注意缺陷多动障碍成人患者执行功能研究☆  

Executive function performances in adults with attention deficit hyperactivity disorder

作　　者：潘美蓉 黄芳[1] 王延菲[1] 赵梦婕[1] 钱秋谨[1] 王玉凤[1] 

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家精神心理疾病临床医学研究中心,卫生部精神卫生学重点实验室,北京100191

出　　处：《中国神经精神疾病杂志》2017年第11期676-682,共7页Chinese Journal of Nervous and Mental Diseases

基　　金：国家科技支撑计划(编号:2015BAI13B01);国家重点基础研究发展计划(编号:2014CB846104);首都卫生发展科研专项项目(编号:首发2016-2-4113)

摘　　要：目的探讨注意缺陷多动障碍(attention deficit hyperactivitydisorder,ADHD)成人患者的执行功能特点。方法采用横断面研究,对符合DSM-IV诊断标准的68例ADHD成人患者及年龄、智商匹配的74例正常对照行ADHD症状评估、执行功能问卷(BRIEF-A)评定及剑桥神经心理测验(CANTAB)评定,分析ADHD成人患者的执行功能特点及其与ADHD症状之间的相关性。结果 ADHD组BRIEF-A分数更高(P<0.01)。空间工作记忆(SWM)测试ADHD组的策略性得分更高[(30.84±5.58)vs.(28.80±5.85),t=2.056,P=0.042]。快速视觉信息加工(RVP)测验ADHD组的总正确反应数[37(33,41.75)vs.43(37,48),Z=-3.184,P<0.001]、总正确抑制率[508(497.5,518)vs.516(503,529.5),Z=-2.229,P=0.026)]较对照组低;总错失数[17(12.25,21)vs.12(7,20),Z=2.293,P=0.022]高于对照组。ADHD注意缺陷分与SWM策略性得分与RVP总错失数呈正相关(P<0.05)。BRIEF-A中工作记忆分与SWM测试中策略性得分、RVP测验中总正确反应数、总正确抑制数、正确率呈负相关(P<0.05),与RVP总错失数呈正相关(P<0.05)。结论 ADHD成人患者的执行功能存在不同维度损害,并与ADHD的核心症状相关。Objective To explore the executive function profiles in adults with attention deficit hyperactivity disorder（ADHD） in a Chinese sample population. Methods We identified 68 outpatients fulfilling the diagnostic criteria for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-IV（DSM-IV） and 74 normal adults. All subjects completed clinical interview, Behavior Rating Inventory of Executive Function-Adult Version （BRIEF-A） and Cambridge Neuropsychological Test Automated Battery （CANTAB）. Results ADHD group had higher scores in all factors of BRIEF-A questionnaire compared with normal control （P〈0.01）. ADHD group had a higher score in SWM strategy score [（30.84±5.58） vs. （28.80±5.85）, t=2.056,P=0.042]compared with control group. Compared with control group, ADHD group had a lower score in RVP total hits [37（33,41.75） vs.3（37,48）, Z=-3.184,P〈0.01] . Total correct rejections[ （508（497.5,518） vs. 516 （503,529.5）, Z=-2.229, P=0.0260） ] were significantly lower, while RVP total misses were significantly higher [（17 （12.25,21） vs. 12 （7,20）, Z=2.293 ,P=0.022）]. ADHD-RS-IV attention deficit score was positively correlated with SWM strategy while RVP total misses were negatively correlated with RVP total hits and RVP correct rejections. Working memory score in BRIEF-A was significantly correlated with the SWM strategy, RVP total hits, RVP total correct rejections and RVP probable of hit as well as RVP total misses. Conclusion Adults with ADHD have executive functioning deficits which is correlated with ADHD core symptoms.

关 键 词：注意缺陷多动障碍 成人 剑桥神经心理测验(CANTAB) 执行功能 

分 类 号：R749[医药卫生—神经病学与精神病学]