Chutko L S, Yakovenko E A, Surushkina S Yu, Anisimova T I, Sergeev A V, Didur M D, Cherednichenko D V
N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(6):100-107. doi: 10.17116/jnevro2022122061100.
To study disorders of emotional regulation in different types of attention deficit hyperactivity disorder (ADHD) in children.
58 children suffering from ADHD, aged 12 to 15 years were divided into 2 subgroups (38 children with a combined form of ADHD and 20 children with ADHD with a predominance of inattention). The control group consisted of 30 children without manifestations of neuropsychiatric disorders. The following research methods were used in the work: the SNAP-IY scale to assess the severity of the disease; the Strengths and Difficulties Questionnaire (SCT), a form for parents to assess emotional and behavioral impairments; Spielberger's self-assessment test in the processing of Khanin to assess the level of anxiety; spectral analysis of the EEG with the construction of graphical power spectra and registration of evoked potentials (EP) with the performance of an attention test in the Go/No-Go paradigm.
The results of the study showed the presence of emotional and behavioral disorders in children with ADHD, more pronounced in the combined form of the disease. Complaints of emotional lability, tearfulness, irritability were noted in 53 children with ADHD in the study group (61.6%). At the same time, these complaints were registered in 39 children from the first group (72.2%) and 14 children from the second group (43.8%). The level of inattention was approximately the same (3.21±0.64 and 3.43±0.56, respectively), while the level of hyperactivity and impulsivity in adolescents from the first group was significantly higher (3.18±0.54, <0.01). Indicators of the SCT scale, as a total indicator (3.4±1.6, <0.01), and on the scales of «behavior problems» (7.4±1.6, <0.01), «emotional problems» (8.0±1.6, <0.01), «problems with peers» (7.6±1.3, <0.01), «prosocial behavior» (3.4±1.6, <0.01) were significantly higher in the subgroup of children from the first group. The performed statistical analysis of the test data for attention in the Go/No-Go paradigm revealed significant differences (<0.01) in the number of omissions of significant pairs of stimuli between healthy children and a subgroup with ADHD with a predominance of inattention, between healthy children and a subgroup with combined form ADHD. When comparing evoked EEG synchronization in the theta range under Go conditions, we found a significant decrease in this parameter in the range of 200-400 ms in the subgroup of children with ADHD with a predominance of inattention and in the subgroup of ADHD with a combined form; under No-Go conditions, a significant decrease in the magnitude of evoked EEG synchronization was revealed in a subgroup of children with combined form ADHD.
In general, the results of this study allow us to conclude that impaired cognitive control has a large impact on the development of emotional disorders in children with ADHD.
研究儿童不同类型注意力缺陷多动障碍（ADHD）中的情绪调节障碍。
58名12至15岁患ADHD的儿童被分为2个亚组（38名患有混合型ADHD的儿童和20名以注意力不集中为主的ADHD儿童）。对照组由30名无神经精神障碍表现的儿童组成。研究中使用了以下研究方法：SNAP-IY量表评估疾病严重程度；优势与困难问卷（SCT），一种供家长评估情绪和行为障碍的表格；在处理卡宁时使用斯皮尔伯格自评测试评估焦虑水平；脑电图频谱分析，构建图形功率谱，并在Go/No-Go范式中进行注意力测试时记录诱发电位（EP）。
研究结果显示ADHD儿童存在情绪和行为障碍，在疾病的混合型中更为明显。研究组中53名ADHD儿童（61.6%）有情绪不稳定、易流泪、易怒的主诉。同时，第一组39名儿童（72.2%）和第二组14名儿童（43.8%）有这些主诉。注意力不集中水平大致相同（分别为3.21±0.64和3.43±0.56），而第一组青少年的多动和冲动水平显著更高（3.18±0.54，<0.01）。SCT量表的指标，作为总指标（3.4±1.6，<0.01），以及在“行为问题”量表（7.4±1.6，<0.01）、“情绪问题”量表（8.0±1.6，<0.01）、“同伴问题”量表（7.6±1.3，<0.01）、“亲社会行为”量表（3.4±1.6，<0.01）上，第一组儿童亚组的指标显著更高。对Go/No-Go范式中注意力测试数据进行的统计分析显示，健康儿童与以注意力不集中为主的ADHD亚组之间、健康儿童与混合型ADHD亚组之间，在重要刺激对遗漏数量上存在显著差异（<0.01）。在比较Go条件下θ范围内的诱发电脑电图同步性时，我们发现以注意力不集中为主的ADHD儿童亚组和混合型ADHD亚组在200 - 400毫秒范围内该参数显著降低；在No-Go条件下，混合型ADHD儿童亚组的诱发电脑电图同步性幅度显著降低。
总体而言，本研究结果使我们得出结论，认知控制受损对ADHD儿童情绪障碍的发展有很大影响。
