学龄期注意缺陷多动障碍儿童注意认知功能与症状的相关性

段桂琴; 赵明方; 王甘雨; 尹嘉宝; 聂文毫; 靳婷婷; 王小宇

doi:10.16835/j.cnki.1000-9817.2025187

学龄期注意缺陷多动障碍儿童注意认知功能与症状的相关性

doi: 10.16835/j.cnki.1000-9817.2025187

1.
郑州大学第三附属医院儿童保健科，河南 450052
2.
郑州大学第三附属医院儿童发育行为科

详细信息

作者简介:
段桂琴(1968-)，女，河南郑州人，硕士，主任医师，主要研究方向为儿童发育行为

通讯作者:
赵明方，E-mail：zmfzmf1004@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.1 R748
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出版历程
- 收稿日期: 2025-01-08
- 修回日期: 2025-03-26
- 网络出版日期: 2025-07-04
- 刊出日期: 2025-06-25

Correlation between attentional cognitive function and symptoms in school-aged children with attention deficit hyperactivity disorder

1.
Child Healthcare Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou (450052), Henan Province, China

摘要

摘要: 目的采用事件相关电位(ERP)技术研究学龄期注意缺陷多动障碍(ADHD)儿童的注意认知功能及症状的相关性，为早期诊断ADHD儿童提供参考。方法选取2022年9月至2024年9月于郑州大学第三附属医院门诊诊断为ADHD的学龄期儿童为ADHD组(52名)，选取同期体检的年龄、性别相匹配的正常儿童为健康对照组(50名)。ERP试验采用听觉Oddball任务，分别对头皮电极Fz、Cz、Pz点失匹配负波(MMN)和P3a成分进行波幅和潜伏期的比较分析。症状评定量表采用SNAP-Ⅳ评定量表和Conners父母症状问卷(PSQ)，由家长填写。采用Spearman相关分析学龄期ADHD儿童ERP成分与症状的相关性。结果健康对照组儿童MMN成分在Fz导联上的潜伏期为(188.30±2.06)ms，波幅为(-15.54±1.35)μV；P3a成分在Pz导联上的潜伏期为(312.82±7.80)ms，波幅为(3.80±0.18)μV。ADHD组儿童MMN成分在Fz导联上的潜伏期为(188.94±1.39)ms，波幅为(-14.78±1.40)μV；P3a成分在Pz导联上的潜伏期为(317.21±5.65)ms，波幅为(3.70±0.13)μV。相较正常儿童，ADHD儿童的MMN在Fz、Cz导联上有较小的波幅，P3a在Cz、Pz导联上有更大的潜伏期和较小的波幅(t值分别为2.79，2.20；-2.04，-3.25；2.35，3.21，P值均＜0.05)。相关性分析显示，ADHD儿童MMN潜伏期与SNAP-Ⅳ中的注意力不足得分呈正相关(r=0.22)，MMN波幅与SNAP-Ⅳ中的注意力不足和PSQ中的学习问题得分均呈负相关(r值分别为-0.26，-0.34)；P3a潜伏期与SNAP-Ⅳ中的注意力不足和PSQ量表中的学习问题得分均呈正相关(r值分别为0.26，0.24)，P3a波幅与SNAP-Ⅳ中的注意力不足、多动/冲动和PSQ量表中的学习问题、冲动/多动得分均呈负相关(r值分别为-0.26，-0.22，-0.25，-0.32)(P值均＜0.05)。结论学龄期ADHD儿童MMN、P3a成分异常，存在注意认知功能缺陷。ADHD儿童注意力不足、学习问题、冲动多动等症状与MMN、P3a成分异常有关。
- 注意力缺陷障碍伴多动 /
- 认知 /
- 精神卫生 /
- 儿童
Abstract: Objective To investigate the attention cognitive function and symptom correlations of school-aged children with attention deficit hyperactivity disorder (ADHD)using event-related potential (ERP) technology, so as to provide references for the early diagnosis of children with ADHD. Methods A total of 52 school-aged children diagnosed with ADHD at the outpatient department of the Third Affiliated Hospital of Zhengzhou University from September 2022 to September 2024 and 50 age-/sex-matched healthy controls were selected. The ERP experiment adopted the auditory Oddball task to conduct comparative analyses of the amplitude and latency of the mismatch negative(MMN) at the Fz, Cz, and Pz points of the scalp electrode and the P3a component respectively. The symptom assessment scales adopted the Swanson, Nolan, and Pelham-Ⅳ Rating Scale (SNAP-Ⅳ) and the Parent Symptom Questionnaire (PSQ), which were filled out by the parents. Spearman correlation analysis was used to analyze the correlation between ERP components and symptoms in school-aged children with ADHD. Results The latency of MMN components in the healthy control group on the Fz lead was (188.30±2.06)ms, and the amplitude was (-15.54±1.35)μV; the latency of the P3a component on the Pz lead was (312.82±7.80)ms, and the amplitude was (3.80±0.18)μV. The latency of MMN components in the ADHD group on the Fz lead was (188.94±1.39)ms, and the amplitude was (-14.78±1.40)μV; the latency of the P3a component on the Pz lead was (317.21±5.65)ms, and the amplitude was (3.70±0.13)μV. Compared with normal children, the MMN of children with ADHD had smaller amplitudes in the Fz and Cz leads, and the P3a had greater latency and smaller amplitudes in the Cz and Pz leads (t=2.79, 2.20;-2.04, -3.25;2.35, 3.21, P < 0.05). Correlation analysis showed that the latency of MMN in children with ADHD was positively correlated with the inattention score in the SNAP-Ⅳ(r=0.22), and the amplitude of MMN was negatively correlated with the inattention score in the SNAP-Ⅳ and the learning problem score in PSQ (r=-0.26, -0.34)(P < 0.05). The latency of P3a was positively correlated with the scores of inattention in the SNAP-Ⅳ and the score of learning problems in the PSQ (r=0.26, 0.24); the amplitude of P3a was negatively correlated with the scores of attention deficit and hyperactivity/impulsivity in the SNAP-Ⅳ and the scores of learning problems and impulsivity/hyperactivity in the PSQ(r=-0.26, -0.22, -0.25, -0.32)(P < 0.05). Conclusions School-aged ADHD children exhibit abnormal MMN/P3a components, indicating attention-related cognitive dysfunction. Symptoms such as inattention, learning problems and hyperactivity/impulsivity in children with ADHD are related to abnormal components of MMN and P3a.
- Attention deficit disorder with hyperactivity /
- Cognition /
- Mental health /
- Child
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表 1 健康对照组和ADHD组儿童症状评定量表得分比较(x±s)

Table 1. Comparison of the scores of symptom rating scales for children between healthy control group and ADHD group(x±s)

组别	人数	SNAP-Ⅳ			PSQ
组别	人数	注意力不足	多动/冲动	其他症状	品行问题	学习问题^*	心身障碍^*	冲动/多动^*	焦虑^*	多动指数^*
健康对照组	50	0.88±0.39	0.80±0.55	0.96±0.56	0.83±0.55	0.32(0.25, 0.69)	0.20(0, 0.30)	0.50(0.25, 1.20)	0.30(0.25, 0.75)	0.50(0.29, 0.80)
ADHD组	52	1.83±0.43	1.14±0.71	0.92±0.57	0.95±0.62	1.42(1.02, 1.75)	0.20(0.20, 0.55)	1.25(0.75, 1.75)	0.50(0.25, 1.00)	0.80(0.30, 1.24)
t/Z值		-11.71	-2.76	0.36	-1.00	-7.28	-2.52	-4.27	-1.68	-2.39
P值		＜0.01	＜0.01	0.72	0.32	＜0.01	0.01	＜0.01	0.09	0.02
注：^*不符合正态分布，用M(P₂₅，P₇₅)描述。

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表 2 健康对照组和ADHD组儿童Fz、Cz、Pz导联MMN及P3a成分指标比较(x±s)

Table 2. Comparison of MMN and P3a components in leads Fz, Cz and Pz for children between healthy control group and ADHD group(x±s)

组别	人数	MMN潜伏期/ms			MMN波幅/μV			P3a潜伏期/ms			P3a波幅/μV
组别	人数	Fz	Cz	Pz	Fz	Cz	Pz	Fz	Cz	Pz	Fz	Cz	Pz
健康对照组	50	188.30±2.06	185.14±2.35	176.34±4.52	-15.54±1.35	-15.12±2.70	-7.36±0.40	323.30±0.95	315.38±2.55	312.82±7.80	1.13±0.09	2.18±0.22	3.80±0.18
ADHD组	52	188.94±1.39	185.38±2.43	175.23±3.32	-14.78±1.40	-13.82±3.27	-7.52±0.50	323.12±1.18	316.56±3.24	317.21±5.65	1.10±0.08	2.08±0.20	3.70±0.13
t值		-1.39	-0.52	1.42	2.79	2.20	-1.86	0.85	-2.04	-3.25	1.49	2.35	3.21
P值		0.18	0.61	0.16	0.01	0.03	0.07	0.40	0.04	＜0.01	0.14	0.02	＜0.01

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表 3 ADHD儿童MMN、P3a潜伏期及波幅与SNAP-Ⅳ、PSQ各因子分之间的相关性(r值，n=52)

Table 3. Correlation between the latency and amplitude of MMN and P3a in children with ADHD and the factor scores of SNAP-Ⅳ and PSQ(r, n=52)

ERP	SNAP-Ⅳ			PSQ
ERP	注意力不足	多动/冲动	其他症状	品行问题	学习问题	心身障碍	冲动/多动	焦虑	多动指数
MMN潜伏期(Fz)	0.22^*	-0.06	0.12	-0.13	0.04	-0.19	0.02	-0.18	-0.05
MMN波幅(Fz)	-0.26^*	-0.02	0.01	0.01	-0.24^**	-0.04	0.17	-0.02	0.18
P3a潜伏期(Pz)	0.26^*	0.08	-0.07	0.01	0.24^*	0.10	0.18	-0.10	0.14
P3a波幅(Pz)	-0.26^*	-0.22^*	-0.04	-0.05	-0.25^*	-0.21	-0.32^**	-0.16	-0.14
注：^* P＜0.05，^** P＜0.01。

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