注意缺陷多动障碍儿童服用单剂量哌甲酯后脑电α波的变化  

Changes of Alpha Competitive Structure after Administration of Single Dose Methylphenidate in Children with Attention Deficit Hyperactivity Disorder

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,卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2009年第8期584-589,共6页Chinese Mental Health Journal

基　　金：十一五科技部支撑计划"重大精神疾病和行为障碍的识别技术与干预措施研究"(2007BAI17B003);卫生行业基金:儿童注意缺陷多动障碍的病因与发病机理及治疗研究"(200802073)

摘　　要：目的:通过观察注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童服用单剂量哌甲酯后其脑电α波的变化,及其用药后是否达到正常水平,探讨ADHD的神经病理机制。方法:本研究为自身对照研究。所有ADHD儿童来自于北京大学精神卫生研究所门诊,正常儿童来自北京大学精神卫生研究所附近学校,各110例。应用脑电超慢涨落分析技术(encephaloflutuographtechnology,ET),对符合DSM-Ⅳ中ADHD诊断的患儿在服用哌甲酯前及服药后(10mg)2h及性别、年龄与之匹配的健康对照的脑电信号进行分析处理。结果:(1)用药后:主频明显变快[(8.97±0.94)Hz vs.(9.40±0.99)Hz,P=0.000];各导联8Hz优势几率明显下降[(27.08±13.04)% vs.(23.50±13.66)%,P<0.05];全脑10Hz平均优势几率呈上升趋势[(28.83±14.90)% vs.(30.64±16.66)%,P=0.06];全脑11Hz平均优势几率明显上升[(12.35±10.50)% vs.(13.90±12.73),P=0.047];全脑平均熵值(Qm)明显降低[(0.72±0.11) vs.(0.69±0.12),P<0.001]。(2)用药后,主频仍明显低于健康对照[(9.40±0.99)Hz vs.(9.67±0.92)Hz,P<0.001],8Hz全脑平均优势几率仍高于健康对照[(23.50±13.66)% vs.(18.19±12.27)%,P<0.001],10Hz各脑区平均优势几率与健康对照差异无统计学意义[(30.64±16.66)% vs.(34.24±17.13),P>0.05],总熵值仍明显高于健康对照[(0.69±0.12)vs.(0.65±0.11),P<0.05]。结论:通过观察ADHD患儿单次服用哌甲酯前后两种状态脑功能的变化,提示单剂量哌甲酯可使ADHD患儿脑电图趋向正常,可使其脑有序度提高、低功效状态改善。Objective： To investigate the effects of stimulant medications on the EEG of children with attention deficit hyperactivity disorder （ ADHD ） by measuring the changes of the alpha competitive structure after administration of single dose of methylphenidate, and to explore the neuropathological mechanism of ADHD. Methods： The study involved 110 ADHD children who met the DSM-IV diagnostic criteria of ADHD and 110 normal children matched by age and sex. Their continuous EEG data were collected before and 2 hours after taking methylphenidate （ 10 mg） and were analyzed with EEG-encephaloflutuographic technology （ EEG-ET） . Results： （ 1 ） After taking methylphenidate, the main frequency of alpha band obviously increased [ （ 8.97 ± 0. 94 ） Hz vs. （ 9. 40 ± 0. 99 } Hz, P 〈0. 01 ], the dominant probability of 8 Hz was significantly decreased at all electrode sites [ （27.08 ± 13.04） % vs. （23.50 ± 13.66） %, P 〈0. 05], the dominant probability of 10 Hz was significantly increased [ （28. 83 ± 14. 90） % vs. （30. 64 ± 16. 66） %, P 〈0. 05], the dominant probability of 11 Hz was significantly increased [ （ 12. 35 ± 10. 50） % vs. （13.90 ± 12. 73） %, P 〈0. 05], and the entropy value also showed significantly decreased [ （0. 72±0. 11 ） vs. （0. 69 ±0. 12}, P 〈0. 01 ] . （2） After taking methylphenidate, the main frequency of alpha band of ADHD children obviously increased, but still lower than that of controls [ （9. 40 ± 0. 99 ） Hz vs. （ 9.67± 0. 92 ）, P 〈 0. 01 ] . The dominant probability of 8 Hz still higher than that of controls [ （ 23.50 ± 13.66） % vs. （ 18. 19± 12. 27 ） %, P 〈 0. 01 ], The total entropy value still higher than that of the controls [（0. 69 ±0. 12）vs. （0. 65 ±0. 11）, P 〈0. 05] . The dominant probability of 10 Hz had no significantly difference compare to normal controls [ （ 30. 64 ± 16. 66 ） % vs.（34. 24± 17. 13 ）, P 〉 0. 05 ] . Conclusion： Single dose methylphenidate can ameliorate t

关 键 词：哌甲酯 注意缺陷伴多动障碍 Α节律 自身对照研究 

分 类 号：R749.94[医药卫生—神经病学与精神病学]