事件相关电位P300在儿童注意缺陷多动障碍诊断中的应用

The application of P300 to diagnosing attention-deficit-hyperactivity disorder in children

目的 探讨事件相关电位 (ERP)P30 0在儿童注意缺陷多动障碍 (ADHD)诊断中的应用。方法 应用意大利AmplaidMK - 15诱发电位系统 ,采用听觉Oddball刺激序列 ,对ADHD 30例与正常儿童 4 5例进行P30 0测定。观察ERP主要波形N1、P2、N2及P3的潜伏期和波幅变化。结果 1.ADHD组靶刺激P30 0潜伏期明显延迟 ,与对照组比较 ,两组有显著性差异 (P <0 .0 1) ;ADHD组靶刺激P30 0波幅降低 ,但与对照组比较 ,差别无显著性 (P >0 .0 5 ) ;ERP其他主要波形N1、P2、N2的潜伏期和波幅两组间无显著性差别。 2 .P30 0试验在ADHD的临床诊断参考值为靶刺激P30 0潜伏期 >370ms,可疑诊断值范围为 35 0～ 370ms。其特异度为84 .5 % ,灵敏度为 6 6 .7%。结论 靶刺激P30 0潜伏期测定可协助ADHD临床诊断。该方法操作简便 ,客观性强 ,患儿易合作 。

Objective Although attention deficit hyperactivity disorder (ADHD) is the most common childhood behavior disorder, there are no reliable physiological and biochemical measures to contribute to the objective diagnosis. The aim of this study is to explore the application of P300 in the clinical diagnosis of ADHD.Methods 30 children with ADHD (study group) and 45 normal children (as controls) aged 8.5～11.5 years were tested with Amplaid MK 15 electrophysiological diagnostic system. Auditory 'Oddball' paradigm was used in the P300 recordings. The amplitudes and latencies of N1, P2, N2, P3 responses to the rare stimuli and N1, P2, N2 responses to the frequent stimuli in the two groups were observed.Results The P300 latency in the study group was significantly longer than that in the control group (P<0.01); the clinical diagnostic value of P300 latency was >370 ms. Its suspicious diagnostic range was 350 ms～370 ms. Its specialty was 84.5 % and sensitivity was 66.7 %.Conclusions P300 latency measures , which was used to evaluate the cognitive dysfunction in children with ADHD, might be helpful in the clinical diagnosis of ADHD in children. This method is simple ,objective and well cooperated by the children and provides the neurophysiological base for the diagnosis of ADHD.