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儿童诵读困难的轻度神经功能障碍。

Minor neurological dysfunction in children with dyslexia.

机构信息

Department of Child and Adolescent Psychiatry, Fornhese, Amersfoort, Netherlands.

出版信息

Dev Med Child Neurol. 2010 Dec;52(12):1127-32. doi: 10.1111/j.1469-8749.2010.03712.x.

DOI:10.1111/j.1469-8749.2010.03712.x
PMID:20518800
Abstract

AIM

to improve understanding of brain function in children with severe dyslexia in terms of minor neurological dysfunctions (MNDs).

METHOD

one hundred and four children (81 males, 23 females; age range 7-12y; mean age 9y 7mo, SD 1y 2mo;) with severe dyslexia (the presence of a Full-scale IQ score of ≥ 85, retardation in single-word or text reading of ≥2y), assessed in a department of dyslexia of a third-level regional psychiatric centre, underwent a neurological examination according to Touwen and a multidisciplinary child psychiatric assessment. Special attention was paid to severity and type of MND. Data were compared with neurological morbidity data of children in the general population.

RESULTS

most children had MND (87%): 43% had simple MND, 44% complex MND. The incidence of MND was significantly higher (p<0.001) in the children with dyslexia than in the general population (simple MND 15%, complex MND 6%). Children with dyslexia showed especially fine manipulative disability and - to a lesser extent - mild dysfunction in muscle tone regulation and excessive presence of associated movements. A comorbid psychiatric syndrome was diagnosed in 66 children (63%): emotional disturbances (27%), adjustment disorder (42%), hyperkinetic disorder (15%), autism spectrum disorder (3%), specific disturbances of childhood not otherwise specified (13%). The neurological findings of children with dyslexia with and without psychiatric comorbidity were similar.

INTERPRETATION

our results demonstrate the importance of neurological and child psychiatric assessment in children with severe dyslexia. Our findings suggest that dysfunction of cortical structures plays a dominant role in dyslexia.

摘要

目的

从轻微神经功能障碍(MNDs)方面提高对患有严重诵读困难儿童大脑功能的理解。

方法

104 名儿童(81 名男性,23 名女性;年龄范围 7-12 岁;平均年龄 9 岁 7 个月,标准差 1 岁 2 个月;)患有严重诵读困难(全量表智商得分≥85,单字或文本阅读延迟≥2 年),在三级区域精神病中心的诵读困难科进行评估,接受 Touwen 神经检查和多学科儿童精神病评估。特别注意 MND 的严重程度和类型。将数据与一般人群中儿童的神经发病率数据进行比较。

结果

大多数儿童有 MND(87%):43%有单纯 MND,44%有复杂 MND。诵读困难儿童 MND 的发生率明显高于一般人群(单纯 MND 为 15%,复杂 MND 为 6%)(p<0.001)。诵读困难儿童表现出精细运动障碍,肌肉张力调节轻度功能障碍,以及伴运动过多,尤为明显。66 名儿童(63%)被诊断出患有共病性精神综合征:情绪障碍(27%)、适应障碍(42%)、多动障碍(15%)、自闭症谱系障碍(3%)、特定儿童时期未特指障碍(13%)。有和没有精神共病的诵读困难儿童的神经检查结果相似。

解释

我们的研究结果表明,在患有严重诵读困难的儿童中进行神经和儿童精神病评估非常重要。我们的发现表明皮质结构功能障碍在诵读困难中起主导作用。

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