皮质醇浓度与ADHD患儿反应抑制和冲突控制的关系

Relationship between Cortisol Concentration and Response Inhibition and Conflict Control in Children with ADHD

目的:探究不同皮质醇浓度对注意缺陷多动障碍(ADHD)患儿反应抑制和冲突控制的影响。方法:对98例ADHD患儿觉醒后4个时间点的唾液皮质醇浓度进行分析检测,采用Go/NoGo和Stroop任务分别评估ADHD患儿的反应抑制功能和冲突控制功能。结果:多动冲动型患儿在完成Go/NoGo任务时在三个亚型中NoGo正确率最低(P<0.001),错误NoGo反应时间最长(P<0.001);混合型患儿在完成Stroop任务中字色不一致时间在三个亚型中最长(P<0.05);低皮质醇浓度组患儿比高皮质醇浓度组在Go/NoGo任务中NoGo正确率更低(P<0.01),Stroop任务中字色不一致任务的时间更长(P<0.01);皮质醇浓度与亚型的交互作用显著,进一步简单效应分析显示,仅低皮质醇浓度组存在临床亚型差异,ADHD-HI组在NoGo任务正确率(P<0.01)、错误NoGo反应时间(P<0.01)、字色不一致时间(P<0.01)上显著低于ADHD-C组和ADHD-I组。结论:临床亚型和皮质醇浓度共同对ADHD患儿的抑制控制功能产生影响。

Objective:To explore the effects of different cortisol concentrations on response inhibition and conflict control in children with ADHD.Methods:The salivary cortisol concentration of 98 ADHD children at 4 time points after awakening was detected and analyzed.Go/NoGo and Stroop tasks were used to evaluate the response inhibition function and conflict control function of ADHD children.Results:In the three subtypes of ADHD children,the correct rate of NoGo in the ADHD-C group was the lowest and their response time of wrong NoGo was the longest(P<0.001).In Stroop task,the mixed type had the longest discordant time(P<0.05);The NoGo accuracy in the low cortisol concentration group was lower than that in the high cortisol concentration group,and their reaction time in the Stroop task was longer(P<0.01).The interaction between cortisol concentration and subtype was significant.Further simple effect analysis showed that only the low cortisol concentration group had clinical subtype differences,and ADHD-HI group was significantly lower than ADHD-C group and ADHD-I group in terms of correct rate of NoGo task,wrong NoGo reaction time and inconsistent time of word and color(P<0.01).Conclusion:Clinical subtypes and cortisol concentration together affect the inhibitory control function of individuals.