CAJ | 학술논문

目的使用行为学及事件相关电位(ERP)技术探讨注意缺陷多动障碍(ADHD)患儿数学认知功能受损的神经机制.方法 2012年7至10月在苏州大学附属第三医院门诊就诊的27例ADHD患儿(ADHD组)及29名年龄、性别相匹配的健康儿童作为对照组,采用20以内加、减、乘法计算模块刺激记录行为学,使用BESA软件提取ERP并进行组间比较.结果 (1)行为学:加、减、乘法计算的反应时间ADHD组均明显长于对照组[(949±144)比(829±166) ms,(981±129)比(856±170) ms,(944±136)比(825±172) ms,均P＜0.05],正确率[M(Q1,Q3)]则均低[0.80％(0.72％,0.88％)比0.90％(0.85％,0.96％),0.78％(0.64％,0.85％)比0.90％(0.84％,0.93％),0.86％(0.74％,0.92％)比0.93％ (0.90％,0.98％),均P＜0.05].(2)ERP:ADHD和对照组在额部均产生明显的N2波,F3、Fz导联ADHD加、减、乘法波幅均明显低于对照组[F3:(-3.5±5.2)比(-6.7±3.5)μV、(-3.8±4.0)比(-7.4±4.5)μV、-5.8(-7.6,1.6)比-6.4(-10.3,-4.9)μV,Fz:(-4.3±6.4)比(-7.4±4.2)μV、(-5.0±5.4)比(-7.9±4.6)μV、-5.2(-9.7,-0.6)比-7.9(-10.5,-5.1)μV,均P＜0.05],减法计算在F3、Fz、F4导联ADHD组潜伏期均长于对照组[(328±36)比(307±27) ms,(331±35)比(311±30)ms,325 (307,354)比309(280,330) ms,均P＜0.05].ADHD和对照组在加及乘法的潜伏期上差异均无统计学意义(均P＞0.05).结论 ADHD患儿抑制无关信息及注意控制的能力较弱,在解决加减乘法的计算题时存在计算认知功能的损害,在选择最佳策略完成认知任务中存在缺陷.
목적 사용행위학급사건상관전위(ERP)기술탐토주의결함다동장애(ADHD)환인수학인지공능수손적신경궤제.방법 2012년7지10월재소주대학부속제삼의원문진취진적27례ADHD환인(ADHD조)급29명년령、성별상필배적건강인동작위대조조,채용20이내가、감、승법계산모괴자격기록행위학,사용BESA연건제취ERP병진행조간비교.결과 (1)행위학:가、감、승법계산적반응시간ADHD조균명현장우대조조[(949±144)비(829±166) ms,(981±129)비(856±170) ms,(944±136)비(825±172) ms,균P＜0.05],정학솔[M(Q1,Q3)]칙균저[0.80％(0.72％,0.88％)비0.90％(0.85％,0.96％),0.78％(0.64％,0.85％)비0.90％(0.84％,0.93％),0.86％(0.74％,0.92％)비0.93％ (0.90％,0.98％),균P＜0.05].(2)ERP:ADHD화대조조재액부균산생명현적N2파,F3、Fz도련ADHD가、감、승법파폭균명현저우대조조[F3:(-3.5±5.2)비(-6.7±3.5)μV、(-3.8±4.0)비(-7.4±4.5)μV、-5.8(-7.6,1.6)비-6.4(-10.3,-4.9)μV,Fz:(-4.3±6.4)비(-7.4±4.2)μV、(-5.0±5.4)비(-7.9±4.6)μV、-5.2(-9.7,-0.6)비-7.9(-10.5,-5.1)μV,균P＜0.05],감법계산재F3、Fz、F4도련ADHD조잠복기균장우대조조[(328±36)비(307±27) ms,(331±35)비(311±30)ms,325 (307,354)비309(280,330) ms,균P＜0.05].ADHD화대조조재가급승법적잠복기상차이균무통계학의의(균P＞0.05).결론 ADHD환인억제무관신식급주의공제적능력교약,재해결가감승법적계산제시존재계산인지공능적손해,재선택최가책략완성인지임무중존재결함.
Objective To explore the mathematics cognitive function of children with attention deficit hyperactivity disorder and explore neural mechanisms with event-related potential (ERP).and behaviors.Methods Behavior data and ERP elicited by performing mental calculation tasks were recorded in 27 children with ADHD and 29 normal controls from July to October 2012 at Third Afiliated Hospital of Soochow University.The differences of behaviors and N2 component of ERP were compared and analyzed.Results The reaction time of the children with ADHD were longer than the control group in addition,subtraction and multiplication ((949 ± 144) vs (829 ± 166) ms,(981 ± 129) vs (856 ± 170) ms,(944 ± 136) vs (825 ± 172)ms,all P ＜ 0.05).While the correct rate were less than normal control in all three arithmetic operations (0.80％ (0.72％,0.88％) vs 0.90％ (0.85％,0.96％),0.78％ (0.64％,0.85％) vs 0.90％ (0.84％,0.93％),0.86％ (0.74％,0.92％) vs 0.93％ (0.90％,0.98％),all P ＜0.05).N2 component could be elicited by all subjects in forehead.The amplitude of N2 of children with ADHD were significantly lower than control group in all three arithmetic operations at left frontal (F3:(-3.5 ± 5.2) vs (-6.7 ± 3.5)μV,(-3.8±4.0) vs (-7.4±4.5)μV,-5.8(-7.6,1.6)vs-6.4(-10.3,-4.9)μV,all P＜0.05)and Fz ((-4.3±6.4) vs (-7.4±4.2)μV,(-5.0±5.4) vs (-7.9±4.6)μV,-5.2 (-9.7,-0.6) vs-7.9 (-10.5,-5.1) μV,all P ＜ 0.05),the latency of ADHD group were prolonger than controls in subtraction operations at right and left frontal ((328 ± 36) vs (307 ± 27) ms,325 (307,354) vs 309 (280,330) ms) and frontal electrodes ((331 ± 35) vs (311 ± 30) ms,all P ＜ 0.05).In addition and multiplication operations,there was no significant difference in latency (all P ＞ 0.05).Conclusions The children with ADHD have weak capacities of inhibition irrelevant information and paying attention to control.Their deficits in mental arithmetics may be due to the difficulties of selecting the best strategy during cognitive tasks.