注意缺陷多动障碍儿童计算机在线认知训练研究

Computerized online cognitive training of children with attention deficit hyperactivity disorder

目的评估计算机在线认知训练方法对注意缺陷多动障碍（ADHD）患儿认知功能的改善作用。方法对首都儿科研究所附属儿童医院神经科门诊筛选出的ADHD儿童15例进行计算机在线认知训练，包括注意力训练、视知觉训练和记忆力训练，采用认知功能测试（选择反应时、三维心理旋转、词语辨析、简单减法、言语工作记忆和视觉追踪）评估训练前后的基本反应能力和反应速度、视空间认知能力、语义理解能力、计算流畅性、工作记忆和注意能力。使用配对样本t检验比较计算机在线认知训练前后认知功能测试成绩。结果所有认知功能测试校正后的正确题数转化为百分位数。配对样本t检验结果表明，ADHD儿童工作记忆测验后测成绩高于前测[（52．00±20．77）％比（39．73±23．64）％]，差异有统计学意义（t=2．72，P〈0．05）。ADHD患儿训练后选择反应时、三维心理旋转、词语辨析、简单减法和视觉搜索的任务测试成绩，较训练前均差异无统计学意义（P均〉0．05）。结论计算机在线认知训练可显著改善ADHD儿童的工作记忆，需要进一步扩大样本量，对训练效果进行长期追踪。

Objective To evaluate the therapeutic effect of computerized ouline cognitive training for children with attention deficit hyperactivity disorder （ADHD）. Methods Fifteen children with ADHD recruited from Department of Neurology in the Children＇s Hospital Affiliated to Capital Institute of Pediatrics received computerized online cognitive training including attention training, visual spatial training and memory training. Cognitive neuropsychological test battery （choice reaction time, mental rotation, word semantic, simple subtraction, working memory and visual tracing） was used to assess the cognitive function in pre -training and post -training stages, such as basic response abili- ty, reaction speed, visuo - spatial cognitive ability, semantic comprehension, calculation fluency, working memory and attention ability. Paired - samples t test was used to make comparison of the cognitive test results between pre - training condition and post - training condition. Results All the correction scores of cognitive tests were transformed to percentile scores. Paired - samples t test results showed that the ADHD children got higher scores in the post - training condition than in the pre - training condition in working memory test [ （52.00 ± 20.77 ） % vs （ 39.73 ± 23.64） %, t = 2.72, P 〈 0. 051. There was no significant training effect in choice reaction time, mental rotation, sentence completion, simple subtraction and visual tracing（ all P 〉 0. 05）. Conclusions Computerized online cognitive training can significantly improve the working memory of children with ADHD, and has no side effects on other cognitive functions. It need to further expand the sample size and follow up the training effect for a tongtenn.