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[儿童和青少年时期的执行功能缺陷与神经发育障碍]

[Executive function deficits and neurodevelopmental disorders in childhood and adolescence].

作者信息

Bausela-Herreras E, Tirapu-Ustárroz J, Cordero-Andrés P

机构信息

Universidad Pública de Navarra, Pamplona, España.

Hospital San Juan de Dios, Pamplona, España.

出版信息

Rev Neurol. 2019 Dec 1;69(11):461-469. doi: 10.33588/rn.6911.2019133.

Abstract

INTRODUCTION

Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has new criteria that include a diagnostic reference to neurodevelopmental disorders. Neurodevelopmental disorders are diverse, and even though they are independent diagnostic entities they share common manifestations in people with brain damage or dysfunction of the prefrontal cortex; that is, neurodevelopmental disorders present different alterations in executive functions.

DEVELOPMENT

The aim of the present study was to offer an overview of the recent findings on executive functioning in children, adolescents and young adults with different neurodevelopmental disorders: autistic spectrum disorder, attention-deficit/hyperactivity disorder and specific learning disorder. Hence, with this objective, 27 studies from the literature were reviewed. The results indicate a statistically significant association between the dimension of flexibility and attention deficit/hyperactivity disorder (W of Wilcoxon = 123.0; p = 0.011), and flexibility with autistic spectrum disorder (W of Wilcoxon = 101.5; p = 0.003); and absence of a statistically significant association between the different assessed dimensions and specific learning disorder.

CONCLUSIONS

The dimensions of executive functioning are affected to a variable degree in different neurodevelopmental disorders. We can hypothesis that the dimensions that are affected in the different neurodevelopmental disorders can be characterized in terms of the existence of a continuum, and occasionally those dimensions are too complex to establish categorical limits when comparing different neurodevelopmental disorders.

摘要

引言

目前,《精神疾病诊断与统计手册》(第五版)(DSM - 5)有了新的标准,其中包括对神经发育障碍的诊断参考。神经发育障碍多种多样,尽管它们是独立的诊断实体,但在脑损伤或前额叶皮质功能障碍的人群中存在共同表现;也就是说,神经发育障碍在执行功能方面呈现出不同的改变。

发展

本研究的目的是概述近期关于患有不同神经发育障碍(自闭症谱系障碍、注意力缺陷多动障碍和特定学习障碍)的儿童、青少年和年轻人执行功能的研究结果。因此,基于这一目标,对文献中的27项研究进行了综述。结果表明,灵活性维度与注意力缺陷多动障碍之间存在统计学上的显著关联(威尔科克森W值 = 123.0;p = 0.011),以及灵活性与自闭症谱系障碍之间存在关联(威尔科克森W值 = 101.5;p = 0.003);并且不同评估维度与特定学习障碍之间不存在统计学上的显著关联。

结论

执行功能维度在不同的神经发育障碍中受到不同程度的影响。我们可以假设,在不同神经发育障碍中受到影响的维度可以根据连续体的存在来表征,并且在比较不同神经发育障碍时,这些维度有时过于复杂以至于无法确定分类界限。

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