177例儿童注意缺陷多动障碍的脑电图及神经心理特征分析

Analysis on electroencephalogram and neuropsychological characteristics of 177 children with attention deficit-hyperactivity disorder

目的探讨儿童注意缺陷多动障碍(ADHD)的脑电图及神经心理特征情况,为儿童ADHD的诊治提供参考。方法选取2013年11月-2016年12月北京安定医院收治的ADHD患儿177例为研究对象,根据精神障碍诊断与统计手册(第4版)(DSM-IV)中ADHD分型分为多动/冲动为主型组31例,混合型组95例,注意缺陷为主型组51例。3组患儿入院后均采用日本光电EEG-4418K型脑电图进行测定,并对3组患儿进行视觉-运动整合发育测验(VMI)、联合型瑞文测验(CRT)、反应时测定,比较不同类型儿童ADHD的脑电图及神经心理特征情况。结果 177例ADHD患儿均行脑电图检查,其中79例脑电图正常,占44.63%,98例脑电图异常,占55.37%。异常脑电图患儿中56例轻度脑电图异常,42例中重度脑电图异常;多动/冲动为主型组VMI测定结果高于混合型组与注意缺陷为主型组,差异有统计学意义(均P<0.05);注意缺陷为主型组CRT测定结果高于多动/冲动为主型组与混合型组,差异有统计学意义(均P<0.05);混合型组平均反应时、最快反应时及最慢反应时长于多动/冲动为主型组与注意缺陷为主型组,差异有统计学意义(均P<0.05)。结论儿童ADHD伴有不同程度的脑电图异常,能显示特异性与非特异性改变,并且儿童的视觉-运动整合能力较差,VMI则能反应ADHD亚型中患儿注意力障碍问题。

Objective To explore electroencephalogram（ EEG） and neuropsychological characteristics of children with attention deficit-hyperactivity disorder（ ADHD）,provide a reference for diagnosis and treatment of ADHD in children. Methods From November2013 to December 2016,177 children with ADHD were selected from Beijing Anding Hospital,then they were divided into hyperkinetic/impulsive type group（ 31 children）,mixed type group（ 95 children）,and attention deficit type group（ 51 children） according to ADHD types based on DSM-Ⅳ. EEG-4418 K electroencephalograph was used to measure the children in the three groups. VMI,CRT,and reaction time determination were performed in the three groups. EEG and neuropsychological characteristics of children in the three groups were compared. Results Among 177 children,79 children were found with normal EEG result,accounting for 44. 63%; 98 children were found with abnormal EEG result,accounting for 55. 37%. Among the children with abnormal EEG result,56 children were found with mild abnormal EEG,and 42 children were found with severe abnormal EEG. The level of VMI in hyperkinetic/impulsive type group was statistically significantly higher than those in the other two groups（ P〈0. 05）. The level of CRT in attention deficit type group was statistically significantly higher than those in the other two groups（ P〈0. 05）. The average response time,the fastest response time,and the slowest reaction time in mixed type group was statistically significantly longer than those in the other two groups（ P〈0. 05）. Conclusion ADHD children are found with varying degrees of abnormal EEG,which indicates specific and non-specific changes,visual motor integration ability of children is poor,VMI can reflect attention deficit in ADHD children.