Ornitz E M, Hanna G L, de Traversay J
Department of Psychiatry, University of California, Los Angeles.
Psychophysiology. 1992 Jul;29(4):437-51. doi: 10.1111/j.1469-8986.1992.tb01717.x.
Startle modulation was induced by prestimulation in 43, 6-11 year old boys with attention-deficit hyperactivity disorder (ADHD), 13 of whom were or had been enuretic, 17 age-matched enuretic boys, and 42 age-matched normal boys, using 60-ms and 120-ms prestimulation intervals and a 4000-ms continuous tone. There was a significant multivariate effect of enuresis on startle amplitude modulation. This effect was attributed primarily to the reduction of amplitude inhibition following the 120-ms prestimulation interval regardless of whether or not enuresis was associated with ADHD. There was no effect of ADHD on startle modulation by prestimulation. The inhibition following the 120-ms prestimulation interval in the enuretic boys was reduced to the level of 5-year-old normal children, suggesting a maturational component of the deficient startle inhibition. The neurophysiologic dysfunction underlying the deficient startle inhibition in enuresis, but not ADHD, is discussed in terms of a possible dysfunction of mesopontine reticular mechanisms mediating preattentive processing of signals associated with spinal reflexes involved in urinary bladder control.
对43名6至11岁患有注意力缺陷多动障碍（ADHD）的男孩、其中13名有尿床史或曾有尿床经历的男孩、17名年龄匹配的尿床男孩以及42名年龄匹配的正常男孩，采用60毫秒和120毫秒的预刺激间隔以及4000毫秒的持续音调，诱导惊吓调制。尿床对惊吓幅度调制有显著的多变量效应。这种效应主要归因于120毫秒预刺激间隔后幅度抑制的降低，无论尿床是否与ADHD相关。ADHD对预刺激引起的惊吓调制没有影响。尿床男孩中120毫秒预刺激间隔后的抑制降低到了5岁正常儿童的水平，表明惊吓抑制不足存在成熟因素。根据中脑桥网状机制可能存在的功能障碍来讨论尿床（而非ADHD）中惊吓抑制不足的潜在神经生理功能障碍，该机制介导与膀胱控制所涉及的脊髓反射相关信号的预注意处理。
