Brain Dynamics Center, Westmead Millennium Institute and University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia.
Pediatr Neurol. 2010 Feb;42(2):118-26. doi: 10.1016/j.pediatrneurol.2009.08.010.
Measures of cognition support diagnostic and treatment decisions in attention deficit hyperactivity disorder. We used an integrative neuroscience framework to assess cognition and associated brain-function correlates in large attention deficit hyperactivity disorder and healthy groups. Matched groups of 175 attention deficit hyperactivity disorder children/adolescents and 175 healthy control subjects were assessed clinically, with the touch screen-based cognitive assessment battery "IntegNeuro" (Brain Resource Ltd., Sydney, Australia) and the "LabNeuro" (Brain Resource Ltd., Sydney, Australia) platform for psychophysiologic recordings of brain function and body arousal. IntegNeuro continuous performance task measures of sustained attention classified 68% of attention deficit hyperactivity disorder patients with 76% specificity, consistent with previous reports. Our additional cognitive measures of impulsivity, intrusive errors, inhibition, and response variability improved sensitivity to 88%, and specificity to 91%. Positive predictive power was 96%, and negative predictive power, 88%. These metrics were stable across attention deficit hyperactivity disorder subtypes and age. Consistent with their brain-based validity, cognitive measures were correlated with corresponding brain-function and body-arousal measures. We propose a combination of candidate cognitive "markers" that define a signature for attention deficit hyperactivity disorder: "sustained attention," "impulsivity," "inhibition," "intrusions," and "response variability." These markers offer a frame of reference to support diagnostic and treatment decisions, and an objective benchmark for monitoring outcomes of interventions.
认知测量支持注意缺陷多动障碍的诊断和治疗决策。我们使用综合神经科学框架来评估大量注意缺陷多动障碍和健康组的认知和相关大脑功能相关性。对 175 名注意缺陷多动障碍儿童/青少年和 175 名健康对照组进行了临床评估，使用基于触摸屏的认知评估电池“IntegNeuro”（Brain Resource Ltd.，悉尼，澳大利亚）和“LabNeuro”（Brain Resource Ltd.，悉尼，澳大利亚）平台进行大脑功能和身体唤醒的心理生理记录。IntegNeuro 持续注意力任务的测量将 68%的注意缺陷多动障碍患者分类，特异性为 76%，与之前的报告一致。我们对冲动性、侵入性错误、抑制和反应可变性的额外认知测量提高了敏感性至 88%，特异性至 91%。阳性预测值为 96%，阴性预测值为 88%。这些指标在注意缺陷多动障碍亚型和年龄上是稳定的。与大脑的有效性一致，认知测量与相应的大脑功能和身体唤醒测量相关。我们提出了一组候选认知“标志物”，这些标志物定义了注意缺陷多动障碍的特征：“持续注意力”、“冲动性”、“抑制”、“侵入性”和“反应可变性”。这些标志物为支持诊断和治疗决策提供了参考框架，并为监测干预措施的结果提供了客观基准。
