注意缺陷多动障碍患儿空间忽视与听觉P300的关系

目的探讨注意缺陷多动障碍(ADHD)儿童空间忽视与听觉P300的关系。方法对32例ADHD和32例健康儿童进行划星试验、线等分试验及普通非忽视测试,并以听觉靶和非靶刺激为诱发事件检测前额区(Fz)、中央区(Cz)、顶区(Pz)、左中央区(C3)、右中央区(C4)、左前额(F3)、右前额(F4)7个点的听觉P300潜伏期、波幅、脑电地形图,并进行比较研究。结果1.ADHD患儿线等分测试结果(-9.37±6.57)与对照组(-5.46±4.69)比较,差异有显著性(P<0.05);左侧划星试验成绩(11.44±5.55)差于对照组(16.34±4.82)(P<0.01),且左侧较右侧(17.13±6.36)差(P<0.01);2.二组线等分测试成绩均偏向零值的右侧(P<0.01),两侧划星测试成绩也较期望值27/27差(P<0.01);3.ADHD患儿Pz、C4、F4P300波幅、潜伏期较健康儿童组长,有显著差异(Pa<0.05);4.二组P300脑电地形图叠加后,健康儿童组P300呈同心圆状均匀扩散,左右对称,而ADHD患儿电位存在左侧脑区偏移;5.ADHD患儿划线测试结果或左侧划星测试成绩与P300电位在Fz、Pz、C4和F4的潜伏期与波幅具有线性关系(P<0.05)。结论ADHD患儿可能存在偏侧空间忽视和注意认知功能损害,且左侧空间忽视发生及程度与大脑右半球相应脑区电生理的不对称损害一致。

Relationship between Unilateral Spatial Neglect and P300 in Children with Attention Deficit Hyperactivity Disorder

Objective To explore the relationship of unilateral spatial neglect and P300 in children with attention deficit hyperactivity di-sorder(ADHD).Methods Thirty-two ADHD children and 32 healthy children all accepted the following management.The spatially sensitive line bisection test and star cancellation test and more general measures of(non-spatial)were used to evaluate attention and intellectual function of children with ADHD,and neuroscan instrument to record event-related potentials.P300 provocated by audition in frontal region(Fz),central region(Cz),central region(Pz),left central zone(C3),right central zone(C4),left performs zone(F3)and right performs zone(F4)were used to reflect attention cognition function of them.Results Compared with controls,children with ADHD whose bisections were consistent with relative inattention to the left indeed had higher ratings and performed significantly more poorly on tests of line bisection test(Pa<0.01).Interestingly controls also had bad left spatial executive function of bisections test contrasted with the theoretical normal range(Pa<0.01).Children with ADHD showed in the wave shape,latent period and wave amplitude of P300 in Fz,Pz,C4 and F4 abnormality relatively to controls(Pa<0.05),and showed association with bisection test assessment by correlation analysis(P<0.05).Conclusion The results suggest an association between poor attention cognition and some relative left spatial bias which may stem from certain region of right hemisphere inefficiency in children with ADHD.