注意缺陷多动障碍患儿事件相关电位P_3波分析

Analysis of Event Related Potentials P_3 Wave of Children with Attention Deficit Hyperactivity Disorder

目的研究注意缺陷多动障碍(ADHD)患儿的认知功能,探讨事件相关电位(ERP)在ADHD中的应用及ERP P3波与年龄的相关性。方法 78例ADHD患儿(ADHD组)和78例健康对照儿童(健康对照组)分别按年龄分为3组,即6.50～8.40岁组、8.50～10.40岁组和10.50～12.50岁组。对所有受试者分别进行听觉ERP P3波的检测。应用t检验和Bivariate analyze方法分析资料。结果 1.ADHD组3个年龄段患儿P3波潜伏期均较健康对照组对应年龄儿童延长(Pa<0.01),波幅差异不明显。2.与健康对照组儿童比较,ADHD组患儿靶刺激击中正确率显著降低(P<0.01),误按非靶刺激数显著增多(P<0.01)。3.ADHD组和健康对照组儿童ERP P3波潜伏期与年龄均呈显著负相关(r=-0.448 1、-0.570 4,Pa<0.001),P3波波幅与年龄均呈显著正相关(r=0.269 7、0.317 6,Pa<0.05)。4.ADHD组与健康对照组儿童大脑左中央区(Cz1)、右中央区(Cz2)P3波潜伏期、波幅比较均无统计学差异(Pa>0.05)。结论 ADHD患儿认知功能和排除干扰的能力显著低于健康儿童。ERP P3波测试可作为临床判断ADHD患儿认知障碍的客观指标,对ADHD儿童的诊断、药物疗效和预后判断可能有辅助作用。采用ERP P3波评价ADHD患儿时,要特别考虑年龄问题。

Objective To investigate the cognitive functions of children with attention deficit hyperactivity disorder （ADHD）, and explore the application of event related potentials（ERP） in ADHD children and the correlation of ERP P3 wave with age. Methods Seventy - eight cases of ADHD children（ ADHD group） and 78 cases of healthy children（ healthy control group） were divided into 3 groups according to age,including 6.50- 8.40 group,8.50- 10.40 group and 10.50 -12.50 group. All subjects were examined with auditory event related potentials P3 wave test. Data were analyzed by student t test and Bivariate analyze methods. Results 1. Compared to age - matched healthy con- trois, ADHD groups did not show differences in the amplitude of the P3 wave, however,the ADHD group had significantly longer latency of P3 wave in all 3 age groups（ Pa 〈 0. 01 ）. 2. Children with ADHD had significantly lower rate of stimulated target hitting and higher frequency of false hitting than those of age -matched healthy control groups（Pa 〈0. 01 ）. 3. In both groups, the latency of P3 wave showed a significantly negative correlation with age（ r = -0. 448 1, -0. 570 4,Pa 〈 0. 001 ）,while amplitudes had positive correlation with age（ r = 0. 269 7, 0.317 6 ,Pa 〈 0.05 ）. d. The latency and amplitude of P3 wave in the central gyrus of the left hemisphere （Czl） in ADHD children and healthy control group were nat significantly different from those in the right hemosphere （ Cz2 ） （ P 〉 0.05 ）. Conclusions ADHD children have significant deficits in cognitive functions and in the ability of excluding disturbance compared with healthy children. The ERP P3 wave test is an useful method to evaluate cognitive deficits in the clinic. It can be used to assistant ADHD diagnosis,evaluate treatment efficiency and prognosis. When using this test to evaluate children with ADHD, age must be considered.