注意缺陷多动障碍与正常儿童心算事件相关电位及行为学特征比较

Comparative ERP and behavior study of ADHD and normal children in mental arithmetic practice

目的 比较注意缺陷多动障碍（ADHD）患儿与正常儿童执行心算任务时左右大脑半球事件相关电位（ERP）及行为学特征,探讨ADHD心算神经机制.方法 对象ADHD组32例,正常对照组32名,采用20以内加、减、乘法心算任务,进行ERP及行为学检测.结果 （1） ERP：①心算加、减、乘法左右额区N2波幅比较：ADHD组差异无统计学意义[加法（-6.2±7.3）μV,（-6.6±8.1）μV;减法（-5.5±6.4）μV,（-5.8±6.5）μV;乘法（-5.9±8.2）μV,（-6.0±8.6）μV;均P＞0.05].正常组左额区（F3）明显高于右额区（F4）,差异有统计学意义[加法（-6.8±4.0）μV,（-5.9±4.3）μV;减法（-7.5±4.8）μV,（-6.3±4.4）μV;乘法（-6.9±3.7）μV,（-5.7±4.4）μV;均P＜0.05].②ADHD组执行减法任务时额区N2波幅明显低于加法及乘法,正常组则减法最高.③心算加、减、乘法左右额区N2潜伏期比较：二组比较均差异无统计学意义（P＞0.05）.（2）行为学：①反应时间：ADHD组明显长于正常对照组,差异有统计学意义[加法（983± 183） ms,（833±164） ms;减法（1 005± 160） ms,（859±170） ms;乘法（975± 180） ms,（836± 175） ms;均P＜0.05].②正确率：ADHD组均低于正常组.结论 ADHD心算时大脑激活无明显优势半球,功能协调受限,处理冲突信息及判断决策障碍,尤其减法更为明显.

Objective To compare the differences of event-related potentials （ERP） of left and right cerebral hemispheres and behavioral characteristics in the mental arithmetic practice between ADHD and normal children,and to explore the neural mechanisms of mental arithmetic by ADHD children.Methods ERP and behavioral data of 32 ADHD and 32 normal children in mental arithmetic,to illustrate,simple addition,subtraction and multiplication within 20 were recorded.Results ERP：① The differences of N2 amplitudes in ADHD children ＇s left and right cerebral hemispheres while doing mental arithmetic,such as,addition,subtraction and multiplication were not statistically significant （addition：（-6.2±7.3） μV,（-6.6± 8.1） pV ; subtraction：（-5.5±6.4） μV,（-5.8± 6.5） μV ; multiplication：（-5.9± 8.2） μV,（-6.0± 8.6） μV ; all P〉0.05）.However,normal group＇s N2 amplitude of left hemisphere（F3） were obviously higher than those of the right hemisphere （F4）,considered to be statistically significant difference （addition：（-6.8±4.0） μV,（-5.9±4.3） μV ; subtraction：（-7.5±4.8） μV,（-6.3±4.4） μV ;multiplication：（-6.9±3.7）μV,（-5.7±4.4）pV ; all P〈0.05）.② ADHD group＇s N2 amplitude of subtraction practice was significantly lower than that of addition and multiplication,while normal control group was the opposite.③There were not statistically difference between N2 incubation of left and right hemisphere while addition,subtraction,and multiplication were done （P〉0.05）.Behaviorism：① ADHD group＇s reaction time towards answer making were much longer than those of the normal control group （addition：（983± 183） ms,（833± 164） ms ; subtraction：（1005±160）ms,（859±170）ms;multiphcation：（975±180）ms,（836±175）ms; P〈0.05）.② Accurate rate：ADHD group were all lower than those of normal group.Conclusion There were functional limitations of no obviously advantage hemisphere and two hemisphere coordination while ADHD children were performing mental arithmetic,also hmitations in conflicting information processing,decision making,and more obviously in subtraction practice.