Potgieter S, Vervisch J, Lagae L
Department of Paediatric Neurology, University Hospitals Gasthuisberg, 49 Herestreet, 3000, Leuven, Belgium.
Clin Neurophysiol. 2003 Oct;114(10):1841-9. doi: 10.1016/s1388-2457(03)00198-6.
Children born prematurely have a higher incidence of attention deficit disorder with or without hyperactivity. We have used visual event related potentials to study possible brain dysfunctions that could explain this higher incidence.
Very low birth weight (VLBW) children with and without AD/HD and term born children with and without AD/HD, were matched for IQ, age and socio-economic status (n=41, mean age 104 months). A visual oddball paradigm, consisting of target and non-target stimuli, was used with analysis of response times, error scores, N200, P300 and a P500 component.
AD/HD children responded slower (F (1,38)=11.20, p<0.002); more varied (F (1,38)=21.77, p<0.000) and made more commission and omission errors (Kruskal-Wallis p<0.000). Non-target N200 was increased in amplitude (F (1.39)=4.01, p=0.05) with a wide anterior topography in children with AD/HD. The late positivity (P500) was decreased over central leads in children with AD/HD during the non-target stimuli (F (3,75)=3.00, p<0.036). No differences could be found in latency, amplitude or topography between VLBW children with AD/HD and term born children with AD/HD.
Prematurity does not induce specific attentional brain dysfunction or maturation delays in stimulus processing during cognitive tasks. Other factors should be investigated to explain the higher incidence of AD/HD in VLBW children.
早产出生的儿童患注意力缺陷多动障碍（无论有无多动症状）的几率更高。我们利用视觉事件相关电位来研究可能导致这种高发病率的脑功能障碍。
将患有和未患注意力缺陷多动障碍（AD/HD）的极低出生体重（VLBW）儿童以及患有和未患AD/HD的足月儿，按照智商、年龄和社会经济地位进行匹配（n = 41，平均年龄104个月）。采用由目标刺激和非目标刺激组成的视觉oddball范式，分析反应时间、错误分数、N200、P300和P500成分。
AD/HD儿童反应更慢（F(1,38)=11.20，p<0.002）；反应更具多样性（F(1,38)=21.77，p<0.000），且犯更多的误判和漏判错误（Kruskal-Wallis检验，p<0.000）。AD/HD儿童非目标刺激的N200波幅增大（F(1.39)=4.01，p = 0.05），且在大脑前部广泛分布。在非目标刺激期间，AD/HD儿童中央导联的晚期正波（P500）降低（F(3,75)=3.00，p<0.036）。患有AD/HD的极低出生体重儿童和足月儿在潜伏期、波幅或地形图方面未发现差异。
早产并不会在认知任务期间诱发特定的注意力脑功能障碍或刺激处理方面的成熟延迟。应研究其他因素来解释极低出生体重儿童中AD/HD发病率较高的现象。
