伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿不同放电侧别间认知损害差异分析

Analysis of cognitive impairment on different discharge side in children with benign epilepsy of childhood with centrotemporal spikes co-associated with attention deficit hyperactivity disorder

目的探讨伴中央颞区棘波的儿童良性癫痫(BECT)共患注意缺陷多动障碍(ADHD)患儿,脑电图(EEG)不同放电侧别间认知损害差异。方法前瞻性选取沧州市人民医院初次诊断的BECT共患ADHD患儿69例及单纯BECT患儿65例为研究对象,每组患儿再根据放电侧别分为左侧放电组和右侧放电组。采用视频脑电图(VEEG)、事件相关电位P300、韦氏儿童智力量表、视听整合连续测试检查,分别测定并比较BECT共患ADHD组与单纯BECT组相同放电侧别患儿间及每组内不同放电侧别患儿间认知损害差异。结果左侧放电时,与单纯BECT组比较,BECT共患ADHD组言语理解指数(VCI)、知觉推理指数(PRI)、加工速度指数(PSI)分值均降低(P<0.05);右侧放电时,与单纯BECT组比较,BECT共患ADHD组知觉推理指数(PRI)、工作记忆指数(WMI)、加工速度指数(PSI)及听觉反应控制商数(ARCQ)、视觉反应控制商数(VRCQ)分值均降低(P<0.05);单纯BECT组内,左侧放电组较右侧放电组知觉推理指数(PRI)分值降低(P<0.05)。结论不论左侧放电还是右侧放电,BECT共患ADHD患儿均有部分认知功能损害程度较单纯BECT患儿更加严重;BECT共患ADHD患儿及单纯BECT患儿组内,左侧放电和右侧放电间认知功能损害无明显差异。

Objective To investigate the cognitive impairment of different electroencephalogram(EEG)discharge sides in children with benign epilepsy of childhood with centrotemporal spikes(BECT)co-associated with attention deficit hyperactivity disorder(ADHD).Methods Sixty-nine children with BECT co-associated with ADHD and Sixty-five children with BECT alone who were first diagnosed were prospectively selected as the research subjects.Each group of children were divided into left discharge group and right discharge group according to the discharge side.Video electroencephalogram(VEEG),event-related potential P300,wechsler child intelligence scale and audiovisual integration continuous test were used to measure and compare the differences of cognitive impairment between the BECT co-associated with ADHD group and the BECT alone group with the same discharge side and the children with different discharge side within each group.Results Compared with the BECT alone group,the scores of speech comprehension index(VCI),perceptual reasoning index(PRI)and processing speed index(PSI)in the BECT co-associated with ADHD group decreased(P<0.05).Compared with the BECT alone group,perceptual reasoning index(PRI),working memory index(WMI),processing speed index(PSI),auditory response control quotient(ARCQ)and visual response control quotient(VRCQ)decreased in the BECT co-associated with ADHD group(P<0.05).Within the BECT alone group,the score of perceptual reasoning index(PRI)in the left group was lower than that in the right group(P<0.05).Conclusion The degree of cognitive impairment in children with BECT co-associated with ADHD was more severe than that in children with BECT alone,regardless of left-side discharge or right-side discharge.But there was no significant difference in cognitive impairment between left-side discharge and right-side discharge in children with BECT co-associated with ADHD and children with BECT alone.