多动障碍（ADHD）是儿童期最常见的精神和行为障碍之一，大量证据表明 ADHD是一个涉及大脑的生物学疾病。目前对ADHD儿童的干预主要以药物以及行为疗法为主。文章 结合国外对ADHD儿童的脑研究——运动控制以及与反应时相关的神经系统，进一步探讨脑电生物反馈 干预对ADHD儿童脑神经以及自我控制的影响。     

脑电生物反馈治疗儿童ADHD研究进展

综合国内外文献，对脑电生物反馈治疗儿童ADHD原理、方法、现状和前景进行综述。     

脑电生物反馈对慢性精神分裂症迟发性运动障碍治疗效果的初步研究

目的 了解脑电生物反馈治疗对慢性精神分裂症迟发性运动障碍(TD)患者的治疗效果. 方法 运用脑电生物反馈治疗对34名慢性精神分裂症TD患者进行治疗,共3个月.记录其脑电活动特征,并用异常不自主运动量表(AIMS)评估. 结果 脑电生物反馈治疗慢性精神分裂症TD患者的显效率为67.7%,治疗后AIMS评分下降[基线:(8.9±2.7)分,治疗后:(2.8±1.4)分,t=18.34,P<0.001].患者C3、C4、P3、P4点β频段的脑电功率值升高.结论 慢性精神分裂症迟发性运动障碍患者某些频段脑电功率值存在异常,通过脑电生物反馈治疗让患者训练选择性地强化某些频段的脑电波,能够减轻患者的不自主运动症状.     

哌甲酯联合脑电生物反馈治疗共患特定阅读障碍的注意缺陷多动障碍对照研究

目的：评估哌甲酯联合脑电生物反馈治疗共患特定阅读障碍的注意缺陷多动障碍（ADHD）患者的临床疗效。方法：40例患儿按门诊顺序分为联合组（哌甲酯联合脑电生物反馈治疗）和单一组（单一哌甲酯治疗）各20例。疗程20周。于治疗前、治疗10周和20周分别进行Conners多动指数（CHI）及儿童汉语阅读障碍量表（DCCC）评定。结果：两组CHI评分治疗后均较治疗前显著降低（P〈0.01）,两组间比较,差异无统计学意义（P〉0.05）。联合组DCCC评分治疗后显著低于治疗前（P〈0.05）,单一组DCCC评分治疗前后比较差异无统计学意义（P〉0.05）;与单一组比较,差异有统计学意义（P〈0.05）。结论：哌甲酯联合脑电生物反馈不仅能改善ADHD核心症状,而且能提高阅读能力,有效治疗共患特定阅读障碍。     

注意缺陷多动障碍患儿哌甲酯治疗前后的脑诱发电位研究

目的 探讨注意缺陷多动障碍(ADHD)患儿4种脑诱发电位指标及其治疗前后的特点.方法 应用美国Nicolet Spirit脑诱发电位仪,记录37例ADHD患儿(ADHD组)和30名正常儿童(正常对照组)的事件相关电位P300、失配性负波(MMN)、关联性负变(CNV)和脑干听觉反应(ABR),对其中31例ADHD患儿于哌甲酯(10～15 mg口服)治疗4个月后再次检测.结果 (1)与正常对照组比较,ADHD组P300-N2靶潜伏期长,P300-P3靶波幅低;ABR-波Ⅲ绝对潜伏期短,绝对波幅波V低;MMN潜伏期长,波幅高;CNV-M2波幅低,反应时间(RT)长;差异均有统计学意义(P＜0.05～0.01).(2)哌甲酯治疗4个月后,ADHD组随多动症状改善,P300-N2靶潜伏期缩短[治疗前后分别为(278±18)ms和(261±16)ms,P＜0.01],P3靶波幅升高[分别为(2.8±1.8)μV和(4.2±1.9)μV,P＜0.05];MMN潜伏期缩短[分别为(208±24)ms和(193±24)ms,P＜0.05];CNV-M1波幅升高[分别为(10.3±5.0)μV和(14.3±4.1)μV,P＜0.01];RT缩短[分别为(478±158)ms和(349±144)ms,P＜0.01],但ABR治疗前后的差异无统计学意义(P＞0.05).结论 ADHD患儿的P300,MMN,CNV和ABR 4种脑电诱发电位较正常对照组均有改变;治疗后随多动症状的改善,与认知功能有关的P300,MMN和CNV 3项指标亦有相应的改善.     

肌电生物反馈疗法在重症手足口病患儿康复中的对照研究

目的观察肌电生物反馈疗法在重症手足口病患者康复中的作用。方法将36例重症手足口病伴急性迟缓性瘫痪患儿随机分为肌电生物反馈治疗组和对照组。2组均予运动疗法、等速肌力训练、引导式教育、普通针刺等治疗,肌电生物反馈治疗组加用MyoTrac肌电生物反馈系统。分别在治疗前、治疗后1个月对患儿进行被动踝关节关节活动度(ROM)测量、胫骨前肌表面肌电检测。结果治疗后2组踝关节ROM增加、自主收缩时胫骨前肌肌电积分(iEMG)均较治疗前提高,差异有统计学意义(P0.05);治疗后2组间对比,肌电生物反馈治疗组患儿踝关节ROM及胫骨前肌的iEMG均优于对照组(P0.05)。结论肌电生物反馈疗法能显著提高重症手足口病伴急性迟缓性瘫痪患儿的下肢运动功能,可作为该类患儿下肢功能康复的一种有效治疗方法。     

肌电生物反馈配合悬吊治疗对痉挛型脑性瘫痪患儿下肢肌力和H反射的影响

目的研究肌电生物反馈配合悬吊治疗对痉挛型脑性瘫痪患儿下肢肌力和H反射的影响。方法选取2016-08—2017-08河南省省立医院98例痉挛型脑性瘫痪患儿,采用单双号法随机平均分为对照组与联合组,均给予运动训练、推拿、脑循环等常规疗法,对照组加用悬吊训练,联合组加用悬吊训练+肌电生物反馈疗法,治疗12周,比较2组治疗效果。结果治疗后,2组儿童改良巴氏指数量表(ADL)评分、粗大运动功能量表(GMFM-88)D区和E区评分显著提升(P0.05),改良Ashworth痉挛等级量表(MAS)评分、足背屈角均显著降低和综合痉挛评分量表(CSS)评分均显著降低(P0.05),且联合组变化幅度大于对照组(P0.05);治疗后,联合组H反射潜伏期显著长于对照组(P0.05),波幅和最大H波/最大M波(H/M值)显著小于对照组(P0.05)。结论肌电生物反馈联合悬吊运动治疗痉挛型脑瘫患儿,可明显改善其日常生活能力、下肢运动能力、肌痉挛症状、关节活动度、肌张力和收缩性,效果显著,值得推广。     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Bibliography of officers of department of mental hygiene

Psychiatric Quarterly -