注意缺陷多动障碍儿童的眼动抑制缺陷对照研究(1)
【摘 要】目的:探讨注意缺陷多动障碍(Attention Deficit Hyperactivity Disorder,ADHD)儿童在抑制性眼动任务中的反应特征。 方法:采用注视、主动眼动及反向眼动任务对21例ADHD儿童和21例正常对照儿童进行评估。 结果:(1)注视任务中,ADHD组侵入性眼跳数目高于对照组[无分心条件:(12.67±12.28) vs.(6.38±6.95),P=0.040;分心条件:(16.91±10.00) vs.(11.29±5.99),P=0.030];(2)主动眼动任务中,两组儿童眼跳参数差异无统计学意义;(3)反向眼动任务中,ADHD组眼跳方向错误率高于对照组[间隔条件:(68.14±17.85) % vs.(54.10±20.22) %,P=0.020;重叠条件:(62.49±17.54) % vs.(49.27±17.21) %, P=0.020]。 结论:注意缺陷多动障碍儿童眼动抑制能力存在缺陷,推测可能是由于注意缺陷多动障碍儿童具有异常的额叶-纹状体结构和/或功能所致。
【关键词】注意缺陷多动障碍;眼动任务;抑制;眼跳; 病例对照研究
中图分类号:R749.94 文献标识码:A 文章编号:1000-6729(2010)001-0038-05
doi:10.3969/j.issn.1000-6729.2010.01.009
Inhibitory deficits of oculomotor behavior in children with attention deficit hyperactivity disorder
CHEN Qiang1,2,JING Jin1,YANG Wen-Han1
1Department of Maternal and Child Health,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China
2Department of Child Psychological Behavior,Zhuhai Maternal and Child Health's Hospital,Zhuhai 519000,Guangdong Province,China
Corresponding author:JING Jin,E-mail:jingjin@mail.sysu.edu.cn
【Abstract】Objective:To examine the characteristics of oculomotor inhibition about children with attention deficit hyperactivity disorder(ADHD).Methods:Twenty-one children with ADHD according to the Diagnostic and Statistical Manual of Mental Disorder,4th edition(DSM-IV) and 21 matched controls were administered with fixation,prosaccade and antisaccade tasks.Results:(1) In the fixation task,the children with ADHD demonstrated significantly more intrusive saccade errors than the controls in either condition with distractors or without distractors[no distractors:(12.67±12.28) vs.(6.38±6.95),P=0.040;distractors:(16.91±10.00) vs.(11.29±5.99),P=0.030].(2) In the prosaccade task,there were no significant differences found between groups in saccadic parameters,in either gap condition or overlap condition.(3) In antisaccade task,the direction error rates of the ADHD group in either gap condition or overlap condition,were both higher than that of the control group[gap:(68.14±17.85) % vs.(54.10±20.22) %,P=0.020;overlap:(62.49±17.54) % vs.(49.27±17.21) %,P=0.020].Conclusion: It suggests that there is an abnormality of the oculomotor inhibition,which may be caused by abnormal structure and/or function of fronto-striatal in ADHD children.
【Key words】 attention deficit hyperactivity disorder;oculomotor task;inhibition;saccade;case-control study
注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期常见的精神卫生问题之一,以明显的注意缺陷、多动和冲动行为为特征。到目前为止,ADHD的病因和发病机制仍然不甚清楚。认知和行为学症状表明,ADHD的临床症状与大脑额叶及基底神经核结构或功能异常所导致的病理症状相类似[1],从而提出ADHD患者存在额叶-纹状体功能紊乱的神经生理假设[2-3] ,该假设认为ADHD患者的额叶-纹状体功能异常(可能牵涉到多巴胺转运功能的异常)导致了其典型临床症状的产生以及抑制非必要或不恰当行为反应能力的减弱。抑制性眼动任务被认为具有直接测试被试抑制非必要或不恰当行为反应的能力,而不受其语言表达及动作反应的影响[4]。因为额叶皮层和基底神经核被证实在随意反应的产生和反射性反应的抑制上具有重要作用,我们推测ADHD患者在抑制性眼动任务中具有特殊的困难。为了测试这个假设,我们使用一系列眼动任务,去探索ADHD儿童在抑制性眼动任务中的反应特征。
1 对象与方法
1.1 对象
ADHD组:2006年3月至2006年12月在中山大学附属第三医院儿童发育行为中心就诊者,根据美国精神病协会《精神障碍诊断和统计手册》第四版(DSM-Ⅳ)中ADHD的诊断标准,收集21例确诊为ADHD的儿童(男17人,女4人),年龄7～11岁,平均(9±1)岁,经《中国修订韦氏儿童智力量表(C-WISC)城市版》[5]评估智商为75～129分,平均(97.7±14.7)分。排除标准:①既往有精神病性障碍,癫痫病以及脑部器质性疾病史;②有眼科疾病;③其他明显的家族遗传病史;④近2周有服用精神兴奋药物如哌甲酯史。, 百拇医药(陈 强 静 进 杨文翰)
【关键词】注意缺陷多动障碍;眼动任务;抑制;眼跳; 病例对照研究
中图分类号:R749.94 文献标识码:A 文章编号:1000-6729(2010)001-0038-05
doi:10.3969/j.issn.1000-6729.2010.01.009
Inhibitory deficits of oculomotor behavior in children with attention deficit hyperactivity disorder
CHEN Qiang1,2,JING Jin1,YANG Wen-Han1
1Department of Maternal and Child Health,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China
2Department of Child Psychological Behavior,Zhuhai Maternal and Child Health's Hospital,Zhuhai 519000,Guangdong Province,China
Corresponding author:JING Jin,E-mail:jingjin@mail.sysu.edu.cn
【Abstract】Objective:To examine the characteristics of oculomotor inhibition about children with attention deficit hyperactivity disorder(ADHD).Methods:Twenty-one children with ADHD according to the Diagnostic and Statistical Manual of Mental Disorder,4th edition(DSM-IV) and 21 matched controls were administered with fixation,prosaccade and antisaccade tasks.Results:(1) In the fixation task,the children with ADHD demonstrated significantly more intrusive saccade errors than the controls in either condition with distractors or without distractors[no distractors:(12.67±12.28) vs.(6.38±6.95),P=0.040;distractors:(16.91±10.00) vs.(11.29±5.99),P=0.030].(2) In the prosaccade task,there were no significant differences found between groups in saccadic parameters,in either gap condition or overlap condition.(3) In antisaccade task,the direction error rates of the ADHD group in either gap condition or overlap condition,were both higher than that of the control group[gap:(68.14±17.85) % vs.(54.10±20.22) %,P=0.020;overlap:(62.49±17.54) % vs.(49.27±17.21) %,P=0.020].Conclusion: It suggests that there is an abnormality of the oculomotor inhibition,which may be caused by abnormal structure and/or function of fronto-striatal in ADHD children.
【Key words】 attention deficit hyperactivity disorder;oculomotor task;inhibition;saccade;case-control study
注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期常见的精神卫生问题之一,以明显的注意缺陷、多动和冲动行为为特征。到目前为止,ADHD的病因和发病机制仍然不甚清楚。认知和行为学症状表明,ADHD的临床症状与大脑额叶及基底神经核结构或功能异常所导致的病理症状相类似[1],从而提出ADHD患者存在额叶-纹状体功能紊乱的神经生理假设[2-3] ,该假设认为ADHD患者的额叶-纹状体功能异常(可能牵涉到多巴胺转运功能的异常)导致了其典型临床症状的产生以及抑制非必要或不恰当行为反应能力的减弱。抑制性眼动任务被认为具有直接测试被试抑制非必要或不恰当行为反应的能力,而不受其语言表达及动作反应的影响[4]。因为额叶皮层和基底神经核被证实在随意反应的产生和反射性反应的抑制上具有重要作用,我们推测ADHD患者在抑制性眼动任务中具有特殊的困难。为了测试这个假设,我们使用一系列眼动任务,去探索ADHD儿童在抑制性眼动任务中的反应特征。
1 对象与方法
1.1 对象
ADHD组:2006年3月至2006年12月在中山大学附属第三医院儿童发育行为中心就诊者,根据美国精神病协会《精神障碍诊断和统计手册》第四版(DSM-Ⅳ)中ADHD的诊断标准,收集21例确诊为ADHD的儿童(男17人,女4人),年龄7～11岁,平均(9±1)岁,经《中国修订韦氏儿童智力量表(C-WISC)城市版》[5]评估智商为75～129分,平均(97.7±14.7)分。排除标准:①既往有精神病性障碍,癫痫病以及脑部器质性疾病史;②有眼科疾病;③其他明显的家族遗传病史;④近2周有服用精神兴奋药物如哌甲酯史。, 百拇医药(陈 强 静 进 杨文翰)