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[θ/β比值(神经能量生物标志物分析)在注意力缺陷多动障碍诊断中的应用]

[Theta/beta ratio (NEBA) in the diagnosis of attention deficit hyperactivity disorder].

作者信息

Delgado-Mejía Iván D, Palencia-Avendaño M Luisa, Mogollón-Rincón Carolina, Etchepareborda Máximo C

机构信息

Laboratorio para el estudio de las Funciones Superiores (LAFUN), Buenos Aires, Argentina.

出版信息

Rev Neurol. 2014 Feb 24;58 Suppl 1:S57-63.

Abstract

INTRODUCTION

In July 2013, the US Food and Drug Administration approved the use of NEBA as the first device for the complementary evaluation of attention deficit hyperactivity disorder (ADHD). It is based on quantitative electroencephalogram (qEEG) and includes the standardised theta/beta ratio, the results of which were consistent with both the medical and psychological clinical evaluation. Likewise, it has proved to be a useful tool for determining whether the ADHD is primary, secondary or comorbid to another pathology. Yet, to date no publications have specified whether it is a total theta/beta ratio or theta/beta-1 and theta/beta-2. Additionally, no data are provided to be able to discriminate between diagnostic subtypes of ADHD.

AIMS

To quantify the theta/beta ratios, by means of qEEG, in a sample of patients from the Rio de la Plata area with a main confirmed diagnosis of ADHD, in order to compare the neurophysiological patterns according to the diagnostic subtypes.

PATIENTS AND METHODS

We used a randomised stratified sample of 62 subjects of both sexes, with ages between 8 and 17 years, distributed into two groups, depending on the diagnostic subtype: attention deficit subtype of ADHD (n = 31) and the combined subtype of ADHD (n = 31).

RESULTS

High theta/beta-1 and theta/beta-2 ratios were confirmed in the Cz region, being higher than the ratios in the C3 and C4 areas. Moderate and statistically significant differences were found between the two subtypes only in the beta-1 band in the occipital regions. The analysis of the interhemispheric coherence suggests an association of the power peak crossed with the diagnostic subtype, which is the fastest peak (10 Hz) for the combined subtype. No important differences are found on analysing the phase spectra or the theta/beta ratios.

CONCLUSIONS

Although the scientific literature, especially the NEBA system, highlights the importance of the theta/beta ratio in the differential diagnosis of ADHD in control samples and other neurodevelopmental disorders, a distinction must be made between beta-1 and beta-2.

摘要

引言

2013年7月,美国食品药品监督管理局批准将NEBA作为首个用于注意力缺陷多动障碍(ADHD)补充评估的设备。它基于定量脑电图(qEEG),包括标准化的θ/β比值,其结果与医学和心理临床评估均一致。同样,它已被证明是确定ADHD是原发性、继发性还是与另一种病理状态共病的有用工具。然而,迄今为止,尚无出版物明确说明它是总θ/β比值还是θ/β-1和θ/β-2。此外,没有提供能够区分ADHD诊断亚型的数据。

目的

通过qEEG对来自拉普拉塔地区的主要确诊为ADHD的患者样本中的θ/β比值进行量化,以便根据诊断亚型比较神经生理模式。

患者与方法

我们使用了一个随机分层样本,包括62名年龄在8至17岁之间的男女受试者,根据诊断亚型分为两组:ADHD注意力缺陷亚型(n = 31)和ADHD混合型亚型(n = 31)。

结果

在Cz区域证实了较高的θ/β-1和θ/β-2比值,高于C3和C4区域的比值。仅在枕叶区域的β-1频段中,两种亚型之间发现了中度且具有统计学意义的差异。半球间相干性分析表明,功率峰值与诊断亚型相关,其中混合型亚型的最快峰值(10 Hz)。在分析相位谱或θ/β比值时未发现重要差异。

结论

尽管科学文献,尤其是NEBA系统,强调了θ/β比值在对照样本和其他神经发育障碍中ADHD鉴别诊断中的重要性,但必须区分β-1和β-2。

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