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神经软体征与注意力缺陷多动障碍儿童的注意力功能障碍有关。

Neurological soft signs are associated with attentional dysfunction in children with attention deficit hyperactivity disorder.

作者信息

Pitzianti Mariabernarda, D'Agati Elisa, Casarelli Livia, Pontis Marco, Kaunzinger Ivo, Lange Klaus W, Tucha Oliver, Curatolo Paolo, Pasini Augusto

机构信息

a Department of Systems Medicine, Unit of Child Neurology and Psychiatry , "Tor Vergata" University of Rome , Rome , Italy.

b Comprehensive Rehabilitation Center, Ctr Asl 8 , Cagliari , Italy.

出版信息

Cogn Neuropsychiatry. 2016 Nov;21(6):475-493. doi: 10.1080/13546805.2016.1235029. Epub 2016 Oct 1.

Abstract

INTRODUCTION

Inattention is one of the core symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Most of patients with ADHD show motor impairment, consisting in the persistence of neurological soft signs (NSS). Our aim was to evaluate attentional and motor functioning in an ADHD sample and healthy children (HC) and possible link between attentional dysfunction and motor impairment in ADHD.

METHOD

Twenty-seven drug-naive patients with ADHD and 23 HC were tested with a test battery, measuring different aspects of attention. Motor evaluation has provided three primary variables: overflow movements (OM), dysrhythmia and total speed of timed activities.

RESULTS

Compared to HC, patients were impaired in a considerable number of attentional processes and showed a greater number of NSS. Significant correlations between disturbances of attention and motor abnormalities were observed in ADHD group.

CONCLUSION

Our findings suggest that attentional processes could be involved in the pathophysiology of the NSS and add scientific evidence to the predictive value of NSS as indicators of the severity of functional impairment in ADHD. Given the marked improvement or complete resolution of NSS following treatment with methylphenidate, we suggest that evaluation of NSS is useful to monitor the effectiveness of pharmacological treatment with MPH in ADHD.

摘要

引言

注意力不集中是注意力缺陷多动障碍(ADHD)的核心症状之一。大多数ADHD患者存在运动障碍,表现为神经学软体征(NSS)持续存在。我们的目的是评估ADHD样本和健康儿童(HC)的注意力及运动功能,以及ADHD中注意力功能障碍与运动障碍之间的可能联系。

方法

对27名未服用药物的ADHD患者和23名HC进行了一组测试,测量注意力的不同方面。运动评估提供了三个主要变量:溢出动作(OM)、节律异常和定时活动的总速度。

结果

与HC相比,患者在相当数量的注意力过程中存在损害,且表现出更多的NSS。在ADHD组中观察到注意力障碍与运动异常之间存在显著相关性。

结论

我们的研究结果表明,注意力过程可能参与了NSS的病理生理学,并为NSS作为ADHD功能损害严重程度指标的预测价值增添了科学证据。鉴于使用哌甲酯治疗后NSS有明显改善或完全缓解,我们建议评估NSS有助于监测MPH对ADHD进行药物治疗的有效性。

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