运动干预对注意缺陷多动障碍儿童脑执行功能影响的神经影像学研究进展

孔德华; 张功

doi:10.11852/zgetbjzz2022-1475

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中国儿童保健杂志 ›› 2023, Vol. 31 ›› Issue (8) : 879-883. DOI: 10.11852/zgetbjzz2022-1475

综述

运动干预对注意缺陷多动障碍儿童脑执行功能影响的神经影像学研究进展

孔德华, 张功

作者信息 +

Neuroimaging advances in the effects of exercise interventions on brain executive function inchildren with attention deficit hyperactivity disorder

KONG Dehua, ZHANG Gong

Author information +

文章历史 +

摘要

注意缺陷多动障碍(ADHD)是儿童常见的神经心理行为障碍,主要表现为抑制、刷新、转换等执行功能的缺陷。诸多研究表明运动干预作为一种新兴的治疗方式可以替代药物治疗和心理行为干预,对ADHD儿童产生积极作用,改善其刷新、转换、抑制等执行功能。功能性磁共振成像技术(fMRI)和事件相关电位(ERP)技术做为常用的两种神经影像学技术,是研究ADHD在完成各种认知加工活动和进行脑区及电位差异对比时的重要方法。已有研究表明运动干预可以激活ADHD儿童额叶、双侧顶叶、颞叶、海马、小脑等与执行功能密切相关的脑区,有效改善ADHD儿童ERP成分中N2、P3等成分的潜伏期和波幅,促进ADHD儿童执行功能的改善,进而改善其认知能力、记忆能力、学习障碍、情绪异常等临床症状。fMRI和ERP技术均有各自的缺点和不足,在未来的研究中,可以使用多模态神经影像学研究和新兴技术来提高ADHD儿童脑功能障碍的诊断和干预效果,对ADHD儿童的神经生理机制进行整体的研究和干预,深入探索ADHD的病因和干预方法。

Abstract

Attention deficit and hyperactivity disorder(ADHD) is a common neuropsychological disorder in children, which is mainly manifested by defects in executive function such as inhibition, refresh, and conversion. Many studies have shown that exercise intervention, as an emerging treatment modality, can replace medication and psycho-behavioral interventions, and have a positive effect on ADHD children, improving their executive functions such as refreshment, conversion and inhibition. Functional magnetic resonance imaging(fMRI) and event-related potentials(ERP), two commonly used neuroimaging techniques, are important methods for studying ADHD in the completion of various cognitive processing activities and for comparing differences in brain regions and potentials. It has been shown that exercise interventions can activate brain areas closely related to executive functions such as the frontal lobe, bilateral parietal lobe, temporal lobe, hippocampus and cerebellum in ADHD children, effectively improving the latency and amplitude of the N2 and P3 components of the ERP in ADHD children, promoting the improvement of executive functions in ADHD children and consequently improving their clinical symptoms such as cognitive performance, memory, learning difficulties and emotional abnormalities. Both fMRI and ERP techniques have their own drawbacks and shortcomings. In future research, multimodal neuroimaging studies and emerging technologies can be used to improve the diagnosis and intervention of brain dysfunction in children with ADHD, to investigate and intervene on the neurophysiological mechanisms of children with ADHD as a whole, and to further explore the etiology and intervention methods of ADHD.

导出引用

孔德华, 张功. 运动干预对注意缺陷多动障碍儿童脑执行功能影响的神经影像学研究进展[J]. 中国儿童保健杂志. 2023, 31(8): 879-883 https://doi.org/10.11852/zgetbjzz2022-1475

KONG Dehua, ZHANG Gong. Neuroimaging advances in the effects of exercise interventions on brain executive function inchildren with attention deficit hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2023, 31(8): 879-883 https://doi.org/10.11852/zgetbjzz2022-1475

中图分类号： R749.94

参考文献

[1] Paul HA. Attention-deficit hyperactivity disorder:A handbook for diagnosis and treatment, fourth edition, edited by R. A. Barkley[J]. Child Fam Behav Ther, 2016, 38(4):331-338.
[2] Sayal K, Prasad V, Daley D, et al. ADHD in children and young people:Prevalence, care pathways, and service provision[J]. Lancet Psychiatry, 2018, 5(2):175-186.
[3] 李世明, 冯为, 方芳, 等. 中国儿童注意缺陷多动障碍患病率Meta分析[J]. 中华流行病学杂志, 2018, 39(7):993-998.
Li SM,Feng W, Fang F, et al. Prevalence of attention deficit and hyperactivity disorder in children in China:A systematic review and meta-analysis[J]. Chin J Epidemiol, 2018, 39(7):993-998.(in Chinese)
[4] Srichawla BS, Telles CC, Schweitzer M, et al. Attention deficit hyperactivity disorder and substance usedisorder:A narrative review[J]. Cureus, 2022, 14(4):1-9.
[5] 张功. 学校中的多动症:基于优势的视角[J]. 内蒙古师范大学学报(教育科学版), 2018, 31(12):79-82, 87.
Zhang G. ADHD in schools:An advantage-based perspective[J]. J Inner Mong Norm Univ(Educ Science Edition), 2018, 31(12):79-82, 87.(in Chinese)
[6] 王鑫洋. 注意缺陷与多动障碍儿童执行功能障碍诊断与康复训练的最新进展[J]. 中国医学创新, 2022, 19(13):172-175.
Wang XY. The latest progress in diagnosis and rehabilitation training of executive dysfunction in children with attention deficit and hyperactivity disorder[J]. Chin MedInnov, 2022,19(13):172-175.(in Chinese)
[7] Kofler MJ, Irwin LN, Soto EF, et al. Executive functioning heterogeneity in pediatric ADHD[J]. J Abnorm Child Psychol, 2018, 47(2):273-286.
[8] 宋杨, 刘阳, 杨宁, 等. 定向运动练习改善注意缺陷多动障碍儿童执行功能的研究[J]. 体育学刊, 2020, 27(3):110-115.
Song Y, Liu Y, Yang N, et al. Research on directional exercise to improve executive function of children with attention deficit hyperactivity disorder[J]. J Sports, 2020, 27(3):110-115.(in Chinese)
[9] Betsy H, Smith AL,Shoulberg EK, et al. A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children[J]. J Abnorm Child Psychol, 2015, 43(4):655-667.
[10] Sun W, Yu M, Zhou X. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD:A Meta-analysis[J]. Psychiatry Res, 2022, 311:1-9.
[11] 于宏达, 于晶. 不同运动项目对ADHD儿童的影响[J]. 当代体育科技, 2022, 12(25):161-164.
Yu HD, Yu J. Effects of different sports on children with ADHD[J].Contemp Sports Science Technol, 2022, 12(25):161-164.(in Chinese)
[12] 刘阳, 杨宁. 定向运动练习对ADHD儿童认知能力影响的实验研究[J]. 中国特殊教育, 2018,25(11):39-44.
Liu Y, Yang N. An experimental study on the effect of directional exercise on the cognitive ability of ADHD children[J]. Chin Spec Educ, 2018,25(11):39-44.(in Chinese)
[13] 任园春, 宋以玲, 谢永涛. 运动改善注意缺陷多动障碍儿童抑制功能的meta分析[J]. 中国心理卫生杂志, 2022, 36(3):217-223.
Ren YC, Song YL, Xie YS. Meta-analysis of the effect of exercise on inhibition in children with attention deficit hyperactivity disorder[J].Chin J Ment Health, 2022, 36(3):217-223.(in Chinese)
[14] Pan CY,Tsai CL,Chu CH, et al. Effects of physical exercise intervention on motorskills and executive functions in children with ADHD:A pilot study[J]. J Atten Disord, 2019, 23(4):384-397.
[15] Montalva-Valenzuela F, Andrades-Ramírez O, Castillo-Paredes A. Effects of physical activity, exercise and sport on executive function in young people with attention deficit hyperactivity disorder:A systematic review[J]. Eur J Investig Health Psychol Educ. 2022; 12(1):61-76.
[16] 王岩, 于晶. 不同运动干预模式对ADHD儿童执行功能影响的研究进展[J]. 当代体育科技, 2022, 12(30):51-54.
Wang Y, Yu J. Research progress on the effect of different exercise intervention modes on executive function of children with ADHD[J].Contemp Sports Science Technol, 2022, 12(30):51-54.(in Chinese)
[17] 周仁来. 高级心理实验技术[M]. 北京:北京师范大学出版社, 2013:1-2, 32.
[18] 肖英霞, 张莹瑞. 注意缺陷多动障碍的ERP研究[J]. 中国特殊教育, 2014,21(6):47-53.
Xiao YX, Zhang YR. ERP study of attention deficit hyperactivity disorder[J]. Chin Specl Educ, 2014,21(6):47-53.(in Chinese)
[19] Patton MH,Blundon JA, Zakharenko SS. Rejuvenation of plasticity in the brain:Opening the critical period[J]. Curr Opin Neurobiol, 2018, 54:83-89.
[20] Bush G. Cingulate, frontal, and parietal cortical dysfunction in attention-deficit/hyperactivity disorder[J].Biol Psychiatry, 2011, 69(12):1160-1167.
[21] Samea F, Soluki S, Nejati V, et al. Brain alterations in children/adolescents with ADHD revisited:A neuroimagi-ng meta-analysis of 96 structural and functional studies[J]. Neurosci Biobehav Rev, 2019, 100:1-8.
[22] Damiani S, Tarchi L, Scalabrini A, et al. Beneath the s-urface:hyper-connectivity between caudate and salience regions in ADHD fMRI at rest[J]. Eur Child Adolesc Psychiatry, 2021, 30(4):619-631.
[23] Ahmadi M, Kazemi K, Kuc K, et al. Resting state dynamic functional connectivity in children with attention deficit/hyperactivity disorder[J]. J Neural Eng, 2021, 18(4):10.
[24] Friedman LA,Rapoport LJ. Brain development in ADHD[J]. Curr Opin Neurobiol, 2015, 30:106-111.
[25] Kumar U,Arya A, Agarwal V. Neural network connectivity in ADHD children:An independent component and functional connectivity analysis of resting state fMRI data[J]. Brain Imaging Behav, 2021, 15(1):157-165.
[26] Sato JR,Hoexter MQ, Castellanos XF, et al. Abnormal brain connectivity patterns in adults with ADHD:A coherence study[J]. PLoS One, 2018, 7(9):1-9.
[27] 郑杰, 陈燕惠. 注意缺陷多动障碍发病机制研究进展[J]. 中国当代儿科杂志, 2018, 20(9):775-780.
Zheng J, Chen YH. Research progress in the pathogenesis of attention deficit hyperactivity disorder[J]. Chin J Contemp Pediatr, 2018, 20(9):775-780.(in Chinese)
[28] Kolodny T, Mevorach C, Stern P, et al. Fronto-parietal engagement in response inhibition is inversely scaled with attention-deficit/hyperactivity disorder symptom severity[J]. Neuroimage Clin. 2020, 25:102-119.
[29] 王延菲, 孙黎, 刘璐, 等. 注意缺陷多动障碍儿童磁共振成像的低频振幅特点及性别差异[J]. 中国心理卫生杂志, 2017, 31(11):872-878.
Wang YF, Sun L, Liu L, et al. The low-frequency amplitude characteristics and gender differences of magnetic resonance imaging in children with attention deficit hyperactivity disorder[J]. Chin JMent Health, 2017,31(11):872-878.(in Chinese)
[30] Choi JW, Han DH, Kang KD, et al. Aerobic exercise and attention deficit hyperactivity disorder:Brain research[J]. MedSci Sports Exerc, 2015, 47(1):33-39.
[31] Mehren A, Özyurt J, Thiel CM, et al. Effects of acute aerobic exercise on response inhibition in adult patients with ADHD[J]. Sci Rep. 2019, 9(1):1-13.
[32] Jiang K,Xu Y, Li Y, et al. How aerobic exercise improves executive function in ADHD children:A resting-state fMRI study[J]. Int J Dev Neurosci. 2022, 82(4):295-302.
[33] 葛亚文, 丁洁珺, 江凯华. 有氧运动改善注意缺陷多动障碍儿童执行功能的脑低频振幅研究[J]. 中国儿童保健杂志, 2022, 30(12):1287-1290,1303.
Ge YW, Ding JJ, Jiang KH. Study on low-frequency brain amplitude of aerobic exercise to improve executive function of children with attention deficit hyperactivity disorder[J]. Chin J Child Health Care, 2022, 30(12):1287-1290,1303.(in Chinese)
[34] 肖英霞, 张莹瑞. 注意缺陷多动障碍的ERP研究[J]. 中国特殊教育, 2014,21(6):47-53.
Xiao YX, Zhang YR. ERP study of attention deficit hyperactivity disorder[J]. Chin Specl Educ, 2014,21(6):47-53.(in Chinese)
[35] Szilvia P, Tombor L, Brigitta K, et al. Impaired early information processing in adult ADHD:A high-density ERP study[J]. BMC Psychiatry, 2020, 20(1):292.
[36] 赵希希, 孙黎, 王长明, 等. 成人注意缺陷多动障碍患者工作记忆特点的事件相关电位研究[J]. 中华精神科杂志, 2020, 53(5):406-413.
Zhao XX, Sun L, Wang CM, et al. An event-related potential study on the characteristics of working memory in adults with attention deficit hyperactivity disorder[J]. Chin J Psychiatry, 2020,53(5):406-413.(in Chinese)
[37] 李宗磊, 王文强, 吴为阁, 等. 注意力缺陷多动障碍儿童事件相关电位检测及与智力的相关性[J]. 神经疾病与精神卫生, 2021, 21(10):701-705.
Li ZL, Wang WQ, Wu WG, et al. Detection of event-related potentials in children with attention deficit hyperactivity disorder and its correlation with intelligence[J]. Neurology Ment Health, 2021,21(10):701-705.(in Chinese)
[38] 冯硕, 刘肖予, 张烨, 等. 注意缺陷多动障碍患儿事件相关电位P300潜伏期的探讨[J]. 中国实用儿科杂志, 2020, 35(5):383-386.
Feng S, Liu XY, Zhang Y, et al. Discussion on P300 latency of event-related potential in children with attention deficit hyperactivity disorder[J]. Chin J Practical Pediatr, 2020, 35(5):383-386.(in Chinese)
[39] Chen C, Yang H, Du Y, et al. Altered functional connectivity in children with ADHD revealed by scalp EEG:An ERP study[J]. NeuralPlast, 2021. Doi:org/10.1155/2021/6615384
[40] Münger M, Sele S, Candrian G, et al. Longitudinal investigation in children and adolescents with ADHD and healthy controls:A 2-year ERP study[J]. Int J Psychophysiol, 2023, 183:117-129.
[41] Münger M, Sele S, Candrian G, et al. Longitudinal analysis of self-reported symptoms, behavioral measures, and event-related potential components of a cued Go/NoGo task in adults with attention-deficit/hyperactivity disorder and controls[J]. Front Hum Neurosci, 2022, 16:767-789.
[42] Lynn M, Heike E, Lundervold AJ, et al. Event-Related-Potential(ERP) correlates of performance monitoring in adults with attention-aeficit hyperactivity disorder(ADHD)[J]. Front Psychol, 2018, 9:485.
[43] Smith SD, Crowley MJ,Ferrey A, et al. Effects of integrated brain, body, and social(IBBS) intervention on ERP measures of attentional control in children with ADHD[J]. Psychiatry Res, 2019, 278:248-257.
[44] Hung CL, Huang CJ, Tsai YJ, et al.Neuroelectric and behavioral effects of acute exercise on task switching in children with attention-deficit/hyperactivity disorder[J]. Front Psychol, 2016, 7:1-11.
[45] Chuang LY, Tsai YJ, Chang YK, et al. Effects of acute aerobic exercise on response preparation in a Go/No Go Task in children with ADHD:An ERP study[J]. J Sport HealthSci, 2015, 4(1):82-88.