学龄期多动症患儿视频脑电图异常改变与智力水平的关系

Correlation between changes of video electroencephalogram and intelligence level in children with attention deficit hyperactivity disorder at school-age

目的探讨学龄期多动症患儿视频脑电图的检查结果及其与智力水平的关系。方法选取2015年3月—2019年7月佛山复星禅诚医院收治的80例学龄期多动症患儿作为甲组,另选取同期体检健康的72例学龄期儿童作为乙组。两组均进行视频脑电图检查,对比脑电图异常情况,采用中国韦氏学龄儿童智力量表(C-WISC)评估其智力水平,比较甲组脑电图正常者与异常者的智力水平,采用Spearman法分析学龄期多动症患儿的视频脑电图异常情况与智力水平的关系。结果甲组脑电图异常率为23.75%(19/80),其中9例表现为α波形欠整齐及调节调幅欠佳,θ波增多且呈弥散或阵发性出现,θ/α、θ/β比值升高,6例表现为θ波弥漫性活动、δ波增多、左右不对称及有少量癫痫样放电,有4例表现为明显δ波活动、弥漫性慢波异常且多伴癫痫样放电;乙组脑电图异常率为6.94%(5/72),其中4例表现为θ波弥漫增多及基线不稳、调幅不佳,1例表现为δ波增多且形态不规则;甲组视频脑电图异常率高于乙组(P<0.05);两组言语智商(VIQ)、操作智商(PIQ)及总智商(FIQ)等级比较,差异有统计学意义(P<0.05),甲组VIQ、PIQ及FIQ等级(优秀+中上+中等)占比低于乙组(P<0.05);甲组脑电图异常者的VIQ、PIQ及FIQ的等级与正常者比较,差异有统计学意义(P<0.05),异常者VIQ、PIQ、FIQ等级(优秀+中上+中等)占比低于正常者(P<0.05);经Spearman相关性分析显示,学龄期多动症患儿脑电图异常与其VIQ、PIQ和FIQ水平呈正相关(rs=0.579、0.583和0.562,P=0.002、0.006和0.005)。结论部分学龄期多动症患儿有脑电图异常改变及智力水平下降的表现,且脑电图异常者的智力水平降低更为明显,脑电图异常与智力水平存在一定相关性。

Objective To investigate the examination results of video electroencephalogram in children with attention deficit hyperactivity disorder at school-age and its correlation with intelligence level.Methods From March 2015 to July 2019,80 children with attention deficit hyperactivity disorder at school-age admitted to our hospital were selected as A group,and 72 healthy children at school-age in the same period were selected as B group.The 2 groups were checked by video electroencephalogram,and the abnormal electroencephalogram of the 2 groups were compared,and the intelligence levels of them were assessed by Chinese Wechsler Intelligence Scale for school age children(C-WISC).The intelligence levels of normal and abnormal electroencephalogram patients in A group were compared,then the relationship between the abnormal of video electroencephalogram and intelligence level in children with hyperactivity disorder at school-age age was analyzed by Spearman correlation method.Results The abnormal rate of electroencephalogram in A group was 23.75%(19/80),including 9 cases with incompleteα-waveform and poor adjustment of amplitude modulation,increasedθwave and diffuse or paroxysmal appearance,and increasedθ/αandθ/βratio,6 cases with diffuse activity ofθwave,increasedδwave,asymmetry of left and right,and a small amount of epileptic discharge,and 4 cases with obviousδwave activity,diffuse slow wave abnormality,and epilepsy like discharge.The abnormal rate of electroencephalogram in B group was 6.94%(5/72),including 4 cases with diffuse increase ofθwave,unstable baseline,and poor amplitude modulation,1 case with an increase ofδwave and irregular shape.The abnormal rate of video electroencephalogram in A group was significantly higher than that in B group(P<0.05).There were significant differences in verbal intelligence quotient(VIQ),operational intelligence quotient(PIQ),and total intelligence quotient(FIQ)scores grade between the two groups(P<0.05),and the grade of A group was lower than that of B group.The proportions of(Excellence+Middle and Upper+Medium)of VIQ,PIQ,and FIQ in A group were lower than those in B group(P<0.05).There were significant differences in VIQ,PIQ,and FIQ scores grade between abnormal and normal electroencephalogram children in A group(P<0.05),and the grade of abnormal electroencephalogram children was lower than that of normal children.The(Excellence+Middle and Upper+Medium)ratios in VIQ,PIQ and FIQ of the abnormal electroencephalogram children were lower than those of the normal electroencephalogram children(P<0.05).Spearman correlation analysis showed that abnormal electroencephalogram was positively correlated with VIQ level(rs=0.579,P=0.002),PIQ level(rs=0.583,P=0.006),and FIQ level(rs=0.562,P=0.005)in children with attention deficit hyperactivity disorder at school-age.Conclusion Some children with attention deficit hyperactivity disorder at school-age show abnormal changes of electroencephalogram and decreased intelligence level.The intelligence level of those with abnormal electroencephalogram decreases more obviously,which forecast a certain correlation between the abnormal of electroencephalogram and intelligence level.