目的 探究注意缺陷多动障碍(ADHD)和孤独症谱系障碍(ASD)患者脑干听觉诱发电位(BAEP)是否存在异常,及二者之间BAEP的差异。方法 2018年10月—2019年4月于厦门市仙岳医院采用方便抽样法分别抽取年龄6～16岁的ADHD 27例(53只耳)和ASD 26例(52只耳)首诊患儿为ADHD组和ASD组,招募50例(100只耳)健康志愿者作为对照组。使用诱发电位仪对ADHD组和ASD组行BAEP检测,分析两组Ⅰ、Ⅲ、Ⅴ波潜伏期,Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期及Ⅰ、Ⅴ波波幅异常情况并进行比较。结果 ADHD组和ASD组与对照组相比,异常表现为Ⅰ波潜伏期缩短,Ⅰ-Ⅴ波间期缩短和Ⅰ、Ⅴ波波幅升高,其中ADHD组和ASD组的Ⅰ波潜伏期缩短率分别为5.66%和25.00%,Ⅰ波波幅升高率分别为24.53%和50.00%,差异均有统计学意义(χ2=7.601、7.294,P<0.05)。ADHD组与ASD组相比,Ⅰ波波幅显著降低,Ⅴ波波幅与Ⅴ/Ⅰ波幅比值均显著升高,差异有统计学意义(Z=-2.491、-2.205、-3.140,P<0.05)。结论 ADHD和ASD患儿的听觉传导通路存在差异,且Ⅴ/Ⅰ波幅比值差异可作为二者诊断时参考的重要客观指标。
Abstract
Objective To explore whether there is abnormal brainstem auditory evoked potential (BAEP) in children with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD),and to analyze the differences. Methods A total of 27 children with ADHD (53 ears) and 26 children with ASD (52 ears) aged 6 to 16 years old were selected as ADHD group and ASD group respectively in Xiamen Xian Yue Hospital from October 2018 to April 2019,meanwhile 50 healthy volunteers (100 ears) were recruited as the control group.BAEP was detected in ADHD group and ASD group by evoked potential instrument.The latency of Ⅰ,Ⅲ,Ⅴ waves,the interval of Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ waves and the abnormal amplitude of Ⅰ,Ⅴ waves were analyzed and compared. Results Compared with the control group,the ADHD and ASD groups showed shorter Ⅰ-wave latency,shorter Ⅰ-Ⅴ interval,and higher I and Ⅴ amplitudes.The rate of shorter Ⅰ wave latency in ADHD group and ASD group was 5.66% and 25.00% respectively,and the rate of increasing amplitude of wave Ⅰ was 24.53% and 50.00% respectively,and the differences were statistically significant(χ2=7.601,7.294,P<0.05).Compared with ASD group,the I wave amplitude in the ADHD group significantly reduced,the Ⅴ wave amplitude and the Ⅴ/Ⅰ amplitude ratio significantly increased (Z=-2.491,-2.205,-3.140,P<0.05). Conclusion There are differences on auditory pathways between ADHD and ASD children,and the difference in Ⅴ/Ⅰ amplitude ratio can be used as an important objective indicator for the diagnosis of ADHD and ASD.
关键词
注意缺陷多动障碍 /
孤独症谱系障碍 /
脑干听觉诱发电位
Key words
attention deficit hyperactivity disorder /
autism spectrum disorder /
brainstem auditory evoked potential
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参考文献
[1] Ramos-Quiroga JA,Sanchez-Mora C,Casas M,et al.Genome-wide copy number variation analysis in adult attention-deficit and hyperactivity disorder[J].J Psychiatr Res,2014,49:60-67.
[2] Hamed AM,Kauer AJ,Stevens HE.Why the diagnosis of attention deficit hyperactivity disorder matters[J].Front Psychiatry,2015,6:168.
[3] Rydzewska E,Hughes-McCormack LA,Gillberg C,et al.Age at identification,prevalence and general health of children with autism:observational study of a whole country population[J].BMJ Open,2019,9(7):e25904.
[4] Leitner Y.The co-occurrence of autism and attention deficit hyperactivity disorder in children - what do we know?[J].Front Hum Neuro Sci,2014,8:268.
[5] Miron O,Ari-Even RD,Gabis LV,et al.Prolonged auditory brainstem responses in infants with autism[J].Autism Res,2016,9(6):689-695.
[6] Santos M,Marques C,Nobrega PA,et al.Autism spectrum disorders and the amplitude of auditory brainstem response wave I[J].Autism Res,2017,10(7):1300-1305.
[7] Pinto E,Martinelli MC.Brainstem auditory evoked potentials with speech stimulus in neonates[J].Braz J Otorhinolaryngol,2018.doi:10.1016/j.bjorl.2018.11.006.
[8] 陈芷若.神经电生理学[J].现代电生理学杂志,2008,15(4):230-240.
[9] Jafari Z,Malayeri S,Rostami R.Subcortical encoding of spe ech cues in children with attention deficit hyperactivity disorder[J].Clin Neurophysiol,2015,126(2):325-332.
[10] Ramezani M,Lotfi Y,Moossavi A,et al.Auditory brainstem response to speech in children with high functional autism spectrum disorder[J].Neurol Sci,2019,40(1):121-125.
[11] Ververi A,Vargiami E,Papadopoulou V,et al.Brainstem auditory evoked potentials in boys with autism:still searching for the Hidden Truth[J].Iran J Child Neurol,2015,9(2):21-28.
[12] 吴晓庆,常荷,吴敏,等.27例孤独症儿童的脑干听觉诱发电位检测结果临床分析[J].临床医药实践,2014,23(11):803-805.
[13] Kallstrand J,Olsson O,Nehlstedt SF,et al.Abnormal auditory forward masking pattern in the brainstem response of individuals with Asperger syndrome[J].Neuropsychiatr Dis Treat,2010,6:289-296.
[14] Deoni SC,Zinkstok JR,Daly E,et al.White-matter relaxation time and myelin water fraction differences in young adults with autism[J].Psychol Med,2015,45(4):795-805.
[15] Maximo JO,Cadena EJ,Kana RK.The implications of brain connectivity in the neuropsychology of autism[J].Neuropsychol Rev,2014,24(1):16-31.
[16] Thivierge J,Bedard C,Cote R,et al.Brainstem auditory evoked response and subcortical abnormalities in autism[J].Am J Psychiatry,1990,147(12):1609-1613.
[17] Zurron M,Diaz F.Auditory and visual evoked potentials in individuals with organic and cultural-familial mental retardation[J].Am J Ment Retard,1995,100(3):271-282.
基金
厦门市科技惠民项目(3502Z20174027)
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