Restuccia Domenico, Zanini Sergio, Cazzagon Monica, Del Piero Ivana, Martucci Lucia, Della Marca Giacomo
IRCCS La Nostra Famiglia - E Medea, Polo Friuli Venezia Giulia, Udine, Italy.
Dev Med Child Neurol. 2009 Dec;51(12):991-8. doi: 10.1111/j.1469-8749.2009.03367.x.
Event-related potentials (ERPs) obtained when focused attention is kept away from the stimulus (unnoticed stimulation) are possibly linked to automatic mismatch-detection mechanisms, and could be a useful tool to investigate sensory discrimination ability. By considering the high impact of impaired somatosensory integration on many neurological disturbances in children, we aimed to verify whether mismatch-related responses to somatosensory stimulation could be obtained in healthy children.
Eleven healthy participants (age range 6-11y, mean 8y 2mo, SD 1y 7mo; seven males, four females) underwent 'oddball' electrical stimulation of the right hand (80% frequent stimuli delivered to the thumb, 20% deviant stimuli delivered to the fifth finger). Data were compared with those obtained when the frequent stimuli to the thumb were omitted ('standard-omitted' protocol). ERPs were recorded at frontal, central, and parietal scalp locations. Children's overt attention was engaged by a demanding video game.
In the oddball protocol, deviant stimulation elicited a left central negativity at about 160ms latency, followed by a left frontal negative response at about 220ms latency. Standard-omitted traces showed only a left parietal negative response spreading to right parietal regions.
Mismatch-related somatosensory responses can be reliably obtained in children, providing that appropriate technical contrivances are used. In clinical use, the frontal components, which are present only during the oddball protocol, could be a reliable and unequivocal neurophysiological marker of the automatic mismatch-detection mechanism.
当注意力集中在远离刺激（未被注意的刺激）时获得的事件相关电位（ERP）可能与自动失配检测机制有关，并且可能是研究感觉辨别能力的有用工具。考虑到躯体感觉整合受损对儿童许多神经功能障碍有很大影响，我们旨在验证在健康儿童中是否能获得对躯体感觉刺激的失配相关反应。
11名健康参与者（年龄范围6 - 11岁，平均8岁2个月，标准差1岁7个月；7名男性，4名女性）接受右手的“oddball”电刺激（80%的频繁刺激施加于拇指，20%的偏差刺激施加于小指）。将数据与省略拇指频繁刺激时获得的数据（“标准省略”方案）进行比较。在额部、中央和顶叶头皮部位记录ERP。通过一个要求较高的视频游戏来吸引儿童的显性注意力。
在oddball方案中，偏差刺激在约160毫秒潜伏期引发左中央负波，随后在约220毫秒潜伏期引发左额部负反应。标准省略记录仅显示左顶叶负反应扩展到右顶叶区域。
只要使用适当的技术手段，在儿童中可以可靠地获得失配相关的躯体感觉反应。在临床应用中，仅在oddball方案中出现的额部成分可能是自动失配检测机制的可靠且明确的神经生理标志物。
