Department of Psychiatry, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan.
J Child Psychol Psychiatry. 2010 Jul;51(7):838-49. doi: 10.1111/j.1469-7610.2010.02215.x. Epub 2010 Jan 18.
Little is known about executive functions among unaffected siblings of children with attention deficit/hyperactivity disorder (ADHD), and there is lack of such information from non-Western countries. We examined verbal and nonverbal executive functions in adolescents with ADHD, unaffected siblings and controls to test whether executive functions could be potential endophenotypes for ADHD.
We assessed 279 adolescents (age range: 11-17 years) with a childhood diagnosis of DSM-IV ADHD, 136 biological siblings (108 unaffected, 79.4%), and 173 unaffected controls by using psychiatric interviews, the Wechsler Intelligence Scale for Children - 3rd edition (WISC-III), including digit spans, and the tasks involving executive functions of the Cambridge Neuropsychological Test Automated Battery (CANTAB): Intra-dimensional/Extra-dimensional Shifts (IED), Spatial Span (SSP), Spatial Working Memory (SWM), and Stockings of Cambridge (SOC).
Compared with the controls, adolescents with ADHD and unaffected siblings had a significantly shorter backward digit span, more extra-dimensional shift errors in the IED, shorter spatial span length in the SSP, more total errors and poorer strategy use in the SWM, and fewer problems solved in the minimum number of moves and shorter initial thinking time in the SOC. The magnitudes of the differences in the SWM and SOC increased with increased task difficulties. In general, neither persistent ADHD nor comorbidity was associated with increased deficits in executive functions among adolescents with ADHD.
The lack of much difference in executive dysfunctions between unaffected siblings and ADHD adolescents suggests that executive dysfunctions may be useful cognitive endophenotypes for ADHD genetic studies.
对于注意力缺陷/多动障碍（ADHD）患儿的未受影响的兄弟姐妹的执行功能知之甚少，而且来自非西方国家的相关信息也缺乏。我们对患有 ADHD 的青少年、未受影响的兄弟姐妹和对照组进行了言语和非言语执行功能评估，以测试执行功能是否可以成为 ADHD 的潜在候选基因。
我们通过精神病学访谈、韦氏儿童智力量表第三版（WISC-III），包括数字跨度，以及剑桥神经心理测试自动化电池（CANTAB）的执行功能任务：内/外维度转换（IED）、空间跨度（SSP）、空间工作记忆（SWM）和剑桥袜子任务（SOC），评估了 279 名（年龄范围：11-17 岁）患有 DSM-IV ADHD 的青少年、136 名生物学兄弟姐妹（108 名未受影响，79.4%）和 173 名未受影响的对照组。
与对照组相比，ADHD 青少年和未受影响的兄弟姐妹的后向数字跨度明显缩短，IED 中的额外维度转换错误明显增多，SSP 中的空间跨度长度明显缩短，SWM 中的总错误和策略使用明显较差，SOC 中的最小移动次数问题解决明显较少，初始思维时间明显较短。SWM 和 SOC 中的差异幅度随着任务难度的增加而增加。一般来说，持续性 ADHD 或合并症与 ADHD 青少年执行功能缺陷的增加无关。
未受影响的兄弟姐妹和 ADHD 青少年之间执行功能障碍差异不大，这表明执行功能障碍可能是 ADHD 遗传研究有用的认知候选基因。
