汉语阅读障碍儿童的认知能力[II]

目的 :进一步探讨汉语阅读障碍 (RD)儿童的认知特点及其认知亚型。方法 :采用韦氏儿童智力量表 (C -WISC)和韦氏记忆量表 (WMS -RC)以及汉语阅读技能诊断测验 (CRSDT)对 172例患儿和 6 1例正常儿童进行诊断与评估。结果 :1 RD儿童在Bannatyne、Kaufman智力模型及ACID公式中各变量成绩均低于对照组 ,在Bannatyne智力模型表现出空间能力 >数序列能力 >言语概念化 >获得性知识 ;Kaufman智力模型中表现为左脑加工能力差于右脑加工。 2 聚类分析表明RD儿童可分为三组亚型。结论 :1 RD儿童存在多方面的认知功能缺陷 ,其左右半球功能不平衡。 2 RD儿童存在三种认知障碍亚型。     

汉语阅读障碍儿童的认知能力[Ⅱ]

目的：进一步探讨汉语阅读障碍（RD）儿童的认知特点及其认知亚型。方法：采用韦氏儿童智力量表（C－WISC）和韦氏记忆量表（WMS－RC（）以及汉语阅读技能诊断测验（CRSDT）对172例患儿和61例正常儿童进行诊断与评估，结果：1．RD儿童在Bannatyne,Kaufman智力模型及ACID公式中各变量成绩均低于对照组，在Bannatyne智力模型表现出空间能力＞数序列能力＞言语概念化＞获得性知识；Kaufman智力模型中表现为左脑加工能力差于右脑加工。聚类分析表明RD儿童可分为三维亚型。结论：1．RD儿童存在多方面的认知功能缺陷，其左右半球功能不平衡。2．RD儿童存在三种认知障碍亚型。     

影响汉语阅读障碍儿童文章阅读眼动特征的认知因素

目的:了解汉语阅读障碍儿童认知加工特征,探讨与文章阅读时异常眼动模式的关系。方法:采用病例对照研究,以19例汉语阅读障碍(reading disorder,RD)儿童和年龄、性别、年级与之匹配的19例正常儿童为对象,用韦氏智力测验测试两组被试的认知加工特征。以汉字短文为靶标进行眼动研究,采用回归分析探讨被试阅读时的眼动指标与韦氏分测验得分的相关关系。结果:①RD儿童的知识、分类、词汇、编码四项测验得分,言语智商、全智商,言语理解因子、注意/记忆因子得分均明显低于对照组(均P<0.05);②词汇、图形拼凑、数字广度、知识四项与儿童文章阅读时的平均注视时间相关,其中图形拼凑(r=0.32)、数字广度(r=0.27)得分与其呈正相关,词汇(r=-0.32)、知识(r=-0.27)与其呈负相关;木块图、知识两个分测验与阅读时平均眼跳幅度相关,其中木块图与平均眼跳幅度呈负相关(r=-0.31),知识与其呈正相关(r=0.23)。结论:汉语阅读障碍儿童智力结构存在不平衡,其知识、分类、词汇、编码及言语理解因子及注意/记忆方面存在缺陷,知觉组织方面无明显缺陷;文章阅读时的异常眼动,可能与其知识面和语词知识广度窄密切相关。     

不同学习障碍亚型儿童的认知功能比较

目的:探讨不同学习障碍亚型儿童的认知缺损特点。方法:采用智力测验、成就测验、教师提名、学业成绩相结合的综合标准甄选学习障碍儿童,在长沙市三所小学随机选取4～6年级共12个班,从中抽取混合型学习障碍儿童23名,数学障碍儿童24名,阅读障碍儿童25名,学习正常儿童24名。采用工作记忆成套测验、中国修订韦氏儿童智力量表(C-WISC)之分类分测验、龚氏非文字智力测验之图形分类、图案接龙、填数型分测验对各组被试进行测试。结果:学习障碍各组工作记忆容量、执行功能、加工速度均显著低于正常组,非文字智力测验之填数型、图案接龙以及韦氏智力测验之分类测验成绩亦显著低于正常组。三个学习障碍组之间比较发现,阅读障碍组在空间后退分测验上得分高于混合障碍组,填数型测验成绩高于数学障碍组和混合障碍组;混合障碍组不一致条件下的Stroop数字计数分数低于阅读障碍组,递加和递减时间长于数学障碍和阅读障碍组,加工速度低于数学障碍和阅读障碍组。结论:不同类型的学习障碍儿童存在某些共同而普遍的认知缺损,学习障碍儿童的认知损害可能是领域一般性的。     

fNIRI技术对汉语阅读障碍儿童工作记忆的研究

目的探讨汉语阅读障碍(RD)儿童工作记忆的脑功能活动特点。方法采用功能性近红外光学成像穴fNIRI雪技术,观测24例儿童(RD组和正常对照组各12例)在系列数字加法测验加工过程中,不同波长下左前额皮层区局部血流量(rCBV)和血氧的变化的差异。结果实时记录结果显示,①RD组儿童各年级的测验成绩显著低于正常对照组(P<0.01);②在完成深、浅加工过程中,两组儿童左前额叶各个区域的血流量均呈增加趋势,并且深加工的血流量增加量均显著大于浅加工水平(P<0.01);③两组儿童在完成深、浅加工时,其左前额叶不同检测区域的激活强度均依次为2>3>1>4。与对照组相比,RD儿童的激活范围和强度均明显减弱(P<0.01)。结论左前额叶参与儿童工作记忆的加工作业;RD儿童存在短时记忆信息处理能力的缺陷;RD儿童可能存在脑局部血流代谢异常和脑功能障碍;fNIRI技术在汉语RD儿童大脑高级认知研究中具有重要的应用价值。     

Tourette综合征的神经心理综合研究

为了解Ｔｏｕｒｅｔｅ综合征（ＴＳ）的神经心理特点，本研究采用中国修订的韦氏儿童智力量表、韦氏儿童记忆量表、儿童用艾森克个性问卷和Ａｃｈｅｎｂａｃｈ儿童行为量表，对３９例（未用药组２２例，用药组１７例）７～１４岁ＴＳ患儿的神经心理功能进行了测试，并与１８例正常对照组比较。结果表明：ＴＳ患儿智力测验和记忆测验中的背数、译码和视觉再生分测验量表分低于对照组。其个性测验中的神经质和精神质量表Ｔ分高于对照组，掩饰性量表Ｔ分低于对照组。其行为量表总分高于对照组。用药组的记忆商、理解记忆和累加分测验量表分低于未用药组。提示ＴＳ患儿存在着不同程度的神经心理缺陷。氟哌啶醇等药物对ＴＳ患儿的记忆功能可能产生一定的影响，但对智力、个性和行为无明显影响。     

ADHD儿童脑电生物反馈治疗前后认知功能的比较

目的 :探讨脑电生物反馈治疗 2 0次对注意缺陷多动障碍 (ADHD)患儿认知功能的影响。方法 :对 3 2例符合DSM -IV诊断标准 ,年龄 7-15岁的ADHD患者进行脑电生物反馈治疗 ,治疗前后进行韦氏记忆、数字划消、Stroop、CPT、动态学习能力测试 (DLM)和韦氏智力测试的注意记忆因子测试。结果 :治疗后较治疗前在短时记忆 (韦氏记忆测查中视觉再生、联想记忆、触觉记忆 )、记忆商数 (MQ)、持续注意力 (数字划消中漏划数 ,DLM漏按数 )均有明显改善 (P <0 0 5 ) ;冲动性 (DLM误按数 )下降 (P <0 0 5 ) ;DLM分类提高 (P <0 0 5 ) ;认知加工速度 (Stroop测试色测验时间 )部分改善。结论 :脑电生物反馈治疗 2 0次后 ,视觉短期记忆、认知加工速度、冲动性以及持续注意力提高。听觉短期记忆、言语性工作记忆及选择性注意力的改善不明显     

汉语阅读障碍儿童语言能力缺陷的初步探讨

目的:探讨汉语发育性阅读障碍儿童存在的语言能力缺陷。方法:采用学习困难儿童筛查量表(PRS)、韦氏智力测验(WISC-R)和儿童读写能力家长问卷,从广州市某小学8-12岁儿童中,筛查出13位发育性阅读障碍的儿童,按年龄、性别、年级1∶1匹配正常对照组,应用语音技能、快速命名和词形加工测验等对两组儿童的语言能力进行测试。结果:阅读障碍组在语音技能测验中的辨声母、辨韵母、语音合成三项测验的正确数均低于正常儿童(5.8±2.1/8.8±1.2,5.3±2.7/7.0±2.6,3.7±2.6/5.8±2.7,t=-4.696、-2.690、-0.555,P<0.05);快速命名测验的两项分测验-颜色和数字快速命名测验时间均长于正常儿童(37.9±8.6/28.0±4.5,19.5±2.7/15.6±3.7,t=4.348、3.048,P<0.05);而词形加工测验中,汉字命名测验成绩明显低于正常儿童(31.8±4.6/35.7±2.8,P<0.05),辨真假字两组的成绩无显著差异(P>0.05)。结论:汉语阅读障碍儿童存在语音意识缺陷和快速命名缺陷等语言能力缺陷。     

共患对立违抗性障碍的注意缺陷多动障碍儿童的认知特点研究

目的:探讨共患对立违抗性障碍(ODD)的注意缺陷多动障碍(ADHD)儿童的认知功能特点.方法:以单纯ADHD ODD、单纯ADHD和正常儿童各36例(性别、年龄与ADHD亚型组间匹配)为研究对象,采用龚耀先修订的韦氏儿童智力量表、韦氏记忆量表、数字划消、Stroop测验和瑞文标准推理测验对其智力、记忆力、注意力水平及执行功能进行评定.结果:两病例组的常识、类同、译码、言语智商、操作智商、全量表智商、A因子、C因子、经历定向、心智、再生、触觉、长时记忆、短时记忆、记忆商、瑞文标准推理测验标准分、Stroop测验A完成时间、C完成时间和总完成时间的测验成绩与正常对照组的差异具有显著性,两病例组间差异无显著性;正常组数字划消测验总分有显著高于两病例组(F＝2.521,P＝0.093)及平均失误率显著低于两病例组的趋势(χ2＝5.150,P＝0.076);ADHD组和正常对照组在算术、数字广度、积木、B因子、Stroop测验B完成时间和D完成时间上的差异具有显著性;ADHD ODD组的瑞文标准推理测验标准分有优于ADHD组的趋势(Z=-1.674,P=0.094).结论:伴或不伴ODD的ADHD儿童有着相似的认知模式,如扩大样本量,可能发现共患病组在某些认知功能上与纯ADHD组的差异.     

韦氏记忆量表中国修订本在儿童中的应用

韦氏记忆量表系列是临床心理评估中被广泛应用的评估工具之一.本文试图对近年来韦氏记忆量表中国修订本在国内儿童中的应用情况进行简单总结.发现WMS-RC在儿童中主要应用于临床诊断和疗效评估等,对正常儿童的相关研究较少;ADHD和学习障碍儿童总的记忆功能受到损害,主要表现在短时记忆和长时记忆方面,而TS儿童总的记忆功能处于正常偏低水平,但是短时记忆受损;在临床上,WMS-RC与韦氏智力量表、瑞文测验、WCST、数字划消、Stroop测验联合应用较多.     

Predictive Accuracy of the Wide Range Assessment of Memory and Learning in Children With Attention Deficit Hyperactivity Disorder and Reading Difficulties

The predictive accuracy of the Wide Range Assessment of Memory and Learning (WRAML; Sheslow & Adams, 1990) over and above more standardized diagnostic tools in children with attention deficit hyperactivity disorder (ADHD) and reading disabilities (RD) was examined. Fifty-three children with ADHD, 63 with RD, 63 with ADHD-RD, and 112 normal comparison children were administered the WRAML, the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler, 1991), the Achenbach (1991) Child Behavior Checklist (CBCL), and the Woodcock-Johnson Psycho-Educational Battery-Revised (WJ-R; Woodcock & Johnson, 1989). Results of a series of discriminant function analyses revealed that the academic, intellectual, and behavioral measures could correctly classify 73.1% of children, but the WRAML subtests alone were able to correctly classify only 58.5% of participants. Combining all of the memory, academic, intellectual, and behavioral measures resulted in 77.5% of cases being correctly classified. These results suggest that the use of a measure of memory functioning such as the WRAML did not significantly improve the predictive accuracy of a diagnosis of ADHD, RD, or both over and above more standard diagnostic academic, intellectual, and behavioral measures.     

Visual versus verbal mnemonic training effects on memory‐deficient and language‐deficient subgroups of children with reading disability

This study compared the effectiveness of two different memory strategies for memory‐deficit, reading‐disabled (RD) children with different cognitive patterns. Forty learning‐disabled children 7 to 13 years old were divided into two groups based on whether they showed general language disorder (GLD) or specific memory disorder (SMD) without a language deficit. Each child was then given training in one of two memory strategies: visual mapping or cumulative verbal rehearsal. Subsequent memory performance of the two RD subgroups was compared over the two treatment conditions. There was a significant interaction in the effectiveness of the two treatments for the two groups’ memory performance after treatment. GLD children made significantly greater gains from pretesting to posttesting on the visual mapping treatment than on the cumulative verbal rehearsal treatment, whereas the SMD children demonstrated significantly greater gains on cumulative verbal rehearsal than on visual mapping. The findings suggest that there is a relation between an RD child's cognitive strengths and deficits and ability to employ a given memory strategy effectively.     

躯体形式障碍的事件相关电位及神经认知功能研究

目的:探讨躯体形式障碍的神经认知功能障碍的特点。方法:对95例躯体形式障碍病人采用事件相关电位P300及韦氏智力量表与对照组比较。结果:躯体形式障碍组P300电位成分中N2、、P3潜伏期延长,P3波幅降低,与对照组比较存在显著性差异(t=2.86,3.89,8.66,P均<0.01)。结论:提示躯体形式障碍存在广泛的神经认知功能障碍。     

难治性强迫症与非难治性强迫症认知功能比较研究

目的:比较难治性强迫症与非难治性强迫症认知功能差异。方法:采用韦氏记忆量表(WMS)、数字划销测验、威斯康星卡片分类测验(WCST)评估51例难治性强迫症和59例非难治性强迫症的记忆、注意、执行功能。结果:难治性强迫症的长时记忆较非难治性强迫症差,而两组其它记忆因子分及记商、数字划销测验、威斯康星卡片分类测验分差异无统计学意义。结论:难治性强迫症与非难治性强迫症认知功能无显著性差异。     

Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: in search of the common deficit

Measures of component reading and language skills, executive functions, and processing speed were administered to groups of children with attention deficit hyperactivity disorder (ADHD; n = 113), reading disability (RD; n = 109), both RD and ADHD (n = 64), and neither RD nor ADHD (n = 151). Groups with RD exhibited pronounced deficits on all measures of component reading and language skills, as well as significant weaknesses on measures of verbal working memory, processing speed, and response inhibition. Groups with ADHD exhibited weaknesses on all response-inhibition and processing speed tasks and were impaired on some measures of component reading skills and verbal working memory. The group with comorbid RD and ADHD exhibited the combination of the deficits in the RD-only and ADHD-only groups, providing evidence against the phenocopy and cognitive subtype hypotheses as explanations for the co-occurrence of RD and ADHD. Slow and variable processing speed was characteristic of all 3 clinical groups, suggesting that measures of this domain may be useful for future studies that search for the common genes that increase susceptibility to RD and ADHD.     

Further antinociceptive effects of myricitrin in chemical models of overt nociception in mice

Neurocognitive de?cits are recognized as core features of schizophrenia. The aim of this study was to compare the cognitive performance of antipsychotic, drug-naive patients with first-episode schizophrenia (FES patients) to their healthy siblings and to healthy controls from the Han Chinese population for exploring potential endophenotypes for the early detection of schizophrenia. A battery of cognitive assessment tools was used to measure seven cognitive domains in matched groups consisting of 56 subjects each. Cognitive tests included the grooved pegboard test (GPT), the category fluency test (CFT), the trail making test A (TMT-A), the Wechsler memory scale-III spatial span test (WMS-III SST), the Hopkins verbal learning test-revised (HVLT-R), the brief visuospatial memory test-revised (BVMT-R), the paced auditory serial addition test (PASAT), and the Wisconsin card sorting test-64 cards version (WCST-64). The performances of FEP patients were inferior to normal controls on all neuropsychological tests, while siblings were lower than healthy controls in many of the same tasks. Patients’ performances were lower than siblings’ on all tests except for the CFT, the WMS-III SST backward test, and four subtests of the WCST-64. Our data suggest that FEP patients exhibited pronounced impairment of fine motor skills, speed of processing, attention, verbal memory, visual memory, and executive function, while siblings exhibited deficits intermediate between those of schizophrenic patients and the control group. Semantic fluency function and executive function may be potential endophenotypes for the early diagnosis of schizophrenia.