目的 对注意缺陷多动障碍(ADHD)儿童神经软体征的特征及发生率进行调查。方法 采用病例对照研究的方法,病例组共74人(其中男生70人,女生4人)均符合DSM-Ⅳ-TR中ADHD的诊断标准,对照组从长沙市某小学随机抽取年龄及性别相匹配的正常儿童,所有研究对象年龄6~12岁之间,右利手,排除重大躯体疾病及其他精神障碍者,所有研究对象进行剑桥神经软体征量表评定,并采用SPSS 16.0软件包进行数据统计分析。结果 ADHD儿童在病例组在神经软体征总分、运动协调得分、感觉整合得分均高于对照组(P<0.05),ADHD儿童在左右侧序列对指运动、奥氏试验、左右侧拳-手-掌试验、右侧实体辨别觉、左右皮肤书写觉、左右指向、去抑制、闪烁、左右镜像运动、左侧翻手运动、感觉消退、左侧手指失认症、Go-nogo试验、左侧镜像运动2中平均分高于对照组,发生率较正常儿童高,差别具有统计学意义(P<0.05)。结论 ADHD儿童中神经软体征发生率较高,存在运动协调、感觉整合及抑制功能障碍,神经软体征可能与ADHD症状产生存在共同的神经病理基础。
Abstract
Objective To investigate the prevalence and characteristics of neurological soft signs (NSS) in children with attention deficit hyperactivity disorder (ADHD).Methods The case-control study was adopted ,the study group(n=74,boy=70,girl=4) children suffered from ADHD meeting a criterion of DSM-Ⅳ-TR,the control group were healthy children randomly selected according to age,sex,from the first grade to the sixth grade of the a primary school of Changsha,Hunan province.All subjects were 6~12 years old,right handed.All the subjects were evaluated by the Cambridge Neurological Inventory (CNI).The SPSS 16.0 was used to establish database and make statistical analysis.Results Compared to the control group,the prevalence of children with ADHD were higher in Diadockinesia L,Mirror 2L,Go-nogo,Mirror 1L,FgthumbOPP R,Oseretsky,Fist-Edge-Palm L,Fist-Edge-Palm R,Extinction,Fgagnosia L,Stereognosia R,Graphesthesia L,Graphesthesia R,Point to,Wink,Mirror 1R,the differences were significant (P<0.05).The children with ADHD scored higher total scores of NSS,Motor Coordination,sensory integration,the differences were statistically significant (P<0.05).Conclusion The prevalence of neurological soft signs is higher in ADHD patients than control group,ADHD children may have a motor coordination damaged,sensory integration disorder and disinhibition defects,and a potential nervous system dysfunction may under the NSS.
关键词
神经软体征 /
注意缺陷多动障碍 /
发生率 /
儿童
Key words
neurological soft signs /
attention deficit hyperactivity disorder /
prevalence /
children
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参考文献
[1] Barkley RA.Attention-deficit hyperactivity disorder:A handbook for diagnosis and treatment[M].3rd ed.New York:Guilford,2006.
[2] Sadiq AJ.Attention-deficit/hyperactivity disorder and integrative approaches[J].Pediatr Ann,2007,36(5):508-515.
[3] Faraone SV,Biederman J,Mick E.The agedependent decline of attention deficit hyperactivity disorder; a meta-analysis of follow-up studies[J].Psychological Medicine,2006,36(2):159-166.
[4] Visser S,Bitsko R,Danielson M,et al.Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children United States,2003 and 2007[J].Morbidity and Mortality Weekly Report,2010,59(12):1439-1443.
[5] Kordon AKKG.Attention-deficit/ hyperactivity disorder (ADHD) in adulthood[J].Psychother Psychosom Med Psychol,2000,154(1):124-136.
[6] 袭耀先,蔡太生.中国修订韦氏儿童智力量表(OWISC)手册[M].长沙:湖南地图出版社,1993.
[7] Chen EY,Shapleske J,Luque R,et al.The Cambridge Neurological Inventory:a clinical instrument for assessment of soft neurological signs in psychiatric patients[J].Psychiatry Res,1995,56(2):183-204.
[8] Gustafsson P,Svedin CG,Ericsson I,et al.Reliability and validity of the assessment of neurological soft-signs in children with and without attention-deficit-hyperactivity disorder[J].Dev Med Child Neurol,2010,52(3):364-370.
[9] Dickstein DP,Garvey M,Pradella AG,et al.Neurologic examination abnormalities in children with bipolar disorder or attention-deficit/hyperactivity disorder[J].Biol Psychiatry,2005,58(5):517-524.
[10] Epstein JN,Erkanli A,Conners CK,et al.Relations between continuous performance test performance measures and ADHD behaviors[J].Journal of Abnormal Child Psychology,2003,31(5):543-554.
[11] Brown LN,Vickers JN.Temporal judgments,hemispheric equivalence,and interhemispheric transfer in adolescents with attention deficit hyperactivity disorder[J].Exp Brain Res,2004,154(1):76-84.
[12] Schroder J,Wenz F,Schad LR,et al.Sensorimotor cortex and supplementary motor area changes in schizophrenia.A study with ftmctional magnetic resonance imaging[J].Br J Psychiatry,1995,167(2):197-201.
[13] Chan RC,Rao H,Chen EE,et al.The neural basis of motor sequencing:an fMRI study of healthy subjects[J].Neurosci Lett,2006,398(2):189-194.
[14] Martin P,Tewesmeier M,Albers M,et al.Towards an understanding of sensory soft signs of schizophrenia[J].Psychopathology,1995,28(3):281-284.
[15] Tumkaya S,Karadag F,Oguzhanoglu NK.Neurological soft signs in schizophrenia and obsessive compulsive disorder spectrum[M].Eur Psychiatry,2010.
[16] Diamond A.Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex[J].Child Dev,2000,71(1):44-56.
[17] Chan RC,Mcalonan GM,Yang B,et al.Prevalence of neurological soft signs and their neuropsychological correlates in typically developing Chinese children and Chinese children with ADHD[J].Dev Neuropsychol,2010,35(8):698-711.
[18] Mcalonan GM,Cheung V,Chua SE,et al.Age-related grey matter volume correlates of response inhibition and shifting in attention-deficit hyperactivity disorder[J].The British Journal of Psychiatry,2009,194(1):123-129.
[19] 徐华民,华美英.儿童多动症的神经系统软体征[J].江苏医药,1990,16(11):608-610.
[20] Dazzan P,Morgan KD,Chitnis X,et al.The structural brain correlates of neurological soft signs in healthy individuals[J].Cereb Cortex,2006,16(12):1225-1231.
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