Kubik Aicja, Bogotko-Szarszewska Marta, Tutaj Maria, Laski Sabina
Instytut Neuromedica, Kraków.
Przegl Lek. 2010;67(9):677-81.
ADHD is characterized by lack of attention and concentration, hyperactivity and impulsivity and occurrs in about 3-5% of school-age children. Analysis of EEG plays an important role in comprehending the character of disturbed brain processes. Nowadays significant predictive values of EEG in response to neurostimulation treatment are being looked for.
Visual analysis included results of standard EEG examination of 109 children who underwent neurofeedback treatment in the years 2007-2009. These children were at the age range from 6 to 17 years and boys were predominating (86/109). The groups with "pure" ADHD, ADHD with emotional disorders (26/25 children) and ADHD with tics/dyslexial behaviour disorders/epilepsy (17/14/14/13 children) were the most numerous. 11 parameters were used to characterize basal activity, features of eeg maturation, presence of epileptiform graphoelements, paroxysmality, lateralization and localization of pathological changes. Theta/beta ratio was calculated by computer as well.
Theta/beta ratio did not allow to differentiate groups of patients. Increase of theta and alfa activity was observed in children with ADHD and tics when compared with children with "pure" ADHD. In children with ADHD and dyslexia delta and theta activity in occipital regions was increased as well as theta and alfa activity and their amplitudes in the left fronto-temporo-parietal region (region of speech center). In children with ADHD and behaviour disorders paroxysmal localized changes with slow and sharp waves in the temporo-centroparietal regions occurred more often. In the group with ADHD and emotional disorders higher share of fast beta activity in the centro-middle temporal regions with right hemisphere predominance was revealed, probably associated with higher level of agitation and anxiety. Additionally high percentage of epileptiform grapho-elements was observed in all groups (28-50%).
(1) Visual analysis of EEG recordings enables characterization of type and localization of changes in bioelectrical activity in children with ADHD syndrome. (2) This analysis reveals presence of differences in occurrence of some EEG parameters in the groups of children with ADHD and associated other disorders. (3) ADHD diagnostics is indicated especially among children with emotional disorders. (4) Bioelectric characteristic provides basement for elaboration of individual neurofeedback therapy protocol.
注意力缺陷多动障碍（ADHD）的特征为注意力不集中、多动和冲动，约3%-5%的学龄儿童患有该疾病。脑电图（EEG）分析对于理解大脑功能紊乱的特征具有重要作用。目前，人们正在探寻EEG在神经刺激治疗反应方面的显著预测价值。
视觉分析纳入了2007年至2009年间接受神经反馈治疗的109名儿童的标准EEG检查结果。这些儿童年龄在6至17岁之间，以男孩为主（86/109）。人数最多的组包括“单纯”ADHD组、伴有情绪障碍的ADHD组（26/25名儿童）以及伴有抽动/阅读障碍行为障碍/癫痫的ADHD组（17/14/14/13名儿童）。使用11项参数来描述基础活动、EEG成熟特征、癫痫样图形元素的存在、阵发性、病理变化的侧化和定位。theta/β比值也通过计算机计算得出。
theta/β比值无法区分患者组。与“单纯”ADHD儿童相比，ADHD合并抽动的儿童theta和α活动增加。ADHD合并阅读障碍的儿童枕区的δ和theta活动增加，左额颞顶叶区域（语言中枢区域）的theta和α活动及其振幅也增加。ADHD合并行为障碍的儿童颞中央顶叶区域更常出现伴有慢波和尖波的阵发性局灶性变化。在伴有情绪障碍的ADHD组中，发现中央中颞区快速β活动的比例更高，且以右半球为主，这可能与更高水平的激动和焦虑有关。此外，所有组中癫痫样图形元素的比例都很高（28%-50%）。
（1）EEG记录的视觉分析能够描述ADHD综合征儿童生物电活动变化的类型和定位。（2）该分析揭示了ADHD儿童组与相关其他疾病儿童组在某些EEG参数出现情况上的差异。（3）ADHD诊断尤其适用于伴有情绪障碍的儿童。（4）生物电特征为制定个性化神经反馈治疗方案提供了依据。
