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脑电图评估额叶α波不对称与注意缺陷多动障碍患儿情绪失调的关系
陈磊, 赵莉莉, 吴晓晨, 李虹媛, 张炜炜
中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (12) : 1493-1499.
PDF(597 KB)
PDF(597 KB)
脑电图评估额叶α波不对称与注意缺陷多动障碍患儿情绪失调的关系
Electroencephalographic assessment of the relationship between frontal alpha asymmetry and emotion dysregulation in children with attention deficit hyperactivity disorder
目的 探讨脑电图评估额叶α波不对称(frontal alpha asymmetry, FAA)与注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)患儿情绪失调(emotion dysregulation, ED)的关系。 方法 前瞻性选取2021年9月—2024年12月阜阳市妇女儿童医院收治的104例ADHD患儿为研究对象。按照Achenbach儿童行为量表(Child Behavior Checklist, CBCL)得分分为ED组(3个子量表得分之和<180分;n=41)和非ED组(3个子量表得分之和≥180分;n=63)。收集患儿临床资料,采用中文版ADHD SNAP-Ⅳ量表-父母版、Weiss功能缺陷量表父母版进行评估,使用脑电图检测FAA。分析不同区域FAA与患儿CBCL得分的相关性及其对ADHD患儿发生ED的预测价值。 结果 与非ED组相比,ED组ADHD分型以注意缺陷为主型比例、SNAP-Ⅳ总分、Weiss功能缺陷量表父母版总分、前额(FP1/FP2)区域的FAA、中央区(C3/C4)区域的FAA更高(P<0.05)。ADHD患儿FP1/FP2、C3/C4区域的FAA与CBCL得分呈负相关(P<0.05)。多因素logistic回归分析结果显示,FP1/FP2区域的FAA、C3/C4区域的FAA与ADHD患儿发生ED密切相关(P<0.05)。受试者操作特征曲线结果显示,FP1/FP2区域的FAA、C3/C4区域的FAA单独及两者联合预测ADHD患儿发生ED的曲线下面积分别为0.827、0.685、0.917(P<0.05);两者联合预测曲线下面积高于FP1/FP2区域的FAA或C3/C4区域的FAA单独预测(P<0.05)。多动冲动型ADHD患儿FP1/FP2区域的FAA值低于混合型ADHD患儿和注意缺陷为主型的ADHD患儿(P<0.05)。 结论 FP1/FP2区域的FAA、C3/C4区域的FAA是ADHD患儿情绪失调的可靠神经标志物,两者联合预测性能更优。不同ADHD分型表现出特异的FAA-功能损害关联模式。
Objective To explore the relationship between frontal alpha asymmetry (FAA) assessed by electroencephalogram (EEG) and emotion dysregulation (ED) in children with attention deficit hyperactivity disorder (ADHD). Methods Children with ADHD admitted to Fuyang Women and Children's Hospital from September 2021 to December 2024 were prospectively enrolled (n=104). Based on the Achenbach Child Behavior Checklist (CBCL), participants were classified into an ED group (sum of three subscales <180; n=41) and a non-ED group (sum ≥180; n=63). Clinical data were collected, and the Chinese ADHD SNAP-IV parent version and the Weiss Functional Impairment Rating Scale-Parent Report were used. FAA was measured by EEG. Correlations between FAA in different regions and CBCL score were analyzed, and the predictive value of FAA for ED was evaluated with multivariable logistic regression and receiver operating characteristic curves. Results Compared with the non-ED group, the ED group had a higher proportion of the predominantly inattentive ADHD subtype, higher SNAP-IV total score, higher Weiss Functional Impairment Rating Scale-Parent Report total score, and higher FP1/FP2-FAA and C3/C4-FAA (P<0.05). FP1/FP2-FAA and C3/C4-FAA were negatively correlated with CBCL score (P<0.05). The multivariable logistic regression analysis showed that FP1/FP2-FAA and C3/C4-FAA were closely associated with ED in children with ADHD (P<0.05). The areas under the curve for predicting ED using FP1/FP2-FAA, C3/C4-FAA, and their combination were 0.827, 0.685, and 0.917, respectively (P<0.05), and the combined prediction had a higher area under the curve than either single marker (P<0.05). The FP1/FP2 FAA value in hyperactive-impulsive ADHD was lower than in combined-type ADHD and predominantly inattentive ADHD (P<0.05). Conclusions FP1/FP2-FAA and C3/C4-FAA are reliable neural markers of emotion dysregulation in children with ADHD, and their combination shows superior predictive performance. ADHD subtypes show distinct patterns of FAA-functional impairment associations.
注意缺陷多动障碍 / 脑电图 / 额叶α波不对称 / 情绪失调 / 儿童
Attention deficit hyperactivity disorder / Electroencephalogram / Frontal alpha asymmetry / Emotion dysregulation / Child
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