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注意缺陷多动障碍和广泛性发育障碍中的抑制功能与工作记忆:持续的认知梯度能否解释ADHD和PDD特征?

Inhibitory function and working memory in attention deficit/hyperactivity disorder and pervasive developmental disorders: does a continuous cognitive gradient explain ADHD and PDD traits?

作者信息

Takeuchi Akihito, Ogino Tatsuya, Hanafusa Kaoru, Morooka Teruko, Oka Makio, Yorifuji Takashi, Ohtsuka Yoko

机构信息

Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,

出版信息

Acta Med Okayama. 2013;67(5):293-303. doi: 10.18926/AMO/51865.

Abstract

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.

摘要

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。

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