单剂量哌甲酯对不同亚型注意缺陷多动障碍男孩脑α波竞争图的影响  

Changes of the alpha competitive structure after administration of single dose methylphenidate in different subtypes of attention deficit hyperactivity disorder boys

作　　者：孙黎[1] 王玉凤[1] 何华[1] 陈进[1] 

机构地区：[1]北京大学精神卫生研究所,北京100083

出　　处：《北京大学学报（医学版）》2007年第3期289-292,共4页Journal of Peking University:Health Sciences

基　　金：卫生部临床学科重点项目(2004-468);北京市科技计划项目(Y0204003040831);科技部攻关项目(2004BA720A20)基金资助~~

摘　　要：目的:检测单剂量哌甲酯对不同亚型注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)男孩脑α波竞争图的影响,探讨ADHD的神经病理机制及寻找预测药物疗效的敏感指标。方法:应用脑电超慢涨落分析仪(encephaloflutuograph technology,ET),对符合美国《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)中ADHD诊断的88例男孩(ADHD-C男孩40例、ADHD-I男孩48例)在服用哌甲酯前及服药后2 h的脑电信号进行分析处理。结果:服药后,(1)ADHD-C男孩及ADHD-I男孩脑电α波主频均明显升高,分别为9.05±0.96 Hz升高至9.72±0.99 Hz(P=0.000),8.90±0.93 Hz升高至9.25±0.86 Hz(P=0.002)。且ADHD-C男孩服药后主频升高的程度明显高于ADHD-I男孩,差异有统计学意义(Z=-2.111,P=0.035)。(2)两组儿童的全脑8 Hz优势几率明显下降,分别由24.34%±12.70%下降至20.74%±12.46%(P=0.002),28.82%±12.51%下降至25.64%±12.18%(P=0.003)。两组儿童服药前后的全脑8 Hz优势几率变化差值之间的差异无统计学意义(Z=-0.494,P=0.621)。(3)ADHD-I亚型男孩的总熵值明显下降,由0.74±0.10下降至0.70±0.13(t=3.579,P=0.001),两组儿童服药前后的总熵值变化差值之间的差异无统计学意义(Z=-1.131,P=0.258)。结论:服用单剂量哌甲酯后,ADHD-C亚型男孩服药后主频升高的程度明显高于ADHD-I亚型男孩,ADHD-I亚型男孩熵值降低。主频升高与否可能是预测ADHD药物疗效的敏感指标。Objective： To investigate methylphenidate response to different subtypes of attention deficit hyperactivity disorder （ADHD） boys by measuring the changes of the alpha competitive structure after administration of single close of methylphenidate, explore the neuropathological mechanism and search for the sensitive index to predict methylphenidate response in this disorder. Methods： The study involved 88 ADHD boys （40 ADHD-C boys,48 ADHD-I boys） who met the DSM-Ⅳ diagnostic criteria of ADHD, and their continuous Electroencephalogram（EEG） data collected before and 2 hours after taking methylphenidate （10 mg） were analyzed with EEG - encephaloflutuographic technology （EEG-ET） . Results： After taking methylphenidate, （ 1 ） The main frequency of alpha band obviously increased in ADHD-C boys and ADHD-I boys （ from 9.05 ± 0.96 Hz up to 9.72 ± 0.99 Hz, P = 0.000 ; from 8.90 ± 0.93 Hz up to 9.25 ± 0.86 Hz, P = 0. 002 ; separately） , especially in ADHD-C boy group （ Z = - 2.111, P = 0. 035）. （2） The dominant probability of 8 Hz was significantly decreased in ADHD-C boys and ADHD-I boys （ from 24.34% ± 12.70% clown to 20.74% ± 12.46%, P = 0. 002 ; from 28.82% ±12.51% clown to 25.64% ± 12. 176% , P = 0.003 ; separately）. There was no significant difference in the changes of the dominant probability of 8 Hz between the two ADHD groups （ Z = - 0. 494, P = 0. 621 ）. （3）The entropy value was significantly decreased in ADHD - I boys group（ from 0.74 ± 0.10 clown to 0.70±0.13 ,t =3. 579 ,P =0.001 ）. There was no significant difference in the changes of the entropy value between the two ADHD groups（Z = -1. 131 P = 0.258）. Conclusion：After administration of single close of methylphenidate , slow α wave decreased in ADHD boys , especially in ADHD - C boy group; Single dose of methylphenidate can ameliorate the brain self-organization of ADHD-I boys . These findings suggest that the main frequency of alpha band may be the sensitive index to predict methyl- phe

关 键 词：哌醋甲酯 注意力缺陷障碍伴多动 Α节律 

分 类 号：R742.89[医药卫生—神经病学与精神病学]