Weber Peter, Lütschg Jürg, Fahnenstich Hubert
Department of Neuropediatrics and Developmental Neurology, University Children's Hospital Basel, Römergasse 9, CH-4005 Basel, Switzerland.
J Dev Behav Pediatr. 2005 Apr;26(2):105-11. doi: 10.1097/00004703-200504000-00005.
The aim of the present study was to evaluate the hemodynamic changes in both prefrontal regions induced by a cognitive task in children with a developmental attention-deficit disorder in comparison to normal controls using near-infrared spectroscopy (NIRS). A total of 11 boys with a mean age of 10.4 (+/-1.2) years that met the DSM-IV criteria for attention-deficit hyperactivity disorder (ADHD) participated in the study and were compared with 9 healthy age- and sex-matched controls. Using a trail-making test designed for the task of connecting numbers from 1-90 in four sets, changes in oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin, tissue oxygenation index (TOI), and cerebral blood volume (CBV) were measured by near-infrared spectroscopy. During the first test set, designed as a short-attention task, the children with ADHD showed significant increases in O2Hb and CBV, whereas the controls showed no significant changes. During the 4 task cycles in which extended attention was demanded, both groups showed increases in O2Hb and CBV, but only the controls showed an additional increase in HHb in the left prefrontal region. In the ADHD group only, TOI showed an increase mainly on the left side. NIRS is a sensitive tool for measuring differences in hemodynamic changes between boys with ADHD and normal controls. Overall, the normal controls showed lateralized oxygen consumption in the left prefrontal cortex during an extended-attention task, whereas the boys with ADHD showed an imbalance between oxygenated and deoxygenated hemoglobin during the short- and extended-attention tasks.
本研究的目的是,运用近红外光谱技术(NIRS),评估发育性注意力缺陷障碍儿童与正常对照组儿童在执行认知任务时前额叶区域的血流动力学变化。共有11名平均年龄为10.4(±1.2)岁、符合《精神疾病诊断与统计手册》第四版(DSM-IV)注意力缺陷多动障碍(ADHD)标准的男孩参与了本研究,并与9名年龄和性别匹配的健康对照组进行比较。采用一项为将1至90的数字分成四组进行连接的任务设计的连线测验,通过近红外光谱测量氧化血红蛋白(O2Hb)和脱氧血红蛋白(HHb)、组织氧合指数(TOI)以及脑血容量(CBV)的变化。在第一个设计为短注意力任务的测试组中,患有ADHD的儿童O2Hb和CBV显著增加,而对照组则无显著变化。在需要长时间注意力的4个任务周期中,两组的O2Hb和CBV均增加,但只有对照组左前额叶区域的HHb有额外增加。仅在ADHD组中,TOI主要在左侧增加。NIRS是测量ADHD男孩与正常对照组血流动力学变化差异的敏感工具。总体而言,正常对照组在长时间注意力任务期间左前额叶皮质存在局部氧消耗,而患有ADHD的男孩在短时间和长时间注意力任务期间氧化血红蛋白和脱氧血红蛋白之间存在失衡。