听觉事件相关电位在孤独症儿童的应用

孤独症是一种以社会交往、言语交流及行为障碍为主要特征的广泛性发育障碍,为探讨孤独症儿童的言语及认知能力缺陷的神经生理机制,学者们运用多种方法进行研究.近年来,由于听觉事件相关电位在中枢听觉处理及认知功能评估中的优势,其在孤独症研究中的应用越来越广泛.     

听觉事件相关电位在孤独症儿童的应用

孤独症是一种以社会交往、言语交流及行为障碍为主要特征的广泛性发育障碍,为探讨孤独症儿童的言语及认知能力缺陷的神经生理机制,学者们运用多种方法进行研究.近年来,由于听觉事件相关电位在中枢听觉处理及认知功能评估中的优势,其在孤独症研究中的应用越来越广泛.     

儿童功能性构音障碍的矫治及影响因素分析

目的探讨儿童功能性构音障碍的病因及影响矫治的有关因素。方法总结１１９例功能性构音障碍儿童的临床资料。结果语言发育迟缓者为８９例（７４８％）,胎儿期有高危因素者为４７例（３９５％）,有注意缺陷者为３９例（３２８％）。经矫治全部病例中１１７例达正常构音,２例明显改善。结论语言发育迟缓、注意缺陷等与儿童功能性构音障碍的形成有关。智商偏低、错音复杂、注意缺陷是影响矫治的主要因素。     

注意缺陷多动障碍儿童事件相关电位和智力特点

目的 提高儿童注意缺陷多动障碍(ADHD)诊断、治疗及预后判断的客观性、准确性,观察ADHD患儿认知和智力障碍程度.方法 对60例ADHD患儿(ADHD组)和60例健康对照儿童(健康对照组),分别以听觉靶和非靶刺激为诱发事件进行事件相关电位(ERP)P3波检测,采用<中国韦氏儿童智力量表>(C-WISC)检测患儿认知和智力能力,并比较二组儿童不同智力平衡性的ERP P3波测试结果.结果 ADHD组患儿较健康对照组儿童P3波潜伏期明显延长(P<0.01),波幅差异不明显.C-WISC检测中总智商(NQ)、言语智商(VIQ)、操作智商(PIQ)均低于健康对照组儿童(Pa<0.01);66.7%ADHD患儿VIQ低于PIQ 15分以上,智力不平衡性明显高于健康对照组(P<0.01).ADHD组及健康对照组智力不平衡(PIQ-VIQ差值≥15)儿童ERP P3波潜伏期较智力平衡(PIQ-VIQ差值<15)儿童延迟(P<0.05).结论 ERP儿童P3波的潜伏期是评价认知能力的方法,结合C-WISC测试能判断ADHD患儿认知和智力障碍程度,可作为ADHD诊断和预后判定的辅助依据之一.     

抽动-秽语综合征患儿听觉事件相关电位P300研究

目的：听觉事件相关电位是测定人脑认知加工功能或心理活动的客观指标,应用听觉事件相关电位检测,以探讨抽动-秽语综合征(TS)患儿的认知功能。方法：对30例TS患儿进行听觉事件相关电位P300测定,并与30例健康对照组儿童比较。结果：TS患儿听觉事件相关电位P300潜伏期明显延长、波幅明显降低,与健康对照组相比差异有显著性意义(P＜0.01＝。结论：听觉事件相关电位作为电生理检查,可客观反映TS患儿认知功能障碍,亦可作为治疗效果的评价指标。 ［中国当代儿科杂志,2004, 6(4): 321-322］     

孤独症谱系障碍儿童表情面孔工作记忆的事件相关电位研究

目的探讨孤独症谱系障碍(ASD)儿童表情面孔工作记忆能力及其事件相关电位(ERP)的特点。方法以中国面孔表情图片系统为测试材料,采用事件相关电位系统分别记录16例6~12岁ASD儿童(ASD组)与14例年龄匹配的正常儿童(对照组)在完成表情面孔延迟样本匹配任务时的脑电成分,分析两组儿童脑电P3b成分的特点。结果 ASD组儿童在表情面孔工作记忆任务中的总体反应时比对照组长(1 527 ms vs 1 060 ms,P0.05)、正确率比对照组低(76%vs 88%,P0.01)。ASD组和对照组间编码加工阶段的P3b成分波幅存在差异。ASD组左侧电极的P3b成分波幅值高于右侧电极波幅(P0.05),而对照组无此特点。结论学龄期ASD儿童在表情面孔编码加工阶段的P3b成分异于正常发育儿童,其表情面孔工作记忆过程可能更多地依赖于左半球相关的神经通路。     

精神分裂症患儿事件相关电位关联性负变的特征

目的 探讨精神分裂症患儿事件相关电位关联性负变(CNV)的特征.方法 随机选择6～12岁符合中国精神障碍分类与诊断标准第3版精神分裂症诊断标准的32例患儿作为观察组,健康儿童30例作为健康对照组.观察组应用奥氮平治疗8周,采用简明精神病评定量表(BPRS)评价疾病严重程度.2组分别采用CNV检测,比较CNV反应时间、潜伏期及波幅差异.结果 观察组反应时间较健康对照组明显延长(P<0.05).观察组较健康对照组CNV起点A潜伏期延迟(P<0.05),A点到s2负变化(CNV)的平均波幅低于健康对照组(P<0.01);指令信号后负变化(PINV)平均波幅低于健康对照组(P<0.01).预备信号后出现P2波幅较健康对照组明显增高(P<0.01),潜伏期比较差异无统计学意义(P>0.05).治疗8周观察组CNV潜伏期、平均波幅及PINV平均波幅与治疗前比较,差异无统计学意义(P>0.05).结论 精神分裂症患儿存在认知功能损害,可能与大脑感知容量减低,认知资源减少或分配能力减低有关.     

原发性遗尿症儿童工作记忆缺陷的事件相关电位研究

目的 通过事件相关电位（ERP）探讨原发性遗尿症儿童工作记忆障碍的认知神经机制。方法 纳入原发性遗尿症（遗尿症组）与正常儿童（对照组）各14例,采用学习-再认任务测试,对两组儿童识别旧图（学习过的）及新图（未学习过的）时Fz导联ERP成分P2、N2、P3进行比较分析。结果 遗尿症组识别旧图时P2、N2波幅明显低于对照组（P < 0.05）;而两组识别旧图时P2、N2、P3潜伏期及P3波幅差异均无统计学意义。遗尿症组识别新图时P2潜伏期较对照组明显延长（P < 0.05）,N2波幅明显低于对照组（P < 0.05）;而两组识别新图时P2、P3波幅及N2、P3潜伏期差异均无统计学意义。结论 原发性遗尿症儿童比正常儿童记忆分类信息提取能力下降及反应时延长,记忆容量负荷减少、记忆巩固减弱及冲突监测能力下降,导致工作记忆障碍。     

事件相关电位P300在儿童注意缺陷多动障碍诊断中的应用

目的 探讨事件相关电位（ERP）P300在儿童注意缺陷多动障碍（ADHD）诊断中的应用。方法 应用意大利Amplaid MK-15诱发电位系统，采用听觉Oddball刺激序列，对ADHD 30例与正常儿童45例进行P300测定。观察ERP主要波形N1、P2、N2及P3的潜伏期和波幅变化。结果 1．ADHD组靶刺激P300潜伏期明显延迟，与对照组比较，两组有显著性差异（P＜0．01）；ADHD组靶刺激P300波幅降低，但与对照组比较，差别无显著性（P＞0．05）；ERP其他主要波形N1、P2、N2的潜伏期和波幅两组间无显著性差别。2．P300试验在ADHD的临床诊断参考值为靶刺激P300潜伏期＞370ms，可疑诊断值范围为3500－370ms。其特异度为84．5％，灵敏度为66．7％。结论 靶刺激P300潜伏期测定可协助ADHD临床诊断。该方法操作简便，客观性强，患儿易合作，为临床诊断ADHD提供了神经生理学依据。     

儿童癫癎患者认知功能和事件相关电位P300的研究

目的　探讨儿童癫患者认知功能状况和P3 0 0 特点及二者关系。方法　对 38例儿童癫采用odd ball刺激序列检测P3 0 0 ,采用中国修订韦氏儿童智力量表 (WISC -RC)测定智商。结果　 1.癫儿童智商低于正常 6 5 .8% ,智力损害 2 8.9% ;2 .P3 0 0 潜伏期和波幅较对照组明显延长和降低 (P <0 .0 1) ,且智力正常的癫组P3 0 0 潜伏期和波幅较对照组也明显延长和降低 (P <0 .0 5 ) ;3.相关分析显示P3 0 0 潜伏期与各智商间均呈显著负相关 (r =- 0 .2 76～ - 0 .32 7　P均 <0 .0 5 ) ,波幅与语言智商、总智商呈显著正相关。结论　癫儿童存在不同程度的认知障碍 ,智商和P3 0 0 有密切关系 ,但二者又不完全等同 ,均是评价癫儿童认知功能的客观指标     

学龄早期注意缺陷多动障碍儿童事件相关电位和行为问题的相关性

目的采用事件相关电位(ERP)技术和Achenbach儿童行为量表(CBCL)研究学龄早期注意缺陷多动障碍(ADHD)儿童的认知特征,探讨ERP与儿童行为问题的相关性。方法 22例6~7岁ADHD患儿和年龄匹配的19例正常儿童纳入研究。ERP试验采用持续性操作测试(CPT-AX)任务,对Go和Nogo的N2、P3成分进行波幅和潜伏期的比较分析。CBCL量表由患儿家长填写,分析行为因子与ERP成分的相关性。结果 ADHD组ERP遗漏数明显高于正常对照组(10±8 vs 5±4,P0.05),而两组反应时间和虚报数比较差异无统计学意义(P0.05)。ADHD组ERP的Go-N2波幅明显低于正常对照组(-8±5μV vs-10±4μV,P0.05)。ADHD组多动、攻击问题检出率均为27%,违纪问题检出率为9%。攻击及违纪因子得分与ERP的Go-N2波幅呈负相关(分别r=-0.43、r=-0.48,均P0.05),多动因子得分与Go-P3潜伏期呈正相关(r=0.50,P0.05)。结论学龄早期ADHD儿童已出现注意执行功能受损趋势,但抑制功能缺陷尚不明显。学龄早期ADHD儿童多动、攻击及违纪问题与ERP相关。     

Perinatal cerebral insults alter auditory event-related potentials

Background

Auditory event-related potentials (AERPs) can be used as indices of neural information processing. Altered AERPs have been reported in children and young adults with frontal lobe infarction.

Aim

To test the hypothesis that perinatal brain injury affects cortical auditory processing.

Methods

We assessed AERPs at term, 6 and 12 months of age in preterm infants [n = 9, median gestational age (GA) 27.9, range 23.9-30.0 wk], term infants with perinatal intracerebral hemorrhage (ICH) [n = 5, GA 40.3, range 37.4-42.3 wk], and term infants with perinatal asphyxia [n = 4, GA 39.4, range 37.9-40.3 wk]. Healthy preterm (n = 16) and term infants (n = 22) served as controls. A harmonic tone of 500-Hz frequency was used as standard and of 750-Hz as deviant stimulus. Mean AERP amplitudes were calculated over 100 ms periods from 50 to 350 ms. The developmental outcome was followed until 2 years of age.

Results

The term ICH (p = 0.012) and asphyxia (p = 0.0016) group had smaller or more negative responses to the deviant, resulting in smaller or more negative MMR amplitudes than those of the controls. The preterm ICH group did not differ significantly from their preterm born controls. MMR varied in all patient groups and was not associated with adverse outcome.

Conclusion

AERP alterations suggest that perinatal cerebral insults affect cortical auditory processing.     

功能性构音障碍的临床共患病调查及行为问题研究

目的：探讨功能性构音障碍患儿的临床共患病及行为问题。方法：对112例确诊为功能性构音障碍的患儿,采用临床调查方法及DSM-IV注意缺陷多动障碍（ADHD）、口吃、抽动障碍及遗尿症诊断标准进行共患病调查,应用Conners父母问卷量表、儿童行为量表进行行为问题分析。结果：112例功能性构音障碍患儿中合并一种或一种以上共患病者占61.6%。中重度患儿共患病率高于轻度患儿。功能性构音障碍与语言障碍共患病率最高,为30.4%,其他依次为口吃18例(16.1%),遗尿症15例(13.4%),抽动障碍7例(6.3%)。学龄功能性构音障碍患儿与ADHD共患病率最高,达47.5%。儿童行为量表调查显示行为问题发生率为40.2%。Conners父母问卷量表调查结果显示57.1%存在一种或一种以上因子异常。结论：功能性构音障碍患儿合并共患病比例较高,且存在较多行为问题,在临床工作中应给予足够重视,注意检查及治疗。［中国当代儿科杂志,2009,11（3）：225-228］     

儿童功能性构音障碍的分子遗传学研究

遗传因素是造成功能性构音障碍的重要原因。本文综述了最近发现的与功能性构音障碍相关的一些基因和染色体区域。详细介绍了FOXP2基因的结构、表达和功能,以及FOXP2基因在发育性言语失用中的变异。作为重要的转录调控因子,FOXP2基因可以调控很多基因的表达。其中CNTNAP2基因是FOXP2基因的重要靶基因,是影响语言及言语发育的重要基因。功能性构音障碍可能发展为阅读障碍,阅读障碍的候选基因也成为研究功能性构音障碍的重要候选基因。一些与阅读障碍相关的染色体区域3p12-13、15q11-21、6p22 及1p34-36被认为可能与功能性构音障碍相关。位于这部分染色体区域的一些基因如ROBO1基因、ZNF280D 基因、TCF12 基因、EKN1基因、KIAA0319 基因等成为研究功能性构音障碍的候选基因。     

Cortical auditory event-related potentials in newborn infants

The possibility of recording changes in electroencephalography potentials following perception of sound was reported several decades ago. The recent expanding research on auditory cortical event-related potentials (AERPs) for assessing sound discrimination abilities in children and infants has indicated that several methodological issues need to be addressed before it can be implemented in clinical practice. Latencies, polarities, and amplitudes of the responses change with gestational age and during infancy. Thus, the maturation of the infant must be considered when designing stimulus paradigms and interpreting the responses. Of healthy newborn infants, only about 80% will show mismatch negativity, the automatic change detection of the auditory stimuli. Currently, the AERP method cannot be applied in clinical practice in the neonatal period, although the findings in healthy newborns at risk for dyslexia are promising. Further research will elucidate the possibility of developing AERPs as a possible early screening method during infancy for later dyslexia or cognitive dysfunction.     

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??In recent years??the EEG examination has gradually become an important means of children’s cognitive function assessment. This study attempts to outline some of the common childhood cognitive impairment and related event related potential??ERP?? component abnormalities in order to better apply in clinical EEG diagnosis and intervention. Specifically??it includes attention deficit hyperactivity disorder??ADHD?? related abnormality in ERP??dyslexia and abnormality in ERP??as well as ERP abnormality in mathematical disability etc.     

Visual event-related potentials in children with phenylketonuria

Visual event-related potentials (ERPs) were examined in 16 children (aged 5-14 y) with phenylketonuria (PKU) and 16 age- and sex-matched controls. Lifetime median measures of phenylalanine (Phe) were 230-460 μmol/l. The most recent Phe levels were 56-624 μmol/l. ERPs were recorded whilst the children performed a discrimination task. All stimuli were square wave gratings degree, which appeared for 33 ms. A response to an infrequent grating that differed in orientation or spatial frequency was required. The older children with PKU had a delay in the first peak (P1) of the ERP, and age-related changes in the amplitude of P1. There was attenuation of the second peak across age groups in PKU. There was no evidence of reduced response accuracy or longer reaction times in children with PKU. Latencies of the cognitive P3 were not delayed in PKU. The delayed early peaks are consistent with previous studies that have shown delayed visual evoked potentials in PKU. The lack of differences in reaction time and P3 may be due to relatively good Phe control in children with PKU, or to the simplicity of the task. Suggestions are made for future ERP studies of PKU.     

有冲动行为注意缺陷多动障碍儿童脑功能性磁共振的研究

目的：冲动是注意缺陷多动障碍(ADHD)儿童的核心症状。为了解ADHD患儿冲动行为的神经机制,该研究利用功能性磁共振成像技术调查了有冲动行为ADHD儿童的脑功能影像特点。方法：以GO/STOP冲动行为测量软件中的GO及STOP为任务,对自愿参加的10例有冲动行为ADHD、7例无冲动行为ADHD及9例正常男童进行脑功能成像。然后将3组儿童的脑功能像分别合并平均,得出3组在执行两个任务时的平均脑功能像,最后比较3组平均脑激活区的分布情况。结果：执行GO任务时,正常儿童的激活区域主要是额极（额上回、额中回、额内侧回）;无冲动ADHD患儿是小脑（后叶、前叶小结）、扣带回;冲动ADHD患儿是内侧苍白球、岛叶。执行STOP任务时,正常儿童的激活区域主要为额上回等区域;无冲动ADHD患儿为额中回、胼胝体;冲动ADHD患儿为钩回、扣带回。冲动ADHD儿童的激活的脑区远较其他两组少。结论：参与控制冲动的大脑皮层分布广泛,与正常儿童相比,无冲动行为ADHD患儿脑功能明显不足,激活的脑区少;有冲动行为ADHD患儿激活的脑区更少,脑功能表现更差,皮层唤醒不足。［中国当代儿科杂志,2010,12（1）：24-28］     

Auditory event-related brain potentials in children with specific language impairment.

Event-related brain potentials evoked by tone and speech stimuli were recorded in ten children with specific language impairment and a control group. The patient group showed prolonged P3 latencies in both tasks compared with the controls and smaller P3 amplitude in the speech task. There were no group differences concerning the N1-P2 components. The findings indicate that the children with language impairment showed signs of deficient late-stage auditory perceptual processing whereas the earlier sensory stages as indexed by the N1 were no different from the controls. The results are further discussed within the framework of context updating in working memory.