注意缺陷多动障碍儿童哌醋甲酯治疗前后错误监控功能的动态观察

Dynamic observation of error-related negativity before and after methylphenidate treatment in attention deficit hyperactivity disorder

目的探讨注意缺陷多动障碍儿童的错误相关负电位(error-related negativity,ERN)变化与治疗的关系。方法应用德国Brain Products公司的ERP记录与分析系统,对38例ADHD和30名健康儿童作了ERN检测。结果 (1)注意缺陷多动障碍组的正确反应率明显低于健康儿童组,正确反应和错误反应的反应时明显比健康儿童组长。(2)与健康儿童组相比,注意缺陷多动障碍ERN潜伏期在Cz、Oz、C3和C4上明显延迟,波幅(Cz、C3、Oz、Pz)较健康儿童组低。(3)患者组在治疗后6月、18月随访时,ERN潜伏期和波幅差异无显著性(P>0.05)。结论注意缺陷多动障碍儿童的ERN潜伏期和波幅异常,可能反映了本组儿童内在错误监控机制存在缺陷。随访ERN变化可能是一种属性标志。

Objective To explore the variations of error-related negativity （ERN） and treatment in attention deficit hyperactivity disorder patients. Methods The ERN was tested in 38 attention deficit hyperactivity disorder （ADHD） and 30 normal controls （NC） using ERP instruments of Brain Products Company （Germany）. Results ①The correct response rate was significantly lower in the ADHD group than in the NC group, and the reaction periods of correct responses and incorrect responses were significantly longer in the ADHD group than in the NC group. ②The ERN latencies in the ADHD group were significantly longer on Cz、 Oz、 C3 and C4 electrodes compared with those in the NC group, and ERN amplitudes were significantly lower than those in the controls in Cz、C3、 Oz and Pz electrodes. ③The ERN latencies and amplitudes in ADHD group did not show significant difference （P〉 0.05） during treatment. 6 and 18 months Conclusion The anomalies of ERN latencies and amplitudes in ADHD may reflect their deficiency on error-monitoring function which needs to be further investigated. ERN might be a trait marker of ADHD.