注意缺陷多动障碍儿童事件相关电位的对照研究

【目的】探讨事件相关电位(event related potential,ERP)在儿童注意缺陷多动障碍(attention deficit hy-peractivity disorder,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刺激序列测定ADHD儿童与正常儿童P300潜伏期和波幅变化。【结果】病例组靶刺激P300潜伏期为(428.27±19.22)ms,对照组为(341.83±17.72)ms,两组差异有统计学意义(P0.05);病例组靶刺激P300波幅为(12.89±6.10)μV,对照组为(11.75±6.76)μV,两组差异有统计学意义(P0.05);病例组综合反应控制商数和综合注意力商数分别为73.27±13.99和67.93±15.93,对照组分别为104.83±16.11和102.00±15.39,两组差异有非常统计学意义(P0.01);事件相关电位P300潜伏期与综合反应控制商数之间无显著性意义(r=-0.3677,P0.05),但与综合注意力商数之间呈负相关,且具有显著性意义(r=-0.4347,P0.05)。【结论】事件相关电位P300潜伏期测定可协助儿童ADHD的临床诊断。     

注意缺陷多动障碍儿童的事件相关脑电位研究

【目的】探索注意缺陷多动障碍儿童(attention deficit hyperactivity disorder,ADHD)的事件相关脑电位P300的特点。【方法】符合DSM-Ⅳ诊断标准的ADHD患儿组40例,正常对照组22例。对所有对象进行儿童韦氏量表、P300测试。【结果】P300:ADHD组P300各潜伏期与正常对照组相比,靶P2、N2、P3潜伏期延长,差异有显著性(P<0.05),P3波幅下降其差异有显著性(P<0.05)。②P300潜伏期与C-WISC的总智商、操作智商、语言理解智商因子及记忆/注意智商因子具有相关性(P<0.05)。【结论】事件相关脑电位P300可作为临床评价ADHD患儿认知功能的脑电生理指标。     

学龄前注意缺陷多动障碍儿童早期行为干预联合家庭干预的效果观察

目的探讨学龄前注意缺陷多动障碍(ADHD)儿童早期行为干预联合家庭干预疗效。方法选择2020年1月—2020年12月温岭市妇幼保健院收治的学龄前注意缺陷多动障碍儿童60例为研究对象,根据随机分组法分为对照组29例和观察组31例。对照组给予家庭干预治疗,观察组在对照组的基础上加用早期行为干预进行治疗。比较两组患者的临床疗效、缺陷多动障碍量表(SNAP-IV)、注意缺陷多动障碍量表(ADHD)、父母症状(Conners)量表评分变化情况及满意度。结果治疗后,观察组总有效率90.32%,高于对照组的68.97%,差异有统计学意义(χ^(2)=4.271,P<0.05);干预前,两组SNAP-IV、ADHD评分无显著差异;干预后,两组SNAP-IV、ADHD评分均显著降低,且观察组低于对照组,差异有统计学意义(t=12.889、8.823,P<0.05);干预前,两组父母Conners量表无显著差异;干预后,两组父母Conners量表评分均显著降低,但两组品行问题评分无显著差异,观察组学习问题、多动指数低于对照组,差异有统计学意义(P<0.05);观察组总满意度为96.77%,显著高于对照组的75.86%,差异有统计学意义(P<0.05)。结论早期行为干预联合家庭干预对学龄前ADHD儿童效果显著,能改善患儿症状。     

学习障碍儿童的事件相关脑电位研究

[目的]探索学习障碍(learning disabilities,LD)儿童的事件相关脑电位(P300)的特点,为临床诊治提供依据.[方法]采用修订版儿童学习障碍筛查量表(PRS)结合韦氏智测量表得分及学习成绩入组LD儿童38例,正常对照组26例.对所有对象进行儿童韦氏量表、P300测试;对LD患儿进行相应学习能力训练治疗并随访其P300.[结果]①LD组与对照组比较:靶P2、N2、P3潜伏期延长,差异有显著性(P＜0.05),P3波幅下降差异有显著性(P＜0.05),②LD组训练前后比较:P300各潜伏期均有显著性缩短(P＜0.01);P3波幅改变差异无显著性.[结论]LD儿童P300潜伏期延长,波幅低,存在脑认知功能缺陷,事件相关脑电位P300可作为临床评价LD患儿听觉认知功能的脑电生理指标.     

发育性协调障碍儿童听觉事件相关电位测定

目的探讨发育性协调障碍（DCD）儿童听觉事件相关电位P300,从电生理水平分析DCD发病机制,为DCD的病因研究提供依据。方法以《美国精神障碍诊断与统计手册》第4版为诊断标准,结合发育性协调障碍问卷在2所小学中进行筛查,筛选出16名DCD儿童,按1：1配对选择对照;通过协方差分析比较不同组儿童P300的潜伏期与波幅。对受试儿童运动表现与P300潜伏期与波幅进行偏相关分析。结果DCD儿童与对照组儿童P300潜伏期差异无统计学意义（P〉0.05）,而P300波幅组间差异有统计学意义（P〈0.01）;受试儿童运动技能障碍程度与听觉P300的波幅呈负相关（r=-0.906,P〈0.01）。结论智力和年龄是影响P300电位的重要因素,DCD儿童P300波幅异常表明其存在运动控制功能缺陷。     

绘画疗法对注意缺陷多动障碍儿童干预效果分析

目的探讨绘画疗法对注意缺陷多动障碍(attention-deficit hyperactivity disorder,ADHD)儿童行为的影响,为注意缺陷多动障碍儿童的治疗提供新视角。方法于2019年6月,随机抽取白山市3所小学一至六年级已被诊断为注意缺陷多动障碍的儿童,采用实验组-对照组前后测设计,对实验组10名ADHD儿童进行14周,每周4次,每次120 min的绘画疗法干预;对照组10名ADHD儿童不进行干预。研究期间保证两组儿童不进行除绘画疗法以外的其他治疗方式,使用ADHD症状分级父母评定量表、Conners父母评症状量表(Conners Parent Symptom Questionnaire,PSQ)、Rey复杂记忆图形测验进行前测与后测评估。干预结束12周后再次对两组进行PSQ和Rey复杂图形记忆测验。结果干预后,实验组品行行为、学习问题、冲动多动、多动指数4个维度评分与干预前及对照组干预后评分差异均有统计学意义(P值均<0.05),追踪测验显示实验组PSQ分数保持良好(P<0.05),有2个维度因子在后测与追踪后测与干预前差异均无统计学意义。在Rey复杂记忆图形测验分数检验中发现,实验组经干预后4个维度因子评分与干预前及对照组干预后评分差异均有统计学意义(P值均<0.05)。12周后追踪测验分数保持良好(P<0.05)。结论绘画疗法对ADHD儿童行为管理能力及工作记忆能力影响显著,且影响能够最少持续12周。     

事件相关电位在儿童注意缺陷多动障碍不同亚型的应用比较

【目的】 探讨事件相关电位(event related potential, ERP)P300对儿童注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)不同亚型认知功能缺陷的诊断意义。 【方法】 根据美国精神障碍诊断与统计手册第4版(DSM-IV)对门诊ADHD患儿进行临床分型,分为注意缺陷为主型(ADHD-I组:20例),多动/冲动为主型(ADHD-HI组:20例)和混合型(ADHD-C组:20例),对3组患儿及和正常对照组儿童(20例)应用事件相关电位分析系统进行认知功能评定,并进行组间比较。 【结果】 1)与正常对照组比较,各亚型ADHD患儿的靶刺激在前额区(Fz)、中央区(Cz)、左中央区(C3)、右中央区(C4)及顶区(Pz)各脑区P300潜伏期延长,差异具有统计学意义(F值分别为10.211,6.312,7.418,7.665,7.010);2)各脑区P300波幅下降,差异具有统计学意义(F值分别为4.837,4.698,2.902,3.282,5.275,P值均＜0.05);3)ADHD各亚型之间在以上测验中的组间差异无统计学意义。 【结论】 ADHD各临床亚型患儿的事件相关电位P300没有明显差异,但潜伏期均较正常儿童明显延长,波幅明显降低。     

职业性钒暴露对事件相关电位P300的影响

对97例钒职业接触工人及50例对照工人进行事件相关电位P300检测,记录其潜伏期、波幅及按键反应时间等指标。结果显示,在控制了年龄及文化程度的影响后,接钒组P300潜伏期及按键错误次数均大于对照组(P<0.05);接钒工龄与P300潜伏期呈正相关关系(r=0.244,P<0.05)。提示职业性钒暴露可引起事件相关电位P300的改变,降低钒职业接触人群的认知功能。 更多还原     

糖尿病患者事件相关电位P300的变化及相关因素研究

目的探讨2型糖尿病患者事件相关电位P300的改变及其相关危险因素,并评价P300在糖尿病脑病中的诊断价值。方法对50例2型糖尿病患者和30例健康对照者进行事件相关电位P300检测,并分析P300波的潜伏期及波幅与糖尿病的病程、血脂及血压的关系。结果(1)糖尿病患者P300的潜伏期较对照组明显延长(P<0.01);且P300的波幅较对照组明显降低(P<0.05)。(2)糖尿病合并高血压组P300的潜伏期较对照组和糖尿病无高血压合并症组明显延长(P<0.01)。(3)随糖尿病病程的延长P300的潜伏期逐渐延长。(4)P300的潜伏期与糖尿病患者的血脂水平呈正相关。结论糖尿病患者存在明显认知功能障碍,事件相关电位P300可作为一项较客观、有价值的评价糖尿病患者认知功能的指标,并有助于糖尿病慢性脑病的早期诊断。     

父母培训对学龄前注意缺陷多动障碍患儿干预效果的评价

目的:评价父母培训对学龄前注意缺陷多动障碍(ADHD)患儿的临床干预效果。方法:将符合DSM-Ⅳ诊断标准的学龄前4～6岁ADHD儿童随机分为两组:父母培训组即干预组32例,对照组31例。干预组由专业医师对儿童父母进行为期8周的培训,并在培训后进行1个月的巩固干预;对照组则不给予任何干预措施。在干预前和干预3个月后使用SNAP-IV量表对两组儿童的ADHD症状进行评估,干预组进行家庭环境量表-中文版(FES-CV)评估。结果:干预组FES-CV量表的亲密度、情感表达、成功性、知识性、娱乐性、道德观、组织性、控制性分值较干预前有提高(成功性P<0.05,余P<0.01),矛盾性分值较干预前降低(P<0.01),而独立性无明显变化(P>0.05);与对照组相比,干预组儿童的SNAP-IV量表分有减少(P<0.01);干预组有效率达56.7%,症状缓解率达33.3%,与对照组相比差异有统计学意义(前者P<0.01,后者P<0.05)。结论:父母培训对学龄前ADHD儿童安全有效,能够改善患儿的家庭环境及其ADHD症状。     

失配性负波在注意缺陷多动障碍和品行障碍患儿中的应用研究

目的了解注意缺陷多动障碍(ADHD)患儿失配性负波(MMN)的特点.方法应用美国NicoletSpirit脑电生理仪,对37例ADHD患儿、22例品行障碍患儿(CD)和30名正常儿童(NC)的MMN做了检测.结果与正常儿童对照组比较,ADHD和CD患儿MMN潜伏期均延迟.ADHD患儿波幅增高.进一步分析,ADHD组波幅又高于CD组.同时两组事件相关电位P300检测潜伏期改变方向与MMN一致.结论ADHD患儿P300变化,提示患儿可能存在注意力、记忆力缺陷及认知加工缓慢.MMN可作为P300检测的一种补充手段,而用于儿童科临床.ADHD患儿MMN潜伏期延长,提示认知功能损害.     

Improving social adjustment in children with attention-deficit/hyperactivity disorder

OBJECTIVE: To determine if sending motivational letters would improve peer relations in children with social maladjustment and attention-deficit/hyperactivity disorder (ADHD). DESIGN: From a consecutive sample, a case series was followed up for 2 years. SETTING: Primary care, private physician, office-based practice. PATIENTS: Ninety-five children diagnosed as having ADHD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria made up the consecutive sample. Twenty-one children qualified with a comorbid social maladjustment disorder with baseline t scores of 1.5 SDs or greater above the mean on the asocial domain of the Conners' Teacher Rating Scale. Seventeen children completed the study. There were no significant differences between these patients and those who did not complete the study (P = .55 for baseline score differences and P = .85 for age). INTERVENTIONS: In addition to conventional therapy for ADHD when children achieved a goal, such as an improved report card or better conduct, a personal letter about their success was mailed to them. Letters averaged 5 per student per year. MAIN OUTCOME MEASURES: The asocial domain of the Conners' Teacher Rating Scale was repeated during the next 2 school years for comparison. Statistical analysis was by a repeated-measures analysis of variance and Helmert contrasts. RESULTS: Of 17 students who completed the study, 16 improved on the Conners' Teacher Rating Scale asocial domain, and the results were statistically significant (P<.001). CONCLUSIONS: Difficulties with peer relations are commonly seen in children with ADHD. Sending motivational letters correlated with improved social adjustment in these children. The data suggest that busy practitioners might consider incorporating this successful, and time-efficient, intervention into their ADHD treatment regimens.     

事件相关电位在网络成瘾和品行障碍患儿中的应用

目的了解网络成瘾障碍(internet addiction disorder,IAD)和品性障碍患儿事件相关电位的特点。方法应用美国Nicolet Bravo脑电生理仪,对37例IAD患儿、22例品行障碍患儿和30名正常儿童(对照组)进行失配性负波(MMN)和P300检测,分析比较3组之间MMN和P300的差异。结果与对照组相比,IAD组P300潜伏期延长[(346.0±21.1)ms vs(324.7±15.0)ms]、P300波幅增高[(3.1±1.8)μV vs(2.7±1.3)μV]、MMN潜伏期延长[(209.0±26.0)ms vs(190.0±22.0)ms]、MMN靶波波幅增高[(8.8±1.7)μV vs(5.2±2.1)μV];品行障碍组P300潜伏期延长[(341.7±14.4)ms vs(324.7±15.0)ms]、波幅增高[(4.7±2.1)μV vs(2.7±1.3)μV]、MMN潜伏期延长[(215.0±23.0)ms vs(190.0±22.0)ms],差异均具有统计学意义(P0.01)。结论 IAD患儿和品行障碍患儿存在P300和MMN潜伏期延长,波幅升高,且IAD患儿延长较明显,MMN可作为P300检测的一种补充手段,而用于儿科临床。     

儿童注意缺陷多动障碍认知功能不同干预模式效果分析

目的了解单独药物治疗、心理治疗以及药物联合心理治疗干预模式对注意缺陷多动障碍(Attention Deficit HyperactivityDisorder,ADHD)儿童认知功能的作用,探讨最佳干预模式。方法研究对象来源于2008年3月至2009年9月,在南昌大学第一附属医院心身医学科门诊及江西省心理康复中心心理门诊就诊的初诊患儿共102例,均明确诊断为ADHD。将患儿随机分为心理干预组(33例)、药物干预组(35例)及综合干预组(34例),分别应用心理治疗、药物治疗和药物联合心理治疗的方法进行干预,疗程3个月。干预前后使用持续注意测验、威斯康辛卡片分类测验、韦氏儿童智力量表、Conner’s儿童行为量表(父母版)对患儿的认知功能及精神症状进行评估。结果共85例患儿完成治疗;干预3个月后3组患儿持续注意测验、威斯康辛卡片分类测验各项指标以及C因子均较干预前改善(P值均<0.05);综合干预模式对患者认知功能改善效果最佳(P值均<0.05),心理治疗与药物治疗对认知功能改善作用差异无统计学意义(P>0.05);干预1.5月后药物干预组和综合干预组患者精神症状改善程度优于心理干预组(P<0.05),而干预3个月后综合干预组患者精神症状改善程度优于其他两组。结论综合干预模式对ADHD患者的认知功能及精神症状的改善效果优于单纯的心理治疗及药物治疗,是理想的ADHD干预模式。     

帕金森病患者听觉P300测试及治疗前后的对比研究

目的　探讨帕金森病 (PD)智能障碍及应用左旋多巴等治疗后听觉P3 0 0 (P3 )各项参数的变化。方法　对 3 0例特发性PD患者在治疗前及治疗 6个月后进行常规P3测试 ,并以健康查体者为对照 ,对组间P3各参数进行对比分析。结果　PD患者经过左旋多巴等治疗后 ,除反应时 (RT)有显著 (P <0 0 5 )缩短外 ,其潜伏期 (PL)及波幅 (Amp)均无显著变化 ;PD患者与健康对照组相比 ,无论左旋多巴等治疗前或治疗后 ,其PL及RT均明显延长 (P <0 0 5 ) ,Amp无显著变化。结论　特发性PD患者PL及RT延长 ,提示其存在智能障碍 ,而左旋多巴等治疗后 ,虽然PD患者的运动功能有明显改善 ,但PL及Amp无改善 ,只有RT的改善 ,提示PD患者智能障碍与中枢性多巴胺能神经机制关系不大     

Effect of mental fatigue induced by repeated continuous calculation tasks on event-related brain potential (P300)]

It is well known that the amplitude and latency of P300 in event-related brain potentials (ERPs) evoked by performing the oddball paradigm reflect the extent of individuals' selective attention. The purpose of this study was to examine whether P300 is a reliable measure for evaluating mental fatigue. In addition to the measurement of auditory ERPs derived from Fz, Cz and Pz, the concentrations of lactic acid, cortisol in plasma and the reaction time of the oddball paradigm, which are believed to reflect fatigue, were measured. In an attempt to cause mental fatigue, 12 healthy college students (8 males, 4 females; 19.5 +/- 0.5 yr; mean +/- S.D.) were forced to perform a continuous addition task using the Uchida-Kreperin test paper for about 2 h. Before the task, the latencies of P300 in Fz, Cz and Pz were 295.6 +/- 8.7 msec, 298.8 +/- 8.5 msec and 297.5 +/- 7.2 msec (mean +/- S.D.), respectively, and after the task they were 312.6 +/- 11.2 msec, 314.6 +/- 10.1 msec and 315.8 +/- 8.7 msec, respectively. A significant difference in the latency before and after the task was detected (p<0.01). In all subjects, the latency of P300 was prolonged in all recording positions, Fz, Cz and Pz. In a control experiment where the continuous addition task was not loaded, a significant change of the latency was not detected. The amplitude of P300 didn't change significantly in all recording positions after the task. In the control experiment, the amplitude of P300 did not change significantly. On the other hand, the changes in the concentrations of lactic acid and cortisol and the reaction time were not induced by the continuous addition task. The prolongation of the latency of P300 would originate from a decline in brain function. In this study, a prolongation of the latency of P300 after the task was detected in all subjects. It is well known that the value of P300 changes with modification of the recording condition, therefore a recording of P300 under the same conditions is required for qualitative evaluation.     

P300 in heavy social drinkers: The effect of lorazepam

The P300 component of the event-related potential (ERP) and reaction time (RT) were recorded during a simulated driving task using an oddball paradigm. ERPs and RTs were recorded from heavy social drinkers (n = 11) and low social drinkers (n = 11). A pharmacological challenge (lorazepam-ATIVAN) was administered to both groups in a double-blind procedure. In both groups, P300 amplitude was reduced and RT was increased by the presence of lorazepam; however, heavy social drinkers had longer latency P300 than low social drinkers regardless of the drug condition. The P300 amplitude results are consistent with reduced information processing being induced by lorazepam, or with reduced effectiveness of the eliciting stimuli. On the other hand, the P300 latency results suggest that P300 latency may reflect deficits in information processing induced by alcohol abuse or may have preceded the alcohol abuse. The P300 latency results are consistent with heavy social drinkers occupying an early point on the hypothesized continuum of alcohol-related brain damage.     

注意缺陷多动障碍和孤独症谱系障碍患者脑干听觉诱发电位比较

目的 探究注意缺陷多动障碍(ADHD)和孤独症谱系障碍(ASD)患者脑干听觉诱发电位(BAEP)是否存在异常,及二者之间BAEP的差异。方法 2018年10月—2019年4月于厦门市仙岳医院采用方便抽样法分别抽取年龄6～16岁的ADHD 27例(53只耳)和ASD 26例(52只耳)首诊患儿为ADHD组和ASD组,招募50例(100只耳)健康志愿者作为对照组。使用诱发电位仪对ADHD组和ASD组行BAEP检测,分析两组Ⅰ、Ⅲ、Ⅴ波潜伏期,Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期及Ⅰ、Ⅴ波波幅异常情况并进行比较。结果 ADHD组和ASD组与对照组相比,异常表现为Ⅰ波潜伏期缩短,Ⅰ-Ⅴ波间期缩短和Ⅰ、Ⅴ波波幅升高,其中ADHD组和ASD组的Ⅰ波潜伏期缩短率分别为5.66%和25.00%,Ⅰ波波幅升高率分别为24.53%和50.00%,差异均有统计学意义(χ²=7.601、7.294,P<0.05)。ADHD组与ASD组相比,Ⅰ波波幅显著降低,Ⅴ波波幅与Ⅴ/Ⅰ波幅比值均显著升高,差异有统计学意义(Z=-2.491、-2.205、-3.140,P<0.05)。结论 ADHD和ASD患儿的听觉传导通路存在差异,且Ⅴ/Ⅰ波幅比值差异可作为二者诊断时参考的重要客观指标。