健康与遗传心理学研究室知识库

目的:

1分析AD/HD儿童大脑觉醒水平和成熟的特点，探讨AD/11D发生的脑功能障碍机制。

2分析AD/HD儿童前额叶各脑电波的活性特征:

3探索不同亚型的AD/HD儿童前额叶的EEG特征及脑机制。

方法:

1、研究对象

采用教师、家长筛查及精神利一医师综合评定确定符合DSM-IV诊断标准的AD/HD儿童70例，(男性43例，女性27例)，随机选择70例非AD/HD患者作为对照组(男性38例，女性32例)。将筛选出的被试按年龄大小(以96月为界)分出高年龄AD/HD组、低年龄AD/HD组、高年龄对照组组和低年龄对照组组。同时将筛选出的70例AD/HD患者根据DSM-IV之标准分成不同的三种亚型:分为AD/HD注意缺陷组(Predominantly Inattentive9 AD/HDin) 19例(男9，女10), AD/HD多动一冲动组(Predominantly Hyperactive-Impulsive, AD/HDhyp)20例(男11，女9)、AD/HD混合组(Combined Type, AD/HDcom ) 31例(男23，女8)。

2、研究方法:

首先，对班主任老师进行AD/HD诊断标准相关知识的培训，通过班主任的筛查，确定有AD/HD倾向和无AD/HD倾向的对象。发放《注意缺陷多动障碍诊断量表一父母版》调查问卷，按规定时间收回，进行评分，根据DSM-IV诊断标准筛查符合AD/HD标准的对象，再经过精神科医师的综合评定确诊具有AD/HD特征学生。其次，将试验对象带至实验室进行EEG的数据采集，采用中国台湾华幼国际教育机构提供的华幼多功能动态脑波机(Cerebrum Digital Spectrum systematic software.Taiwan 9 500I-Iz样本率，20604放大率，带通滤波器0.15Hz-130Hz，设备型号:huayou-EEG2000)记录所有研究对象左右前额叶的α、β、θ、Б四种脑波的数据变化。脑电波描记电极位置:左右前额( I'pl, Fp2 )各一个电极采样，左右耳后骨突处各一个参考电极。EEG描计程序:前段:安静睁眼状态下描计脑电波1分钟;中段:在闭眼静息状态下描计脑电波2分钟;后段:在心理应激(计算任务下)描计脑电波1分钟;第三，收集将EEG数据经过快速傅立叶转换后得出的绝对和相对脑波功率数据;第四，将收集的数据采用SPSS17. 0软件包进行统计学处理。

结果:

1、安静睁眼状态下，AD/HD组的EEG中。α、β、θ频带绝对功率与对照组存在显著差异，均高于对照组，Б频带绝对功率差异不显著。而在闭眼静息状态下β频带绝对功率与对照组存在显著差异。计算任务状态下两组间无差异。

2、安静睁眼状态下AD/HD组的β/α、θ/a 、θ/β比值与对照组比较，β/α存在差异，θ/a 、θ/β无差异。

3、不同年龄阶段，AD/HD组和对照组之间未发现年龄与EEG各频带功率的交互作用。

4, AD/HD不同亚型组与对照组比较，α、β、θ频带绝对功率均存在显著差异。在安静睁眼状态，AD/HDin组与对照组比较:右额叶。α、β频带绝对功率均存在差异，左额θ、α、β频带绝对功率均存在差异; AD/HDhyp组与对照组比较: 左右额叶θ、α、β频带绝对功率均存在显著差异; AD/HDcom 组与对照组比较: 右额叶θ、α、β频带绝对功率均存在显著差异，左额叶Б、α、β、θ频带绝对功率均存在显著差异。在闭眼静息状态，AD/HDin组与对照组比较:左右额叶Б、θ频带绝对功率均存在显著差异，左额叶α存在显著差异; AD/I-IDhyp组与对照组比较:右额叶θ,β频带绝对功率均存在差异，左额叶α频带绝对功率存在显著差异; AD/HDcom组与对照组比较:左额叶a、右额叶β频带绝对功率存在差异。这种差异来自各亚型与对照组的差异。

5、前额叶后段(计算任务下)与前段(安静睁眼状态下)各频段功率变化之比较，AD/HD组各亚型与对照组之间的比较，α、β、θ频带绝对功率比值均存在差异，β频带绝对功率两段比值四组间差异最大。

结论:

AD/HD患者的EEG与正常对照组存在显著差异，α、β、θ频带绝对功率高于正常对照组，各亚型之间没有发现质的差异，只是严重程度不同，本研究结果支持AD/HD患者“发展偏离”及“大脑低觉醒水平”理论假设，不支持“成熟滞后”理论假设;AD/HD患者从安静睁眼状态转向计算任务状态时，大脑的激活程度低于正常对照组。从而推测，AD/HD患者存在大脑抑制功能障碍，导致大脑激活失调。三个亚型相比，AD/HDhyp组与AD/HDcom组障碍更加严重。

OBJECTIVE:

1 .To analyze the trait of arousal and mature hysterics in children with attention deficit hyperactivity disorder (AD/HD) and explore the underlying mechanisms of brain dysfunction.

2. To analyze the electrical activity of frontal cortex of children with AD/HD.3. To explore the frontal cortex QEEG character and brain mechanism of the different subtypes of the children with AD/HD.

METHOD:

1 .Subject:

The case group was consisted of 70 AD/HD children (43 boys and 27 girls) assessed by teachers, parents and psychiatrists. The control group was consisted of 70 children without AD/HD (38 boys and 32 girls) by random choice. All subjects were separated to higher age AD/HD group, lower age AD/HD group, higher age control group and lower age control group. At the same time, the 70 children with AD/HD were divided into 3 different subtypes: 19 children with AD/HDin(9 boys and 10 girls)，20 children with AD/HDhyp(11 boys and 9 girls) and 31 children with AD/HDcom(23 boys and 8 girls).

2. Experimental method:

First, the teachers were trained on the knowledge of AD/HD diagnosis and make a distinction between the children with and without AD/HD. Investigated these children with AD/HD Rating Scale-IV: Home Version and collected the results within a certain time, and then calculated the scores of the Scale. Evaluated and diagnosed AD/HD by the psychiatrist with the criteria of the DSM-IV Second, all children's data were selected in laboratory with two electrode sites (10 -20 systems) and Al and A2 references, Fpl and Fp2.EEG were recorded with the "huayou-EEG2000 (Cerebrum Digital Spectrum systematic software) provided by Hua-You Education Institution (parameter: S00-Hz sanpling rate, 20,604 gain, and band-pass filtered: 0.15 Hz-130 Hz). EEG recording program: EO, Eyes-Opened resting state; EC, Eyes-Closed resting state; and MAT, Mental Arithmetic Task state.arrayed EO(1 minute)-EC(2 minutes)-MAT(1 minutc).Third, he EEG was visually appraised to exclude artifact,and all suitable 1一sec epochs were Fourier transformed with a Hamming window into absolute and relative power in the delta, theta, alpha and beta bands. Theta/alpha,theta/beta and beta/alpha ratio coefficients were also calculated. At last, the data was analyzed by SPSS17.0 package of software.

RESULTS:

1 Absolute theta, alpha and beta power were increased in the AD/HD group compared with control subjects at the Eyes-Opened resting state. There were no significant differences for absolute delta power between AD/HD and control group. There were significant differences for absolute beta power in Eyes-Closed resting state between AD/HD and control group. No differences were found for absolute delta, theta, alpha and beta power in }cntal Arithmetic Taslc state.

2 The beta/alpha, theta /alpha and theta/beta ratio were evaluated at the Eyes-Opened resting state, and there were significant differences for beta/alpha ratio between AD/HD and control group. The theta /alpha and theta/beta ratio were no differences between AD/HD group and control subjects.

3 No interactive effect was found between EEG frequency bands power and age of AD/HD group and control subjects.

4 Comparing AD/HD subtypes with the control group: there were significant differences in absolute alpha, beta and theta power at the E. state. Comparing AD/HDin with control group at EO state: absolute alpha, beta powers of right frontal cortex were significant different, absolute theta, alpha, beta powers of left frontal cortex wart significant different; Comparing AD/HDhyp with control group: absolute delta, alpha, beta, theta powers of right and left frontal cortexes were significant different; Comparing AD/HDcom with control group: the theta, alpha, beta powers of right frontal cortex were significant different. There were significant differences in absolute delta, alpha, beta, theta powers of left frontal cortex between AD/HDcom and control group. Comparing AD/HDin with control group at the EC state: absolute delta, theta powers of left and right frontal cortexes were different,Absolute alpha powers of left frontal cortex was different; Comparing AD/HDhyp with control group at the EC state: absolute theta, beta powers of right frontal cortex were different and absolute alpha powers of left frontal cortex were different.Comparing AD/HDcom with control group at the EC state: absolute alpha powers of left frontal cortex and absolute beta powers of right frontal cortex were different.These differences came from the comparisons between control group and various subtypes rather than the comparisons among subtypes.

5 In the prefrontal cortex, the change of the alpha, beta and theta from EO to MAT' were significant different in absolute power between AD/HD subtypes and control group, especially the change of the beta from EO to MAT were significant different between AD/HD subtypes and control group.

CONCLUSION:

There were significant differences between children with AD/HD and control group. Absolute alpha, beta, theta band powers of children with AD/HD were higher than control subjects. No significant differences were found among all subtypes and only the degree of severity was different. These data supported the low arousal theoretical hypothesis and contradicted the supposed maturational lag. There was lower activity of brain in the children with AD/HD from Eyes-Opened resting state to Mental Arithmetic Task state compared with control subjects. This result showed that the children with AD/HD had inhibiting function disorder of brain, which led to the dysfunction of activity. Children with AD/HDhyp and AD/HDcom were more severe than children with AD/HDin.