儿童抑郁障碍的执行功能特点

执行功能是指在完成复杂的认知任务时,对各种认知过程进行协调,以保证认知系统以灵活、优化的方式实行特定目标的一般性控制功能。在有关儿童抑郁障碍患者的执行功能特点的神经心理学特点研究中,国外大都关注于持续性注意、选择性注意,抑制反应,定势转换功能,语言工作记忆和语言流利度等相关执行功能的问题,研究结果差异较大,而国内目前这方面研究尚未广泛开展;在有关神经影像学研究中,国内外研究发现儿童抑郁障碍患者存在包括前额叶,眶额叶,前扣带回的执行功能相关脑区异常,推测这些异常可能是其执行功能受损的生理基础。本文提出了未来该领域可能的研究方向。     

青少年媒体多任务操作对认知功能的影响

媒体多任务操作成为青少年新型媒体使用行为, 对认知功能负面影响逐渐受到关注。该文通过查阅与总结国内外相关文献, 对青少年媒体多任务流行现状和评定方法及其对工作记忆、注意力、抑制控制等认知功能的影响进行综述, 探讨可能的脑机制, 为促进青少年身心健康发展提供科学依据。     

注意缺陷多动障碍儿童的工作记忆和反应抑制现状

注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的主要症状是注意力不集中、多动和冲动,其对患者的学习、工作和生活均会产生严重的影响。认知理论认为执行功能障碍,尤其是其核心成分反应抑制和工作记忆障碍,是引起ADHD患者其他障碍的基础。本文从三个方面:反应抑制、工作记忆以及二者协同作用关系的研究入手,系统论述了ADHD患者在反应抑制和工作记忆方面所存在的问题,并为未来研究提出了努力方向。     

抽动障碍患儿的执行功能缺陷

抽动障碍(TD)患儿执行功能的多种成分存在缺陷,表现在工作记忆能力下降,持续性注意和反应抑制、认知灵活性、思维组织性、计划性等方面存在障碍,非语言能力和社交功能损害等。TD患儿如果伴有注意缺陷多动障碍(ADHD)、强迫障碍(OCD)以及孤独症谱系障碍(ASD)等共患病,其执行功能缺陷常常更严重。TD患儿执行功能的某些缺陷与其抽动症状的严重性相关,完整的执行功能发展与抽动症状的缓解过程有关,通过改善TD患儿的执行功能缺陷可以间接地减少TD患儿的抽动症状。     

注意缺陷多动障碍儿童执行功能的评估与干预

ADHD儿童认知障碍的主要特征之一是执行功能损害,涉及包括前额叶皮层在内的特定脑区域及多层级脑网络异常。执行功能按照功能性分为冷-热两方面：冷执行功能损害主要表现于反应抑制、工作记忆以及认知灵活性等;热执行功能损害通常涉及延迟满足、赏罚相关决策、自我调节及情绪调节等。ADHD儿童的执行功能评估应基于可信范式进行文化适应性调整。临床干预不能单一聚焦于冷执行功能,需关注儿童的身体发育以及热执行功能(情绪社会方面)的发展进程,结合其他共病与心理状况,进行全面的动态随访与干预,以达到最佳的长期疗效。     

儿童行为抑制测验及行为训练

行为抑制是执行功能的核心内容,是为完成任务而对无关信息或行为的抑制。其早期缺陷易导致社会性交流障碍,工作记忆、情绪调节、注意力等执行功能问题。随着对行为抑制认识的逐渐深入,出现了一系列成熟的测验方法,包括Stroop任务、侧抑制、Navon任务、Simon任务以及多源冲突任务等,这些行为抑制测验方法在行为障碍的诊断中发挥了重要作用。对正在发育的儿童实施行为抑制训练可促进执行功能发展。行为抑制的早期健康发展可有效提高儿童的自控力和注意力,从而改善学习能力。了解有关行为抑制的测验方法及行为训练,对促进儿童执行功能发展有重要作用。     

童年不良经历青少年执行功能现状及影响因素研究进展

童年不良经历(ACEs)作为全球性的公共卫生问题，可严重损害青少年的执行功能，导致抑制控制失调、工作记忆受损和认知灵活性障碍。执行功能失常可显著增加青少年精神病理学和健康危险行为的风险，从而给自身和社会造成巨大的经济负担。本研究通过对ACEs青少年的执行功能现状及其影响因素进行综述，旨在为ACEs青少年执行功能的改善和提高提供参考依据，促进其身心健康发展。     

精神分裂症认知功能障碍患者工作记忆研究进展

工作记忆的损害被认为是精神分裂症认知功能障碍的核心,因此,以工作记忆为切入点,对其进行深入研究有助于对精神分裂症进行风险评估、疾病监测及为患者预后提供充分的指导。该文就近年来有关工作记忆的相关评估方法、新的技术应用及有关药物的使用等情况进行归纳总结,旨在对精神分裂症认知功能障碍有较为充分的了解,为临床诊治提供思路。     

运动干预对注意缺陷多动障碍儿童青少年执行功能影响的Meta分析

目的 系统评价运动干预对注意缺陷多动障碍(ADHD)儿童青少年执行功能的改善效果，为开拓ADHD的非药物治疗手段提供依据。方法 计算机检索Pubmed、Web of Science、Cochrane Library、Embase、中国知网、万方数据库中有关运动干预对ADHD儿童青少年执行功能影响的文献，检索期限为自建库至2022年11月8日；采用Rev Man 5.4进行Meta分析，计算效应量合并、异质性检验、敏感性分析和亚组分析，采用Stata 15.0中的Egger′s检验进行文献发表偏倚检验。结果 共纳入15篇文献，包括592名研究对象。Meta分析显示：运动干预可改善ADHD儿童青少年的抑制控制(SMD=0.54,95%CI:0.23～0.86,P<0.001)、工作记忆(SMD=0.61,95%CI:0.29～0.93,P<0.001)和认知灵活性(SMD=0.66,95%CI:0.23～1.09,P=0.003)。亚组分析显示：1)中等强度运动对抑制控制和工作记忆均达到中等效应量的改善(P<0.05),中至高强度运动对认知灵活性的改善为中等效应(P<...     

精神分裂症患者与其一级亲属的社会认知功能比较研究

目的：对比分析精神分裂症患者与其一级亲属在社会认知功能方面存在的差异。方法随机选取100名精神分裂患者和该100名患者一级亲属,调查他们的一般资料,并进行威斯康星卡片分类测验、持续操作测验和韦氏成人记忆量表修订版的测评。通过 t 检验和卡方检验比较患者组和亲属组认知功能的差异。结果无论是亲属组还是患者组,均有超过一半的人存在工作记忆-执行功能缺陷,但两组存在工作记忆-执行功能缺陷的概率差异有统计学意义,患者组存在工作记忆-执行功能缺陷的比例高于亲属组(χ2=4.582,P =0.032);而两组人群的注意障碍(χ2=1.496,P =0.221)和记忆障碍的差异无统计学意义(χ2=3.380,P =0.066)。结论与精神分裂症患者相比,其一级亲属存在工作-执行功能缺陷的比例较低,但存在同样风险的注意障碍和记忆障碍。     

The Role of BMI,Body Fat Mass and Visceral Fat in Executive Function in Individuals with Overweight and Obesity

Evidence accumulated to date suggests that excess weight in the adult population is associated with a wide range of impairments in executive function. However, most studies have only examined the influence of body mass index (BMI) on the cognitive function of individuals with overweight and obesity. This study examined the potential associations of markers of adiposity (BMI, body fat, and visceral fat) with five domains of executive function including cognitive flexibility, inhibition, monitoring, planning, and working memory in a sample of 87 adult with overweight (n = 34) and obesity (n = 53). The results show that obese people had poorer working memory than those with overweight. After controlling for educational levels and physical activity, the results suggest that neither the waist–hip index not visceral fat were associated with cognitive function. In overweight, body fat was negatively associated with executive components of inhibition (p = 0.05) and monitoring (p = 0.02). In the obesity subgroup, body fat was negatively associated with inhibition (0.02) and working memory (0.04). The results provide evidence of the importance of adiposity for cognitive function. The implications for understanding the influence of markers of adiposity in adults with overweight and obesity are discussed.     

Relationship between dieting to lose weight and the functioning of the central executive

The study investigated the impact of weight-loss dieting on the four identified functions of the central executive of working memory: dual-task performance, random generation, task switching and activation of long-term memory. Participants were 32 female current dieters and 32 female non-dieters who completed four well-established cognitive tasks designed to tap each specific function. Participants also completed tasks designed to load on the phonological loop and visuo-spatial sketch pad working memory systems, as well as self-report measures of depressed affect and preoccupying cognitions. Dieters performed more poorly than non-dieters on all central executive measures except random generation. These dieting-related differences were most evident on moderately complex trials, and were partially mediated by preoccupying thoughts about food, weight and body shape, but not by BMI or depressed affect. It was concluded that weight-loss dieting has a relatively global impact on central executive functioning and thus has wide-ranging cognitive consequences.     

大学生儿童期不良经历近期生活事件与执行功能的关系

探讨儿童期不良经历和近期生活事件对大学生执行功能的影响,为相关领域的干预工作提供参考.方法 采用方便抽样方法,选取济南市烟台市658名高校学生,使用儿童期不良经历(Adverse Childhood Experiences,ACEs)、青少年生活事件量表(Adolescent Self-Rating Life Events Check List,ASLEC)筛选被试,用E-prime 2.0软件设计执行功能3个子系统的实验.结果大学生ACEs发生率为44.8%.ACEs、生活事件与抑制能力的相关性具有统计学意义(r值分别为0.50,0.47,P值均<0.01).ACEs组在任务转换实验中的反应时大于非ACEs组(t=-2.55,P<0.05).与生活事件低分组相比,高分组的抑制能力、工作记忆1-back、任务转换的平均反应时均较长(t值分别为3.16,2.45,2.46,P值均<0.01).ACEs、生活事件对抑制能力的逐步回归分析结果表明,ACEs、生活事件对抑制能力的预测均达到46%;ACEs与生活事件对抑制能力的回归有统计学意义,对抑制能力的共同预测力达到56%.结论 大学生的儿童期不良经历发生率较高,儿童期不良经历、生活事件均对大学生执行功能造成不良影响.     

铁缺乏与儿童执行功能的研究进展

铁缺乏(iron deficiency,ID)和缺铁性贫血(iron deficiency anemia,IDA)是全球一种常见的单一营养缺乏症,尤其多见于孕妇及婴幼儿。早期缺铁通过影响大脑神经代谢、神经递质及髓鞘化而影响儿童的神经认知功能和行为,包括以工作记忆、抑制性控制、认知灵活度为主要成分的执行功能的发展。执行功能是高级认知功能,其发展在儿童出生后1~2年时达高峰,可能存在着铁依赖的发育关键期。了解儿童执行功能的发展,并弄清其铁依赖的发育关键期,对制定早期预防铁缺乏的公共卫生策略具有重要的意义。     

妊娠相关焦虑对学龄前儿童执行功能的影响及性别差异

  目的  探讨母体妊娠相关焦虑对子代学龄前执行功能(EFs)的影响及性别差异,以期针对性优化子代生命早期发育环境。  方法  选取中国安徽出生队列2008年10月—2010年10月在安徽省马鞍山市妇幼保健院孕早期建卡的孕妇,收集孕妇一般情况和妊娠相关焦虑情况。对队列内的3 556名3~5岁儿童进行随访,收集儿童相关特征,采用《学龄前儿童执行功能评定量表》(父母版)评价其执行功能。  结果  与对照组相比,仅孕早期存在妊娠相关焦虑与学龄前男童工作记忆、计划/组织功能和总执行功能(GEC)异常风险有关[OR 值(95%CI)分别为 1.40(1.06~1.85),1.64(1.06~2.54),1.89(1.27~2.82)];孕早、晚期同时存在妊娠相关焦虑与学龄前男童抑制、工作记忆、计划/组织功能和 GEC 异常风险有关[ OR值(95%CI)分别为 2.60(1.45~4.67),2.45(1.69~3.57),2.23(1.28~3.88),3.27(2.03~5.28)]。 仅孕早期存在妊娠相关焦虑与学龄前女童抑制和工作记忆异常有关[OR 值(95%CI)分别为 1.79(1.13~2.83),1.45(1.07~1.98)];仅孕晚期存在妊娠相关焦虑与学龄前女童抑制功能异常有关[OR 值(95%CI)= 2.26(1.17~4.38)];孕早、晚期同时存在妊娠相关焦虑与学龄前女童抑制和工作记忆功能异常风险有关[OR 值(95%CI)分别为 2.45(1.40~4.28),2.02(1.35~3.01)]。  结论  妊娠相关焦虑显著影响子代学龄前儿童执行功能,并存在剂量反应关系。妊娠相关焦虑在男童中主要影响工作记忆、计划/组织功能和总执行功能,在女童主要影响其工作记忆和抑制功能。     

Dairy consumption and working memory performance in overweight and obese adults

All individuals will experience some degree of cognitive impairment in their later years. Diet is one readily modifiable factor that may influence cognitive function and psychological well-being. Very little research has considered the potential role of dairy foods in modulating cognitive and psychological functions. The objective of this study was to determine the effect of a high intake of reduced fat dairy food on cognitive performance. Overweight adults with habitually low dairy intakes (< two serves/day) were recruited for a 12 month crossover dietary intervention trial and randomised to a high (four serves/day) or low (one serve/day) intake of reduced fat dairy, crossing over to the alternate diet after 6 months. Participants were tested at the end of each 6 month diet period on multiple measures of cognitive performance, including memory, information processing speed, executive function, attention and abstract reasoning. In 38 participants who completed the trial (average age=52±2 years; BMI=31.5±0.8 kg/m(2)), spatial working memory performance was marginally better following 6 months of the high dairy diet compared with the low dairy diet. Increasing the dairy intake of habitually low dairy consumers may have the potential to improve working memory.     

The effect of physical activity interventions on executive functions in children with ADHD: A systematic review and meta-analysis

BackgroundAttention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed behavioral disorder in school-aged children. A core symptom of ADHD is difficulties with executive functions (EF). Physical activity (PA) interventions are proposed to be a valuable addition to traditional treatment approaches for ADHD. This systematic review examined the evidence for the effect of chronic PA on EF, specifically, inhibition, shifting, working memory, and attention in children with ADHD compared to no treatment. The moderating impact of PA cognitive demand and methylphenidate (MPH) treatment on the effect of PA interventions on EF was also examined.MethodsA systematic review and meta-analyses were conducted following the Cochrane Guidelines for Systematic Reviews. A protocol was published with PROSPERO (CRD42018099617); seven databases were searched, and 3690 results screened by two independent researchers. Based on inclusion and exclusion criteria, 12 eligible studies were included, and separate meta-analyses were conducted for each EF domain, each including subgroups of high vs low cognitive demand, and MPH-intake vs. MPH-free.ResultsResults showed beneficial effects of PA for all EF, with 95%-CI compatible with positive effects for shifting (SMD = −1.58; 95%-CI [−3.12; −0.04]) and working memory (SMD = −0.99; 95%-CI [−1.80; −0.18])only. Cognitive demand of PA differed in its impact depending on the domain of EF. Benefits of PA were lesser in those taking MPH, though subgroup differences were statistically non-significant.ConclusionChildren with ADHD benefit from PA leading to enhanced executive functioning performance. However, the cognitive demands of the PA need to be considered when contemplating PA as an adjunctive treatment option.