Rommel Anna-Sophie, James Sarah-Naomi, McLoughlin Gráinne, Brandeis Daniel, Banaschewski Tobias, Asherson Philip, Kuntsi Jonna
Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Psychiatric Hospital, University of Zurich, Zurich, Switzerland; the Center for Integrative Human Physiology, University of Zurich, and the Neuroscience Center Zurich, University of Zurich.
J Am Acad Child Adolesc Psychiatry. 2017 Jan;56(1):40-50. doi: 10.1016/j.jaac.2016.10.006. Epub 2016 Oct 24.
Preterm birth has been associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD)-like symptoms and cognitive impairments similar to those seen in ADHD, including attention and inhibitory control difficulties. Yet data on direct comparisons across ADHD and preterm birth on cognitive-neurophysiological measures are limited.
We directly compared 186 preterm-born adolescents to 69 term-born adolescents with ADHD and 135 term-born controls on cognitive-performance and event-related potential measures associated with attentional and inhibitory processing from a cued continuous performance test (CPT-OX), which we have previously shown to discriminate between the adolescents with ADHD and controls. We aimed to elucidate whether the ADHD-like symptoms and cognitive impairments in preterm-born individuals reflect identical cognitive-neurophysiological impairments in term-born individuals with ADHD.
Go-P3 amplitude was reduced, reflecting impaired executive response control, in preterm-born adolescents compared to both controls and adolescents with ADHD. Moreover, in preterm-born adolescents, as in term-born adolescents with ADHD, contingent negative variation amplitude was attenuated, reflecting impairments in response preparation compared to controls. Although the ADHD group showed significantly increased NoGo-P3 amplitude at FCz compared to preterm group, at Cz preterm-born adolescents demonstrated significantly decreased NoGo-P3 amplitude compared to the control group, similar to term-born adolescents with ADHD.
These findings indicate impairments in response preparation, executive response control, and response inhibition in preterm-born adolescents. Although the response preparation and response inhibition impairments found in preterm-born adolescents overlap with those found in term-born adolescents with ADHD, the preterm group also shows unique impairments, suggesting more wide-ranging impairments in the preterm group compared to the ADHD group.
早产与注意力缺陷多动障碍（ADHD）样症状以及与ADHD中所见类似的认知障碍风险增加有关，包括注意力和抑制控制困难。然而，关于ADHD和早产在认知神经生理学指标上的直接比较数据有限。
我们将186名早产青少年与69名患有ADHD的足月出生青少年以及135名足月出生的对照组进行了直接比较，比较了他们在提示连续性能测试（CPT - OX）中与注意力和抑制处理相关的认知表现和事件相关电位指标，我们之前已证明该测试可区分患有ADHD的青少年和对照组。我们旨在阐明早产个体中的ADHD样症状和认知障碍是否反映了患有ADHD的足月出生个体中相同的认知神经生理学障碍。
与对照组和患有ADHD的青少年相比，早产青少年的Go - P3波幅降低，反映出执行反应控制受损。此外，与对照组相比，早产青少年以及患有ADHD的足月出生青少年的继时性负变化波幅均减弱，反映出反应准备方面的障碍。尽管ADHD组与早产组相比，在FCz处的NoGo - P3波幅显著增加，但在Cz处，早产青少年的NoGo - P3波幅与对照组相比显著降低，这与患有ADHD的足月出生青少年相似。
这些发现表明早产青少年在反应准备、执行反应控制和反应抑制方面存在障碍。尽管早产青少年中发现的反应准备和反应抑制障碍与患有ADHD的足月出生青少年中发现的障碍有重叠，但早产组也表现出独特的障碍，这表明与ADHD组相比，早产组的障碍范围更广。
