帕金森病患者注意网络的研究

目的 探讨帕金森病(PD)患者注意网络状况.方法 运用注意网络测试,对确诊的PD患者(28例)和对照组(28名)进行注意网络检查.结果 PD组注意网络检查正确率(98.4%±0.3%)低于对照组(99.2%±0.2%),差异有统计学意义(U=261.500,Z=-2.160,P＜0.05).PD组的定向网络效率显著高于对照组[分别为(65.7±31.1)ms,(43.5±32.3)ms],差异有统计学意义(U=226.00,Z=-2.720,P＜0.01).PD组的执行控制网络、警觉网络效率[(97.4±63.1)ms,(35.0±41.0)ms]与对照组比较有改变,但差异无统计学意义(Z=-1.065、Z=-1.082,P＞0.05).相关性分析发现,执行网络功能和Hoehn-Yahr分级呈正相关(r=0.794,P＜0.01),警觉网络与Hoehn-Yahr分级呈负相关(r=-0.379,P=0.047),定向网络与其无相关性(r=-0.119,P=0.546).结论 PD患者存在定向网络的损害,警觉和执行控制注意网络随病程进展而损害加重,提示神经解剖结构和神经递质可能和不同注意网络有关.     

局灶性脑损伤患者注意网络功能受损的特点

目的 研究局灶性脑损伤患者注意网络功能受损的特点,探讨额叶、顶叶、颞叶与3个独立的注意网络功能的关系.方法 应用注意网络测验,测试23例额叶损伤、18例颞叶损伤和18例顶叶损伤患者以及53名健康对照的注意网络功能.结果 与对照组相比,额叶损伤组的执行控制网络效率显著减低,额叶损伤组、对照组分别为(143.7±46.6)、(91.6±46.4)ms,Z值为-4.714,P＜0.01;而顶、颞叶损伤组的执行控制网络效率的差异尤统计学意义;顶叶损伤组的定向网络效率显著减低,顶叶损伤组、对照组分别为(34.9±25.2)、(55.1±21.8)ms,Z=-2.418,P＜0.05;额叶损伤组的定向网络效率增高,额叶损伤组、对照组分别为(71.2±35.2)、(55.1±21.8)ms,Z=-2.125,P＜0.05;而颞叶损伤组的定向网络效率的差异无统计学意义;额、顶、颞叶损伤组的警觉网络效率与对照组相比差异均无统计学意义.结论 神经心理学证据提示,额叶与执行控制功能密切相关,顶叶在注意的定向网络中起关键作用,而颞叶损伤患者的注意网络功能基本不受影响.     

颞叶癫痫患者注意网络的研究

目的探讨颞叶癫痫患者注意网络的状况及影响因素。方法连续收录2007年1月至2008年12月在我院就诊的44例颞叶癫痫患者,选择相匹配的健康志愿者40名作为对照研究。应用注意网络测试(attentional networks test,ANT)软件,评估被试者注意网络状况,比较两组注意网络各指标的差异,采用非条件Logistic分析受教育年限、病程等因素对注意网络指标的影响。结果与对照组比较,患者组的ANT平均反应时间较慢[患者组:(688.2±138.1)ms;对照组:(625.1±100.1)ms,t=2.06,P0.05];患者组ANT中执行功能效率显著下降[患者组:(155.7±57.0)ms;对照组:(108.0±33.8)ms,t=4.62,P0.01];两组MMSE、ANT的警觉功能与定向功能效率无统计学差异。非条件Logistic分析显示,存在脑电图痫性放电(95%CI:1.03～42.33,OR=6.603,P=0.043)为患者执行功能损害可能原因。结论初步证实颞叶癫痫患者存在注意网络的执行功能损害,痫性放电可能是导致患者注意执行功能损害的原因。     

精神分裂症患者注意网络功能与情绪认知障碍的相关性研究

目的 探讨精神分裂症患者的注意网络功能和面孔情绪认知功能障碍及两者间的关系.方法 采用注意网络测验(ANT)和中国人面孔情绪测验(CFET)对50例未用抗精神病药的精神分裂症患者(患者组)进行评估,并与53名正常健康者(对照组)进行比较.结果 (1)ANT:患者组的平均反应时间[(743.0±97.0)ms]长于对照组[(668.9±95.8)ms,P＜0.01],定向网络效率[(30.1±30.7)ms]低于对照组[(49.6±21.3)ms,P＜0.01].(2)CFET:患者组和对照组的总分[分别为(75.46±13.28)分和(105.64±4.82)分]及对六种基本情绪的认知评分[分别为:喜(18.82±0.52)分和(19.81±0.39)分、怒(15.10±4.63)分和(18.23±1.37)分、悲(12.96±5.11)分和(18.17±1.52)分、惊(13.24±5.03)分和(18.77±1.12)分、怕(5.96±3.99)分和(15.11±2.15)分、厌(9.38±5.47)分和(15.47±2.18)分]差异均有统计学意义(P＜0.01).(3)Spearman相关分析:患者组ANT正确率与CFET总分呈正相关(r=0.285),ANT平均反应时间与CFET总分(r=-0.302)和对情绪怒的认知评分(r=-0.296)呈负相关,而ANT警觉效率评分与对情绪厌的认知评分(r=0.401)呈正相关(均P＜0.05).结论 精神分裂症患者存在注意定向功能障碍和广泛的情绪认知缺陷,注意功能与情绪认知总体水平存在相关.     

老年人和青年人注意网络的研究

目的探讨老年化对警觉、定向和执行控制等x注意网络加工的影响。方法运用注意网络测试(ANT)观察30名老年人和30名青年人正常被试的警觉、定向和执行控制等注意网络功能。结果与青年人被试者(执行网络为66.8±32.3ms;警觉网络为55.9±31.2ms;定向网络为46.1±20.6ms)相比,老年人被试者注意的执行控制网络功能效应时间明显延长(124.3±64.9ms,P<0.01)以及警觉网络功能效应时间明显缩短(31.7±36.6ms,P<0.05),显著受损;而定向网络功能无差异。结论脑的老年化改变显著影响注意网络的认知加工,老年化对注意的执行控制和警觉网络的影响,可能与年龄相关的额叶功能退化和神经递质系统的异常有关。     

青少年反社会人格高危群体注意网络功能研究

目的:探讨青少年反社会人格障碍高危群体注意网络功能特点。方法:选取1 135名少年犯,根据人格诊断问卷和美国《精神障碍诊断与统计手册》(DSM-IV)结构式访谈,筛选出50例,将其分为反社会人格障碍高危(CD+AP)组(n=26)和品行障碍(CD)组(n=24),采用注意网络测验(ANT)评估其注意警示、定向和执行功能特点,并与健康志愿者(健康对照组,n=30)比较。结果:CD+AP组的注意定向效能[(37.02±15.72)ms]显著低于CD组[(44.34±15.41)ms](P<0.01),却显著强于健康对照组[(31.29±12.16)ms](P<0.05);CD+AP组注意执行功能[(65.83±19.55)ms]显著强于健康对照组[(77.59±14.49)ms](P<0.05)。结论:青少年反社会人格高危群体的注意定向功能和执行功能异常增强,这可能与反社会行为的发生密切相关。     

注意缺陷多动障碍儿童反应抑制功能的磁共振成像研究

目的 探讨注意缺陷多动障碍(ADHD)儿童执行高级反应抑制脑激活的模式和功能状态.方法 对12例注意缺陷多动障碍儿童(ADHD组)和12名正常对照者(对照组)检测执行持续性操作测试任务(CPT)时的功能磁共振成像(fMRT)和行为学,并采集全脑血氧水平依赖对比的fMRI扫描数据.结果 (1)行为学检测,ADHD组的击中数[(18.6±4.1)个]少于对照组[(22.8±1.8)个],反应时间[(579±56)ms]长于正常对照组[(510±35)ms;均P＜0.01],漏击数[(6.3±4.1)个]和错击数[(3.9±2.4)个]均多于对照组[(2.2±1.9)个和(1.9±1.0)个;P＜0.01～0.05].(2)fMRI检测,ADHD组扣带前回、前额叶腹外侧、尾状核和小脑激活弱于对照组(P＜0.05,未校正,体素值＞20).结论 ADHD儿童反应抑制功能存在缺陷,其扣带前回、前额叶、基底节及小脑的功能低下.     

不同亚型轻度认知功能损害患者的神经心理学特征

目的 探讨不同亚型轻度认知功能损害(MCI)患者的神经心理学特征.方法 采用多种神经心理学量表对28例遗忘型MCI (aMCI)、21例血管型MCI (V-MCI)、21例帕金森病型MCI(PD-MCI)及46名健康老年人进行评定,比较不同亚型MCI的神经心理学特征.结果 (1)与健康对照组比较,各亚型MCI组在总体认知评分及剑桥老年认知检查量表中文版(CAMCOG-C)子项评分差异均有统计学意义.aMCI组在定向、语言表达、近记忆、学习记忆、注意、计算、思维及知觉方面均受损,差异具有统计学意义(t=4.580、5.150、3.053、4.070、5.918、2.121、2.952、3.175,均P＜0.05);语言理解、远记忆与执行能力相对保留,差异无统计学意义.V-MCI组定向、语言表达、注意与执行功能受损(t=2.974、3.165、4.216、3.197,均P＜0.05),记忆力、计算、思维及知觉较对照组差异无统计学意义.PD-MCI组在语言表达、近记忆、远记忆、学习记忆、注意及执行功能方面损害均显著,差异具有统计学意义(t=4.433、3.065、3.821、3.447、5.344、0.348,均P＜0.05).(2)各亚型MCI组间比较:与V-MCI组[(3.52±0.87)分、(12.48±1.83)分]相比,aMCI组[(3.07±0.81)分、(11.07±2.28)分]与PD-MCI组[(3.00 ±0.89)分、(11.33 ±1.91)分]在CAMCOG-C总体评分及其子项中记忆能力包括近记忆、学习记忆降低显著,差异具有统计学意义(aMCI与V-MCI比较t=1.868、2.381,PD-MCI与V-MCI比较t=1.921、1.980;均P＜0.05).PD-MCI组中,远记忆及执行功能较其他两组显著降低,差异具有统计学意义(与aMCI比较t=2.498、4.257,与V-MCI比较t=1.684、1.492:均P＜0.05).(3)aMCI组GDS评分较健康对照组显著增高,差异具有统计学意义(t=2.850,P＜0.05),而V-MCI组及PD-MCI组与健康对照组比较差异均无统计学意义,但aMCI组及V-MCI组GDS得分较PD-MCI组增高.结论 3种不同亚型MCI认知损害均为多区域性,aMCI主要表现为记忆损害,V-MCI以执行功能损害为主,PD-MCI记忆及执行功能均受损;aMCI较其他亚型更易出现抑郁倾向.不同亚型MCI神经心理学特征的不同,反映了不同的病理生理学机制.     

男性暴力行为青少年的注意网络研究

目的 探讨青少年暴力行为注意网络认知功能缺损的特点.方法 运用注意网络测试观察比较60例男性暴力青少年(暴力组)和78名无暴力行为青少年(对照组)的警觉、定向和执行控制等注意网络功能.结果 与对照组比较,暴力组青少年注意网络的警觉效能和执行控制效能明显下降(P<0.05);而定向网络效能无明显差异(P>0.05).进一步按来自管教所和学校两种不同来源分析,管教所内暴力组的警觉效能时间比无暴力组明显延迟(P=0.01),而同一来源的暴力组和非暴力组的执行控制效能差异均有统计学意义(P(0.05).结论 有暴力行为的男性青少年注意网络功能尤其是其中的执行控制功能受损.     

紧张型头痛对注意网络的影响

目的探讨紧张型头痛(TTH)对注意网络功能的影响。方法对40例TTH患者(TTH组)进行注意网络测试(ANT),并与40名相匹配的正常对照组进行比较。结果与正常对照组比较,TTH组匹茨堡睡眠质量指数量表(PSQI)评分显著升高(P0.05),而MMSE、数字广度测试、汉密顿抑郁量表、汉密顿焦虑量表评分差异无统计学意义(均P0.05)。与正常对照组比较,TTH组警觉网络效率显著缩短,执行控制网络效率明显延长(均P0.05),定向网络效率、平均反应时间及平均正确率差异无统计学意义(均P0.05)。Pearson相关性分析显示,警觉网络效率与PSQI呈负相关(r=-0.38,P0.05),执行控制网络效率与PSQI呈正相关(r=0.41,P0.05)。结论 TTH患者注意网络功能受损,以警觉网络和执行控制网络为主,定向网络相对保留;注意网络异常与睡眠障碍相关。     

Selective impairments of alerting and executive control in HIV-infected patients: evidence from attention network test

Background

Attention ability can be subdivided into three functionally independent networks, i.e., alerting network, orienting network, and executive network. Previous literature has documented that deficits in attention are a common consequence of HIV infection. However, the precise nature of deficits of attention in HIV-infected patients is poorly understood. Accordingly, the aim of the study was to identify whether the HIV-infected patients showed a specific attention network deficit or a general attentional impairment.

Methods

We investigated 27 HIV-infected patients and 31 normal controls with the Attention Network Test (ANT).

Results

The patients exhibited less efficient alerting network and executive network than controls. No significant difference was found in orienting network effect between groups. Our results also indicate a tendency for poorer efficiency on alerting attention and executive attention in patients with CD4 ≤ 200.

Conclusions

Our findings suggest that HIV-infected patients exhibited selective impairments of attention network of alerting and executive control. The link between lower CD4 T cell count and poorer attention network function imply the importance of starting antiretroviral therapy earlier to avoid irreversible neurocognitive impairment.

     

Testing the efficiency and independence of attentional networks

In recent years, three attentional networks have been defined in anatomical and functional terms. These functions involve alerting, orienting, and executive attention. Reaction time measures can be used to quantify the processing efficiency within each of these three networks. The Attention Network Test (ANT) is designed to evaluate alerting, orienting, and executive attention within a single 30-min testing session that can be easily performed by children, patients, and monkeys. A study with 40 normal adult subjects indicates that the ANT produces reliable single subject estimates of alerting, orienting, and executive function, and further suggests that the efficiencies of these three networks are uncorrelated. There are, however, some interactions in which alerting and orienting can modulate the degree of interference from flankers. This procedure may prove to be convenient and useful in evaluating attentional abnormalities associated with cases of brain injury, stroke, schizophrenia, and attention-deficit disorder. The ANT may also serve as an activation task for neuroimaging studies and as a phenotype for the study of the influence of genes on attentional networks.     

Effects of transcranial direct current stimulation over right posterior parietal cortex on attention function in healthy young adults

Attention involves three distinct networks for alerting, orienting, and executive control. Interventions targeting the specific attentional networks remain lacking. Transcranial direct current stimulation (tDCS) has been shown to modulate cortical excitability, which potentially serves as an interventional tool to treat individuals with attention impairment. The purpose of this study was to examine the effects of applying tDCS over the right posterior parietal cortex (PPC) on the performance of the three attentional networks. Twenty‐six healthy young adults performed the Attention Network Test before and after anodal or sham tDCS stimulation over the right PPC. The alerting, orienting, and executive effects were assessed before and after the stimulation. The results demonstrated that the orienting effect was significantly improved after real tDCS relative to sham, whereas the alerting and executive control effects remained unaffected. Consistent with previous clinical and functional imaging studies, this suggests that the right PPC is actively engaged with the spatial orienting of attention.     

Attention and executive functions in patients with severe obesity. A controlled study using the Attention Network Test

In this paper, attention and temperament are compared between 41 severely obese patients with psychiatric comorbidity and 45 control persons. Networks of attention were assessed by the Attention Network Test: alerting (ability to achieve and maintain an alert state), orienting (ability to orient to a stimulus), and executive attention (ability to resolve conflict). According to hypotheses, obese patients show reduced executive attention, more effortful control, and higher negative affectivity than controls. The concept of attention networks is related to cognitive mechanisms of self-regulation, opening new perspectives for understanding psychiatric disorders.     

Neural correlates of the attention network test in schizophrenia

Attentional deficits are prominent in schizophrenia, affecting nearly all cognitive functions. Human attention comprises three essential components: alerting, orienting and executive control. For the assessment of these functions, the attention network test (ANT) has been proposed and used in healthy controls and patients. In schizophrenia, the ANT has revealed behavioral deficits; however, the corresponding neural correlates have not been examined. In the present study, neural correlates of attention were investigated in 17 schizophrenia patients and 17 healthy controls using the ANT with fMRI. Behavioral deficits emerged in the alertness system with a reduced efficiency for temporal cues. In fMRI, changes were observed for all three domains-alerting, orienting and conflict-and revealed hyper- as well as hypoactivation in patients. Affected regions during alerting comprised a broad fronto-temporo-parieto-occipito-cerebellar network, while differences during orienting mainly tapped fronto-parietal regions and during conflict processing a thalamo-frontal-temporal occipital network including the postcentral regions. In general, hyperactivations were positively correlated with more severe psychopathologial symptoms.     

Neural correlates of attentional deficits in Parkinson's disease patients with mild cognitive impairment

IntroductionDeficits in attentional processing observed in Parkinson's disease (PD) patients with mild cognitive impairment (MCI) increase risk of PD dementia. However, the neural basis of these attentional deficits are presently unknown. The present study aimed to explore the neural correlates of attention dysfunction in PD-MCI using the Attention Network Test (ANT) and functional Magnetic Resonance Imaging (fMRI).MethodFifteen (15) PD-MCI patients, 26 PD patients without MCI (PD-NC) and 22 healthy controls (HC) were scanned (3T Siemens PRISMA) whilst performing the ANT. Reaction time, accuracy and fMRI BOLD activation were compared between groups for the three attentional task components of 1) alerting, 2) orienting, and 3) executive control.ResultsPD-MCI patients showed an overall slower reaction time compared to PD-NC and HC, and showed less interference of reaction time in the orienting effect than HC. fMRI data demonstrated greater activation in the bilateral cerebellum crus 1 during the alerting attention condition in both PD-MCI and PD-NC compared to HC. However, activation was supressed in the left postcentral gyrus in PD-MCI compared to PD-NC and HC.DiscussionAlterations in the alerting attention functional network despite intact task performance in PD-MCI suggests that functional brain changes may precede cognitive changes in the attention domain. Furthermore, increased activation in the cerebellum may reflect an attentional compensatory mechanism unique to the PD pathology. Taken together, the findings suggest that PD has a complex effect on attentional ability that can, at least in part, be elucidated using functional neuroimaging.     

Attention function after childhood stroke.

We investigated attentional outcome after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized attention and neuroimaging assessments. Stroke lesions were quite varied in location and commonly involved regions implicated in Posner's model of attention networks. Children with stroke lesions performed significantly more poorly regarding attention function compared with controls. Performance on the Starry Night, a test demanding alerting and sensory-orienting but not executive attention function, was significantly associated with lesion size in the alerting and sensory-orienting networks but not the executive attention network. Furthermore, earlier age at lesion acquisition was significantly associated with poorer attention function even when lesion size was controlled. These findings support the theory of dissociable networks of attention and add to evidence from studies of children with diffuse and focal brain damage that early insults are associated with worse long-term outcomes in many domains of neuropsychological function. In addition, these results may provide clues towards the understanding of mechanisms underlying attention in children.     

The attention networks in benign epilepsy with centrotemporal spikes: A long-term follow-up study

PurposeTo evaluate the long-term prognosis of attention deficit in children with newly diagnosed benign childhood epilepsy with centrotemporal spikes (BECTS).MethodsAttention network test (ANT) was performed over a period of 7 years on 42 patients who were newly diagnosed with BECTS, in the Department of Neurology of Anhui Provincial Children's Hospital.ResultsIn the patients’ group, the accuracy of ANT was lower (P = 0.000), the total response time was longer (P = 0.000), and the efficiency of orienting (P = 0.000) and alerting (P = 0.041) networks was lower than that of the control group. Accuracy was positively correlated with age of onset (b = 1.184) and negatively correlated with number of seizures (b = −1.321). After 7 years, there was no significant difference in the accuracy (P = 0.385); total response time (P = 0.661); and alerting (P = 0.797), orienting (P = 0.709), and executive control (P = 0.806) network efficiencies between the patients and controls. Accuracy was positively correlated with age of onset (b = 0.8583) and negatively correlated with number of seizures (b = −1.017) and duration of antiepileptic drugs therapy (b = −3.203).ConclusionsIn our study, the newly diagnosed BECTS patients had impaired attention network, mainly in the alerting and orienting domains. Age of onset, number of seizures, and time of antiepileptic treatment may affect the attention networks. With the remission of BECTS, the attention network dysfunction was reversed.