注意缺陷多动障碍儿童记忆和执行功能的研究

背景:注意缺陷多动障碍(attentionaldeficithyperkineticdisorder,ADHD)儿童的注意缺陷和学习困难国内研究较多,但对其记忆和执行功能的研究报道较少。目的:评估ADHD的记忆和执行功能。设计:以诊断为依据的病例对照研究。地点和对象:病例组患儿共45例,为2001-08/2002-02到镇江市第四人民医院门诊就诊的儿童,男39例,女6例,年龄7～14岁。对照组儿童共45例,为镇江市某小学1～6年级学生,男39例,女6例,年龄7～14岁。方法:采用儿童韦氏智力量表中的数字广度测验和韦氏记忆量表中的逻辑记忆和视觉记忆及威斯康星卡片分类测验分别对45例正常儿童和45例ADHD患儿进行检测。主要观察指标:ADHD患儿和正常儿童记忆之间以及ADHD各亚型之间的执行功能的比较。采用龚耀先标化的中国韦氏儿童智力量表及威斯康星卡片分类测验评定记忆和执行功能。结果:ADHD组中的数字广度、逻辑记忆、视觉记忆和威斯康星卡片中的总测验次数、正确反应数、持续错误数、非持续错误数以及分类数(15.12±2.00,9.98±4.16,17.06±3.83,105.52±24.75,21.17±3.43,45.87±21.02,22.99±8.47,1.09±0.31)与正常对照组(22.23±1.08,20.17±2.72,21.88±6.15,63.36±12.37,41.13±10.25,23.97±7.12,10.68±5.80,3.91±1.68)比较,差异有显著性意义(t

A study of the memory and executive functions in the children with attention-deficit hyperkinetic disorder

BACKGROUND:In China,there have been lots of research on attention deficit and learning difficulty in patients with attention deficit hyperkinetic disorders(ADHD).However,reports on memory and executive functions have been rare . OBJECTIVE:To assess the memory and executive functions of ADHD. DESIGN:A case control study based on the diagnosis. SETTING AND PARTICIPANTS:The study group consisted of 45 ADHD children(39 males and 6 females) who sought medical advice at the Out patient Department of the Fourth People's Hospital of Zhenjiang.These patients were documented from August,2001 to February,2002.The range of age was 7- 14 years old.The normal control group consisted of 45 pupils of grade 1- 6 from one of the primary schools in Zhenjiang City during the same period,including 39 males and 6 females.The range of age was 7- 14 years old. METHODS:The digit span test of Wechsler Child Intelligence Scale,the logical memory and visual memory test of Wechsler Memory Scale,and Wisconsin Card Sorting Test were used to assess the memory and executive functions of ADHD children. MAIN OUTCOMES AND MEASURES:A comparative studies of the memory and executive functions between the normal children and those with ADHD as well as among the ADHD subtypes were conducted with Wechsler Child Intelligence Scale(for Chinese) standardized by Dr.Gong Yaoxian and Wisconsin Card Sorting Test. RESULTS:Compared with the control group,the ADHD group showed a significant difference in the scores of digit span(15.12± 2.00 vs 22.23± 1.08),logical memory(9.98± 4.16 vs 20.17± 2.72) and visual memory(17.06± 3.83 vs 21.88± 6.15),and also in the number of total tests(105.52± 24.75 vs 63.36± 12.37),correct responses(21.17± 3.43 vs 41.13± 10.25),persistent errors(54.87± 21.02 vs 23.97± 7.12),non persistent errors(22.99± 8.47 vs 10.68± 5.80),and categories(1.09± 0.31 vs 3.91± 1.68) achieved in WCST(t=4.46- 20.98,P< 0.01). Comparison among the three subtypes of the ADHD group(hyperactive impulsive type,attention deficit type and mixed type) showed that there was no significant difference in almost all the items,except for logical memory,which was significantly higher in the hyperactive impulsive type than in the two other subtypes(P< 0.01). CONCLUSION:Short term memory and executive functions are impaired due to ADHD.