哌醋甲酯对非言语型学习障碍儿童注意功能的影响

Effect of Methylphenidate upon Attention Process in the Nonverbal Learning Disabilities.

【目的】 探讨哌醋甲酯 (MPH)对学习障碍 (LD)儿童选择注意功能的作用及其机理。 【方法】 采用ERP技术附加语义、方向及音调辨别等连续执行课题 (CPT) ,对 9～ 14岁 12名男性非言语型LD儿童进行服用安慰剂和MPH后的两次测试 ,并就其准确率、反应时、误反应率、P3 0 0 振幅和潜伏期等指标进行了比较分析。 【结果】 被检儿童服用MPH后检测结果均较安慰剂结果有显著改善 ,表现为靶标认知率提高 ,误答率降低 ,反应时缩短。服用MPH后P3 0 0 成分振幅增加 ,潜伏时缩短 ;尤其是反映选择注意的负波 (认知处理性负波 )增多。另外 ,被检儿童个体间ERP结果差异较显著。 【结论】 LD儿童存在选择注意缺陷 ,提示与其额叶 基低神经节环路功能障碍有关 ;MPH不仅改善LD儿童多动症状 ,亦能够改善其选择注意功能。

Objective To investigate performance scores and event related potentials(ERP) in the selective attention tasks for nonverbal learning disabilities(LD) with Methylphenidate(MPH). Methods Using ERP technique with CPT conditions,such as semantic,direction and pitch identification,we twice tested 12 LD boys at take the MPH and placebo.A comparative study was made to analyze these indicators of accuracy,reaction time,false alarm,wave amplitude and latency between the two medicine. Results Among the three kinds of identification tests,the MPH group have higher pitch identification accuracy and reaction time compared to placebo group( P <0.05, P <0.01).The false alarm rate of placebo group is much higher than that of MPH group (unattend high simulate P <0.05,all pitch identification accuracy P <0.05).Moreover the P 300 amplitude was decreased( P <0.05) and the latency was delayed( P <0.05). Conclusions There is a disability in selective attention of LD children,and it is suggested that frontal basal ganglia circle amy play a important role in neuropsychological mechanism of LD.The MPH can control hyperactivity and improve the selective attention of LD children.