注意缺陷多动障碍不同表现型的反应时低频振幅研究  

Amplitude of low-frequency fluctuations of behavioral characteristics in different phenotypes of attention deficit hyperactivity disorder

作　　者：王其鹏 曹龙飞 张行[2,3] 方妍彤 叶宝娟[1] WANG Qipeng;CAO Longfei;ZHANG Hang;FANG Yantong;YE Baojuan(School of Psychology,Jiangxi Normal University,Nanchang,Jiangxi 330000,China;Center for Cognition and Brain Disorders,The Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015;Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairment,Hangzhou,Zhejiang 310015,China)

机构地区：[1]江西师范大学心理学院,江西南昌330000 [2]杭州师范大学附属医院认知与脑疾病研究中心,浙江杭州310015 [3]浙江省认知障碍评估技术研究重点实验室,浙江杭州310015

出　　处：《预防医学》2022年第7期747-750,755,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省自然科学基金项目(LY20H090006);江西省社科规划项目(21JY13);江西省高校人文社科重点研究基地课题(JD20068);浙江省卫生厅项目(2019PY062);杭州市科技计划引导项目(20181228Y04)。

摘　　要：目的采用反应时低频振幅(RT-ALFF)分析注意缺陷多动障碍(ADHD)不同表现型之间的行为特征差异,为临床上鉴别ADHD不同表现型的行为特征提供依据。方法选择在杭州师范大学附属医院治疗的ADHD患儿为研究对象,依据《精神障碍诊断与统计手册(第五版)》(DSM-5)分为注意缺陷型(ADHD-I)、多动冲动型(ADHD-HI)和混合型(ADHD-C)3个表现型。采用视听整合测验收集患儿的反应时,计算反应时均值(RT-mean)和反应时标准差(RT-SD),采用低频振幅分析方法计算患儿在0.010~0.027 Hz、0.027~0.073 Hz和0.073~0.167 Hz的RT-ALFF,比较ADHD不同表现型之间的差异。结果纳入ADHD患儿107例,年龄为(8.89±1.93)岁;男童95例,女童12例。其中,ADHD-I型69例,ADHD-HI型8例,ADHD-C型30例。ADHD-C型患儿的RT-SD[(126.003±51.619)ms]高于ADHD-I型患儿[(97.720±45.302)ms],差异有统计学意义(P=0.007)。不同表现型患儿RT-mean比较,差异无统计学意义(F=1.386,P=0.255)。频段与表现型之间存在交互作用(F=2.754,P=0.032);在0.010~0.027 Hz和0.073~0.167 Hz,ADHD-C型患儿的RT-ALFF[(5590.567±231.595)和(4312.609±174.709)ms/Hz]高于ADHD-I型患儿[(4694.001±154.397)和(3690.805±116.473)ms/Hz],差异有统计学意义(P=0.002、0.005)。结论RT-ALFF在ADHD不同表现型间存在差异,且这种差异有频段特异性。Objective To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder(ADHD)using amplitude of low-frequency fluctuation(ALFF),so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD.Methods The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inatten⁃tive type(ADHD-I),hyperactive/impulsive type(ADHD-HI)and combined type(ADHD-C).The reaction time(RT)was measured using integrated visual and auditory continuous performance test,and the mean(RT-mean)and standard devia⁃tion of RT(RT-SD)were estimated.In addition,the ALFF was calculated at 0.010 to 0.027,0.027 to 0.073,0.073 to 0.167 Hz,and the difference of ALFF was compared among children with different types of ADHD.Results A total of 107 children with ADHD were enrolled,including 95 boys and 12 girls,with a mean age of(8.89±1.93)years.There were 69 children with ADHD-I,8 children with ADHD-HI and 30 children with ADHD-C.The RT-SD was significant⁃ly higher among children with ADHD-C than among children with ADHD-I[(126.003±51.619)ms vs.(97.720±45.302)ms;P=0.007];however,there was no significant difference in RT-mean among children with various ADHD phe⁃notypes(F=1.386,P=0.255).There was an interaction between frequency and ADHD phenotypes(F=2.754,P=0.032),and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027[(5590.567±231.595)ms vs.(4694.001±154.397)ms;P=0.002]and 0.073 to 0.167 Hz[(4312.609±174.709)ms vs.(3690.805±116.473)ms;P=0.005].Conclusions The ALFF varies in ADHD phenotypes,and there is a frequency-specific difference.

关 键 词：注意缺陷多动障碍 表现型 行为特征 反应时 低频振幅 

分 类 号：R749.94[医药卫生—神经病学与精神病学]