注意缺陷多动障碍的视听注意反应与P300的相关性研究

摘要

目的 探讨视听整合持续操作测验(IVA-CPT)和事件相关电位P300在注意缺陷多动障碍(ADHD)患者中的相关性及其临床诊断中的应用价值.方法 将符合DSM-V中ADHD诊断标准的30例患儿和30例健康儿童进行IVA-CPT检测和注意缺陷多动障碍筛查量表中文版(SNAP-IV)评估.同时运用视觉oddball范式,记录P300脑电信息参数.结果 在IVA-CPT测试中,ADHD患者的综合注意力商数、综合控制力商数、听觉/视觉控制力商数和听觉/视觉注意力商数均显著降低(均P＜0.01).ADHD患者及三个亚型与对照组相比,P300的潜伏期延长、波幅降低(P＜0.05或0.01),尤在Cz更显著;但是波幅下面积各组间无统计学差异.另外,ADHD患者IVA-CPT的视觉注意力商数和视觉控制力商数与P300波幅呈正相关(P＜0.05或0.01);而与P300潜伏期呈负相关(P＜0.01).结论 ADHD患者的P300有显著改变,主要表现为P300潜伏期延长和波幅降低,可能与注意反应延缓和抑制控制损害有关.提示ADHD患者存在神经认知功能异常.%Objective To investigate the correlation of visual event-related potential P300 with integrated visual auditory continuous performance test (IVA-CPT) in children with attention deficit hyperactivity disorder (ADHD).Methods Thirty children with ADHD and 30 normal children (control group) were enrolled in the study.The visual oddball paradigm was applied,P300 was measured;and the IVA-CPT and SNAP-IV was assessed in all patients and controls.Results The full and secondary scales for attention and response accuracy on the IVA-CPT in children with ADHD were significantly lower compared to normal controls (P＜ 0.01).Children with ADHD showed a significantly longer latency and lower amplitude of P300 compared to normal children,especially for Cz (P＜0.05 or P＜0.01).There were no differences in the area below the wave amplitude between children with ADHD and controls.The visual attention quotient and visual response control quotient were positively correlated with P300(P＜0.05 and P＜0.01),and negatively correlated with the latency of P300 (P＜0.01).Conclusion The endogenous ERPs (P300) is significantly affected in children with ADHD;the increased latency of P300 suggests a slower processing speed,and decreased P300 amplitude suggests the inhibitory control in children with ADHD.These results indicate a neurocognitive abnormality in ADHD.