Takeuchi Akihito, Ogino Tatsuya, Hanafusa Kaoru, Morooka Teruko, Oka Makio, Yorifuji Takashi, Ohtsuka Yoko
Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2013;67(5):293-303. doi: 10.18926/AMO/51865.
To clarify the relationship between attention deficit/hyperactivity disorder (AD/HD) and pervasive developmental disorders (PDD), we investigated the common features and differences of these disorders in neuropsychological profiles. The subjects were 4 groups of Japanese boys aged 6 to 15 years, categorized by diagnosis:AD/HD (n=20), PDD with comorbid AD/HD (PDD+:n=16), PDD without comorbid AD/HD (PDD-:n=8), and typically developing (n=60). We evaluated executive function (EF) through verbal and visuospatial memory tasks, the Go/NoGo task, and the color-word matching Stroop task. We performed a categorical analysis to estimate the effects of the 3 disorders on EF and a dimensional analysis to estimate the effects of symptom scales on EF. We found that the AD/HD and PDD+ subjects had negative effects on verbal working memory and intra-individual response variability. The severity of these impairments was positively correlated with the inattentiveness score. The subjects with a PDD+ or PDD- diagnosis had poorer scores on interference control;the severity of this impairment was correlated with the PDD symptom score. Impairments in visuospatial working memory were detected in the AD/HD and PDD- groups but not in the PDD+ group. Impairments in inhibition of the pre-potent response were noted in all 3 categories. AD/HD and PDD share neuropsychological features, though each disorder has a specific impairment pattern. Our findings partially support the idea that AD/HD and PDD are on a spectrum.
为阐明注意力缺陷/多动障碍(AD/HD)与广泛性发育障碍(PDD)之间的关系,我们调查了这些障碍在神经心理学特征方面的共同特征和差异。研究对象为4组6至15岁的日本男孩,根据诊断分类:AD/HD组(n=20)、合并AD/HD的PDD组(PDD+:n=16)、不合并AD/HD的PDD组(PDD-:n=8)和发育正常组(n=60)。我们通过言语和视觉空间记忆任务、Go/NoGo任务以及颜色-单词匹配Stroop任务评估执行功能(EF)。我们进行了分类分析以估计这三种障碍对EF的影响,并进行了维度分析以估计症状量表对EF的影响。我们发现,AD/HD组和PDD+组受试者在言语工作记忆和个体内反应变异性方面有负面影响。这些损伤的严重程度与注意力不集中得分呈正相关。诊断为PDD+或PDD-的受试者在干扰控制方面得分较低;这种损伤的严重程度与PDD症状评分相关。在AD/HD组和PDD-组中检测到视觉空间工作记忆损伤,但在PDD+组中未检测到。在所有三个类别中均注意到对优势反应的抑制存在损伤。AD/HD和PDD具有共同的神经心理学特征,尽管每种障碍都有特定的损伤模式。我们的研究结果部分支持AD/HD和PDD属于同一谱系的观点。