抽动秽语综合征共患注意缺陷多动障碍男性儿童的反应抑制和精细调节

Response inhibition and fine-motor coordination in male children with Tourette syndrome comorbid attention-deficit/hyperactivity disorder

目的：了解抽动秽语综合征（TS）与注意缺陷多动障碍（ADHD）可能存在的神经心理缺陷的异同点。方法：选择符合疾病和有关健康问题的国际统计分类第十次修订本（ICD-10）诊断标准的6-16岁门诊TS男性患儿30名,TS共病ADHD男性患儿36名,ADHD男性患儿36名以及性别、年龄、智商匹配的健康男性儿童50名作为对象,选择Stroop色-字干扰测验（Stroop）和Purdue钉板测验（Purdue）分别对反应抑制和精细调节经行评估。结果：ADHD组的Stroop测验得分高于TS、TS共病ADHD、正常对照组（均P〈0.05）,而TS和TS共病ADHD组间Stroop得分差异无统计学意义（P〉0.05）。TS组、TS共病ADHD组以及ADHD组Purdue测验中得分均高于正常对照组（均P〈0.05）。结论：男性ADHD儿童可能存在反应抑制缺陷,而TS与TS共病ADHD儿童未发现上述现象,反应抑制功能可能代表了TS神经发育过程中的补偿机制;TS、TS共病ADHD组以及ADHD组均存在精细调节缺陷。

Objective：To explore the differences and similarities of the neuropsychological functioning defi-cits in children between Tourette syndrome （TS）and attention-deficit/hyperactivity disorder （ADHD）. Methods：Thirty boys with TS-only,36 with TS-plus-ADHD,36 with ADHD were selected from out-patient department,and 50 normal boys （NC）matched with gender,age and IQ were recruited as the controls. Patients＇diagnosis was made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision （ICD-10）. They were assessed with the Stroop Color-Word Interference Test （Stroop）and Purdue Pegboard Test （Purdue）to evaluate the response inhibition and fine-motor coordination respectively. Results：The Stroop scores were higher in children with ADHD than in other groups （P〈0. 05 ）,there was no difference between children with TS-only and TS-plus-ADHD （P〉0. 05 ）. All Purdue scores were higher in children with disease than in normal children （P〈0. 05 ）. Conclusion：The results indicate that the response inhibition deficit may be found in children with ADHD,but not in those with TS-only and TS-plus-ADHD. The neural compensatory mechanism may be re-sponsible for the response inhibition function in children with TS whilst the fine-motor coordination deficit was as-sociated with the disease groups.