Division of Neurology, Cincinnati Children's Hospital Medical Center and University of Cincinnati School of Medicine, Cincinnati, OH 45229, USA.
Pediatr Neurol. 2012 Sep;47(3):177-85. doi: 10.1016/j.pediatrneurol.2012.06.003.
Children affected by attention-deficit/hyperactivity disorder demonstrate diminished intrahemispheric inhibition (short interval cortical inhibition), as measured by transcranial magnetic stimulation. This study determined whether interhemispheric inhibition (ipsilateral silent period latency) correlates with clinical behavioral rating and motor control deficits of affected children. In 114 right-handed children (aged 8-12 years; age/sex-matched; 50 affected, 64 controls), we performed comprehensive assessments of behavior, motor skills, and cognition. Transcranial magnetic stimulation reliably elicited ipsilateral silent periods in 54 children (23 affected); all were on average older than those with unobtainable measures. Mean ipsilateral silent period latency was 5 milliseconds longer in the affected group (P = 0.007). Longer latencies correlated with more severe behavioral symptom scores (r = 0.38, P = 0.007), particularly hyperactivity (r = 0.39, P = 0.006), and with worse motor ratings on the Physical and Neurological Examination for Soft Signs (r = 0.27, P = 0.05). Longer latency also correlated with short interval cortical inhibition (r = 0.36, P = 0.008). Longer ipsilateral silent period latencies suggest interhemispheric inhibitory signaling is slower in affected children. The deficit in this inhibitory measure may underlie developmental, behavioral, and motor impairments in children with attention-deficit/hyperactivity disorder.
受注意力缺陷多动障碍影响的儿童表现出半球间抑制（同侧静息期潜伏期）的减少，这可以通过经颅磁刺激来测量。本研究旨在确定同侧抑制（对侧静息期潜伏期）是否与受影响儿童的临床行为评分和运动控制缺陷相关。在 114 名右利手儿童（8-12 岁；年龄/性别匹配；50 名受影响，64 名对照）中，我们对行为、运动技能和认知进行了全面评估。经颅磁刺激可靠地诱发了 54 名儿童（23 名受影响）的同侧静息期；所有受影响儿童的年龄都比无法测量的儿童大。受影响组的同侧静息期潜伏期长 5 毫秒（P = 0.007）。较长的潜伏期与更严重的行为症状评分相关（r = 0.38，P = 0.007），特别是多动（r = 0.39，P = 0.006），与身体和神经检查的软体征评分更差相关（r = 0.27，P = 0.05）。潜伏期较长也与短间隔皮质抑制（r = 0.36，P = 0.008）相关。较长的同侧静息期潜伏期表明受影响儿童的半球间抑制信号传递较慢。这种抑制测量的缺陷可能是注意力缺陷多动障碍儿童发育、行为和运动障碍的基础。
