伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿认知功能损害的前瞻性研究

doi:10.7499/j.issn.1008-8830.2105011

摘要
图/表
参考文献(22)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (566 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨伴中央颞区棘波的儿童良性癫痫（benign childhood epilepsy with centrotemporal spikes，BECT）共患注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）患儿与单纯BECT患儿或单纯ADHD患儿认知功能损害的差异。方法前瞻性选取初次诊断的BECT共患ADHD患儿80例、BECT患儿91例及ADHD患儿70例为研究对象，并选取同期儿童保健门诊行健康体检的同龄儿童70例为健康对照组，采用事件相关电位P300、韦氏儿童智力量表、视听整合连续测试3种评估方法，分别测定并比较各组儿童各指标的差异。结果与健康对照组比较，BECT+ADHD组、BECT组、ADHD组P300潜伏期延长、波幅降低且言语理解指数（verbal comprehension index，VCI）、知觉推理指数（perceptual reasoning index，PRI）、工作记忆指数（working memory index，WMI）、加工速度指数（processing speed index，PSI）、总智商（full scale IQ，FSIQ），以及听觉反应控制商数（auditory response control quotient，ARCQ）、视觉反应控制商数（visual response control quotient，VRCQ）、综合反应控制商数（full response control quotient，FRCQ）、听觉注意力商数（auditory attention quotient，AAQ）、视觉注意力商数（visual attention quotient，VAQ）、综合注意力商数（full attention quotient，FAQ）分值降低（P<0.05）；与BECT组比较，BECT+ADHD组P300潜伏期延长、波幅降低且VCI、PRI、WMI、PSI、FSIQ及FRCQ分值降低（P<0.05）；与ADHD组比较，BECT+ADHD组P300潜伏期延长、波幅降低且VCI、PRI、FSIQ及ARCQ、FRCQ、AAQ分值降低（P<0.05）。结论 BECT共患ADHD患儿，与单纯BECT或单纯ADHD患儿比较，其认知功能损害领域基本一致，但有些领域的损害程度更加严重。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	房海波
	王荣
	褚琳娜
	冯艳芳
	白容荣
	郭丰桐

关键词 ：伴中央颞区棘波的儿童良性癫痫, 注意缺陷多动障碍, 认知功能, 事件相关电位P300, 韦氏儿童智力量表, 视听整合连续测试, 儿童

Abstract：Objective To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone. Methods A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups. Results Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (P<0.05). Compared with the BECT group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, WMI, PSI, FSIQ, and FRCQ (P<0.05). Compared with the ADHD group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, FSIQ, ARCQ, FRCQ, and AAQ (P<0.05). Conclusions Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.

Key words： Benign childhood epilepsy with centrotemporal spikes Attention deficit hyperactivity disorder Cognitive function Event-related potential P300 Wechsler Intelligence Scale for Children Integrated visual and auditory continuous performance test Child

收稿日期: 2021-05-07

作者简介: 房海波，女，硕士，主治医师。Email：fhbgft@163.co；

引用本文:

房海波,王荣,褚琳娜等. 伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿认知功能损害的前瞻性研究[J]. 中国当代儿科杂志, 2021, 23(8): 791-796.

FANG Hai-Bo,WANG Rong,CHU Lin-Na et al. Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder: a prospective study[J]. CJCP, 2021, 23(8): 791-796.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2105011 或 http://www.zgddek.com/CN/Y2021/V23/I8/791

	1 刘晓燕. 临床脑电图学[M]. 2版. 北京: 人民卫生出版社, 2017: 335.
	2 张珺, 孙伟. 儿童良性癫痫伴中央颞区棘波患者的认知损害研究[J]. 癫痫杂志, 2020, 6(2): 93-97. DOI: 10.7507/2096-0247.20200016.
	Wang T, Liu K, Li Z, et al. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis[J]. BMC Psychiatry, 2017, 17(1):32. DOI: 10.1186/s12888-016-1187-9. PMID: 28103833. PMCID: PMC5244567.
	4 程秋莹, 杨斌让, 曾洪武, 等. 注意缺陷多动障碍儿童冷执行功能特征[J]. 中国实用儿科杂志, 2018, 33(4): 297-301. DOI: 10.19538/j.ek2018040613.
	Tovia E, Goldberg-Stern H, Ben Zeev B, et al. The prevalence of atypical presentations and comorbidities of benign childhood epilepsy with centrotemporal spikes[J]. Epilepsia, 2011, 52(8): 1483-1488. DOI: 10.1111/j.1528-1167.2011.03136.x. PMID: 21692792.
	Ofer I, Jacobs J, Jaiser N, et al. Cognitive and behavioral comorbidities in Rolandic epilepsy and their relation with default mode network's functional connectivity and organization[J]. Epilepsy Behav, 2018, 78: 179-186. DOI: 10.1016/j.yebeh.2017.10.013. PMID: 29103838.
	Lima EM, Rzezak P, Guimar?es CA, et al. The executive profile of children with benign epilepsy of childhood with centrotemporal spikes and temporal lobe epilepsy[J]. Epilepsy Behav, 2017, 72: 173-177. DOI: 10.1016/j.yebeh.2017.04.024. PMID: 28622557.
	8 梁锦平. 国际抗癫痫联盟2017年版癫痫分类特点及其解读[J]. 中国实用儿科杂志, 2020, 35(1): 47-54. DOI: 10.19538/j.ek2020010613.
	9 美国精神医学学会. 精神障碍诊断与统计手册(第5版)[M]. 张道龙, 刘春宇, 童慧琦, 等, 译. 北京: 北京大学出版社, 2015: 55-62.
	10 苗青, 王小玉, 张干, 等. 事件相关电位P300在神经疾病伴认知功能障碍中的应用价值[J]. 蚌埠医学院学报, 2019, 44(3): 325-327. DOI: 10.13898/j.cnki.issn.1000-2200.2019.03.012.
	11 张慧敏, 温晓红, 黄金华, 等. 韦氏儿童智力量表第四版在癫痫儿童认知评估中的应用[J]. 中国儿童保健杂志, 2018, 26(10): 1120-1123. DOI: 10.11852/zgetbjzz2018-26-10-20.
	12 金静, 陶明. 注意缺陷多动障碍视听整合测试和皮层网络信息传输与响应特征的相关性分析[J]. 浙江临床医学, 2019, 21(11): 1515-1517.
	Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology[J]. Epilepsia, 2017, 58(4): 512-521. DOI: 10.1111/epi.13709. PMID: 28276062. PMCID: PMC5386840.
	14 张静. 伴中央颞区棘波的儿童良性癫痫治疗前后脑电图、智力及认知水平变化的自身对照研究[D]. 石家庄: 河北医科大学, 2015.
	Wickens S, Bowden SC, D'Souza W. Cognitive functioning in children with self-limited epilepsy with centrotemporal spikes: a systematic review and meta-analysis[J]. Epilepsia, 2017, 58(10):1673-1685. DOI: 10.1111/epi.13865. PMID: 28801973.
	16 林磊, 王晓英. 伴中央颞区棘波良性癫痫变异型儿童智商影响因素分析[J]. 中国儿童保健杂志, 2017, 25(3): 284-287. DOI: 10.11852/zgetbjzz2017-25-03-21.
	Kim HJ, Lee JH, Park CH, et al. Role of language-related functional connectivity in patients with benign childhood epilepsy with centrotemporal spikes[J]. J Clin Neurol, 2018, 14(1): 48-57. DOI: 10.3988/jcn.2018.14.1.48. PMID: 29629540. PMCID: PMC5765256.
	Lima EM, Rzezak P, Dos Santos B, et al. The relevance of attention deficit hyperactivity disorder in self-limited childhood epilepsy with centrotemporal spikes[J]. Epilepsy Behav, 2018, 82: 164-169. DOI: 10.1016/j.yebeh.2018.03.017. PMID: 29649723.
	19 冯硕, 刘肖予, 张烨, 等. 注意缺陷多动障碍患儿事件相关电位P300潜伏期的探讨[J]. 中国实用儿科杂志, 2020, 35(5): 383-386. DOI: 10.19538/j.ek2020050613.
	20 林文璇, 王馨, 吴婕翎, 等. 韦氏儿童智力量表第四版在注意缺陷多动障碍儿童智力结构分析中的应用[J]. 中国儿童保健杂志, 2012, 20(1): 58-61.
	21 陶丹红, 吴绪旭, 石敏, 等. 注意缺陷多动障碍的视听注意反应与P300的相关性研究[J]. 浙江医学, 2017, 39(23): 2093-2097. DOI: 10.12056/j.issn.1006-2785.2017.39.23.2017-550.
	Kang SH, Yum MS, Kim EH, et al. Cognitive function in childhood epilepsy: importance of attention deficit hyperactivity disorder[J]. J Clin Neurol, 2015, 11(1): 20-25. DOI: 10.3988/jcn.2015.11.1.20. PMID: 25628733. PMCID: PMC4302175.