脑电生物反馈治疗注意缺陷多动障碍患儿疗效与学习的关系  

Efficacy of EEG biofeedback therapy in children with attention deficit hyperactivity disorder and its relationship with learning

作　　者：丁强 孙锦华 Ding Qiang;Sun Jinhua(Department of Psychological Medicine, Children's Hospital of Fudan University, Shanghai 201102, China)

机构地区：[1]复旦大学附属儿科医院心理科,上海201102

出　　处：《中华行为医学与脑科学杂志》2019年第3期234-238,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目(81271511);上海市自然科学基金项目(14ZR1435800).

摘　　要：目的探索脑电生物反馈治疗注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿的疗效及其与脑电调节中学习的关系。方法2015年8月至2019年2月完成脑电生物反馈训练的52例ADHD患儿进入本研究,患儿经过标准化的基于定量化脑电图(quantitative electroence-phalogram,QEEG)的脑电生物反馈训练,经训练40次后,根据其训练中反馈的脑电结果,将患儿划分为学习者组(39例)和非学习者组(13例),比较学习者组和非学习者组在训练前后ADHD症状改善的组间差异。结果经干预后,在脑电层面,干预次数对θ波,β波,SMR和TBR活动的主效应分别为[F(1,39)=538.49,F(1,39)=2 712.6,F(1,39)=7 429.45,F(1,39)=1.887],主效应显著(P<0.01);而在临床疗效层面,干预后在SNAP-Ⅳ注意力缺陷分量表[(1.84±0.59)分]、多动/冲动分量表[(0.49±0.30)分]和对立违抗分量表[(0.96±0.44 )分]及全量表[(1.07±0.28)分]评分上,与干预前相比[分别为(2.16±0.56)分、(1.70±0.38)分、(1.08±0.38)分、(1.63±0.32)分],均显著下降(均P<0.05)。将学习者组和非学习者组的干预前和干预后SNAP-Ⅳ全量表和分量表评分进行比较,结果发现,干预前两组在SNAP-Ⅳ各分量表和全量表评分均差异无统计学意义(均P>0.05),而干预后学习者组在SNAP-Ⅳ注意力缺陷分量表[(1.74±0.62)分]、多动/冲动分量表[(0.48±0.22)分]和对立违抗分量表[(0.88±0.43 )分]及全量表[(1.01±0.28)分]评分上都低于非学习者组[分别为(2.12±0.37)分、(0.54±0.48)分、(1.17±0.40)分、(1.24±0.18)分],且除过动/冲动分量表外,其余均差异有统计学意义(均P<0.05)。结论脑电生物反馈训练能显著改善患儿的脑电活动和ADHD症状,脑电调节的学习者比非学习者的ADHD症状改善更明显。Objective To investigate the efficacy of EEG biofeedback therapy in children with attention deficit hyperactivity disorder (ADHD) and its relationship with learning in EEG regulation. Methods Fifty-two children with ADHD who completed EEG biofeedback training from August 2015 to February 2019 entered the study according to the inclusion criteria.The children underwent standardized QEEG-based EEG biofeedback training.After 40 training sessions, the study was conducted.The children were divided into learners group (n=39) and non-learners group (n=13), and the difference between learners group and non-learners group in the improvement of ADHD symptoms before and after training was compared. Results After intervention, at the EEG level, the main effects of the number of interventions for θ wave,β wave, SMR and TBR(F(1, 39)=538.49, F(1, 39)=2 712.6, F(1, 39)=7 429.45, F(1, 39)=1.887) were significant(P<0.01). At the clinical efficacy level, the SNAP-IV attention deficit subscale (1.84±0.59), hyperactivity/impulse subscale (0.49±0.30), opposite deficit resistance subscale (0.96±0.44) and full scale (1.07±0.28) significantly decreased after intervention compared with pre-intervention (respectively (2.16±0.56),(1.70±0.38),(1.08±0.38),(1.63±0.32). The pre-and post-intervention SNAP-Ⅳ full scale and subscale scores of the learners group and the non-learners group were compared.Before intervention, the SNAP-Ⅳ subscale score and full scale were not significant differences between the learners and non-learners(all P>0.05). After intervention, the attention deficit subscale score, hyper/impulsive subscale score, ODD subscale score(1.74±0.62 vs 2.12±0.37, 0.48±0.22 vs 0.54±0.48, 0.88±0.43 vs 1.17±0.40)and total score of SNAP-Ⅳ scale(1.01±0.28 vs 1.24±0.18) in the learners were lower than those in the non-learners, and the differences were significant except for the hyper/impulsive subscale (P<0.05). Conclusion EEG biofeedback training can significantly improve EEG activity and ADHD symptoms in children w

关 键 词：脑电生物反馈 注意缺陷多动障碍 脑电调节 学习 

分 类 号：R749.94[医药卫生—神经病学与精神病学]