脊柱裂患儿注意力的神经心理学评估。
Neuropsychological assessment of attention in children with spina bifida.
作者信息
Vinck Anja, Mullaart Reinier, Rotteveel Jan, Maassen Ben
机构信息
Department of Medical Psychology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
出版信息
Cerebrospinal Fluid Res. 2009 May 28;6:6. doi: 10.1186/1743-8454-6-6.
BACKGROUND
Children with the severe form of spina bifida (SBM: spina bifida with myelomeningocele with accompanying hydrocephalus) may manifest attention deficits, and have a similar psychological profile to children with hydrocephalus due to other etiologies. It is unclear to what extent tests to assess attention in SBM are confounded by the accompanying cognitive or visual-motor impairments. The aim of this study was to analyse attention functions by administering two different types of attention tests, one with high and the other with low cognitive and motor requirements. This enabled the possible interaction between attention and cognitive and motor impairment to be assessed.
METHODS
The study group comprised 31 children with SBM with shunted hydrocephalus. Twenty children with SB-only formed a closely matched comparison group. Of these, 19 children with SBM and 18 with SB had a full-scale IQ (FSIQ) higher than 70. All had undergone spinal surgery and all children with SBM had been shunted within the first months of life. Between 6 and 15 years of age, the children were assessed on focused and sustained attention, encoding, and distractibility/impulsivity, using both traditional tests and computerized attention tests.
RESULTS
Compared to the SB group, attention scores of children with SBM were lower on the traditional tests, but when interfering cognitive and visual-motor requirements were eliminated using the computerised tasks, most differences disappeared. Furthermore, in contrast to traditional attention tasks, computerized tests showed no significant correlations with IQ-scores and visual-motor skills.
CONCLUSION
Assessment of attention functions in children with SBM by traditional tests may be misleading, because this paediatric population with complex cerebral malformations has difficulty with the cognitive and visual-motor requirements. To control for these interactions, the use of both traditional and computerized attention tests is recommended.
背景
患有严重脊柱裂（SBM：伴有脊髓脊膜膨出及脑积水的脊柱裂）的儿童可能会出现注意力缺陷，并且在心理特征上与因其他病因导致脑积水的儿童相似。目前尚不清楚在SBM中评估注意力的测试在多大程度上会受到伴随的认知或视觉运动障碍的干扰。本研究的目的是通过进行两种不同类型的注意力测试来分析注意力功能，一种测试对认知和运动要求高，另一种测试对认知和运动要求低。这使得能够评估注意力与认知及运动障碍之间可能存在的相互作用。
方法
研究组包括31名患有分流性脑积水的SBM儿童。20名仅患有脊柱裂（SB）的儿童组成了一个匹配度很高的对照组。其中，19名SBM儿童和18名SB儿童的全量表智商（FSIQ）高于70。所有儿童均接受了脊柱手术，所有SBM儿童在出生后的头几个月内都进行了分流手术。在6至15岁之间，使用传统测试和计算机化注意力测试对儿童的集中注意力、持续注意力、编码能力以及注意力分散/冲动性进行评估。
结果
与SB组相比，SBM儿童在传统测试中的注意力得分较低，但当使用计算机化任务消除干扰性的认知和视觉运动要求时，大多数差异消失了。此外，与传统注意力任务不同，计算机化测试与智商分数和视觉运动技能没有显著相关性。
结论
用传统测试评估SBM儿童的注意力功能可能会产生误导，因为这一患有复杂脑畸形的儿童群体在认知和视觉运动要求方面存在困难。为了控制这些相互作用，建议同时使用传统和计算机化注意力测试。
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