伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿认知功能损害的前瞻性研究

目的 探讨伴中央颞区棘波的儿童良性癫痫（benign childhood epilepsy with centrotemporal spikes，BECT）共患注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）患儿与单纯BECT患儿或单纯ADHD患儿认知功能损害的差异。 方法 前瞻性选取初次诊断的BECT共患ADHD患儿80例、BECT患儿91例及ADHD患儿70例为研究对象，并选取同期儿童保健门诊行健康体检的同龄儿童70例为健康对照组，采用事件相关电位P300、韦氏儿童智力量表、视听整合连续测试3种评估方法，分别测定并比较各组儿童各指标的差异。 结果 与健康对照组比较，BECT+ADHD组、BECT组、ADHD组P300潜伏期延长、波幅降低且言语理解指数（verbal comprehension index，VCI）、知觉推理指数（perceptual reasoning index，PRI）、工作记忆指数（working memory index，WMI）、加工速度指数（processing speed index，PSI）、总智商（full scale IQ，FSIQ），以及听觉反应控制商数（auditory response control quotient，ARCQ）、视觉反应控制商数（visual response control quotient，VRCQ）、综合反应控制商数（full response control quotient，FRCQ）、听觉注意力商数（auditory attention quotient，AAQ）、视觉注意力商数（visual attention quotient，VAQ）、综合注意力商数（full attention quotient，FAQ）分值降低（P<0.05）；与BECT组比较，BECT+ADHD组P300潜伏期延长、波幅降低且VCI、PRI、WMI、PSI、FSIQ及FRCQ分值降低（P<0.05）；与ADHD组比较，BECT+ADHD组P300潜伏期延长、波幅降低且VCI、PRI、FSIQ及ARCQ、FRCQ、AAQ分值降低（P<0.05）。 结论 BECT共患ADHD患儿，与单纯BECT或单纯ADHD患儿比较，其认知功能损害领域基本一致，但有些领域的损害程度更加严重。

Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder: a prospective study

Objective To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone. Methods A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups. Results Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (P<0.05). Compared with the BECT group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, WMI, PSI, FSIQ, and FRCQ (P<0.05). Compared with the ADHD group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, FSIQ, ARCQ, FRCQ, and AAQ (P<0.05). Conclusions Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.