Tan Chuanxue, Zhou Huimin, Yang Miao, Li Chunyang, Chen Huanli, He Li, Yang Ting, Chen Jie, Zhang Jie, Li Tingyu
Children'S Nutrition Research Center, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children'S Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Department of Child Health Care, The Children'S Hospital Affiliated of Xi 'an Jiaotong University, Xi'an, China.
Sci Rep. 2025 Mar 21;15(1):9802. doi: 10.1038/s41598-025-94156-1.
Purpose The study aimed to assess the value of event-related potentials (ERP) of executive functions in distinguishing between attention deficit hyperactivity disorder (ADHD) and ADHD combined with autism spectrum disorder (ADHD&ASD). Methods This retrospective analysis included 204 participants divided into three groups: ADHD&ASD (64/204), ADHD (70/204), and typical development (TD) (70/204). Neuropsychological tests, including the Digit Span Test, Behavior Rating Inventory of Executive Function (BRIEF), Trail Making Test at its Chinese equivalent version, the Shape Trail Test (STT), and the Stroop Color Word Interference Test, were compared across groups. ERP measures, such as latency and amplitude at the frontal zone (Fz), central zone (Cz), and parietal zone (Pz), along with reaction times and target stimulus hits using an oddball paradigm, were analyzed. Post-hoc analyses and receiver operating characteristic (ROC) curves identified key indicators for distinguishing ADHD from ADHD&ASD. Results Significant differences were found in ERP and BRIEF indicators (P < 0.001), as well as selected TMT and Stroop parameters (P < 0.05) across the groups. The ADHD&ASD group exhibited notably higher Fz, Cz, and Pz latencies, interference times, and reaction times compared to the ADHD group (P < 0.05). With the exception of word meaning interference time, the area under ROC curves (AUC) of the remaining five indicators exceeds 0.8. Particularly noteworthy is the combined ROC curve of Fz latency and average reaction time, which demonstrated a sensitivity, specificity, and AUC of 88.68%, 97.14%, and 0.938 (95%CI: 0.885-0.990, P < 0.001), respectively. Conclusion ERP measurements using oddball paradigms hold strong potential for distinguishing ADHD from ADHD&ASD, enabling the development of more targeted treatment approaches through precise neurophysiological markers.
目的 本研究旨在评估执行功能的事件相关电位（ERP）在区分注意力缺陷多动障碍（ADHD）与ADHD合并自闭症谱系障碍（ADHD&ASD）中的价值。方法 本回顾性分析纳入204名参与者，分为三组：ADHD&ASD组（64/204）、ADHD组（70/204）和典型发育（TD）组（70/204）。对各组进行了神经心理学测试，包括数字广度测试、执行功能行为评定量表（BRIEF）、中文版连线测验、形状连线测验（STT）和斯特鲁普色词干扰测验，并进行了比较。分析了ERP测量指标，如额叶区（Fz）、中央区（Cz）和顶叶区（Pz）的潜伏期和波幅，以及使用oddball范式的反应时间和目标刺激击中率。事后分析和受试者工作特征（ROC）曲线确定了区分ADHD与ADHD&ASD的关键指标。结果 各组在ERP和BRIEF指标（P < 0.001）以及选定的连线测验和斯特鲁普参数（P < 0.05）上存在显著差异。与ADHD组相比，ADHD&ASD组的Fz、Cz和Pz潜伏期、干扰时间和反应时间明显更长（P < 0.05）。除词义干扰时间外，其余五项指标的ROC曲线下面积（AUC）均超过0.8。特别值得注意的是Fz潜伏期和平均反应时间的联合ROC曲线，其敏感性、特异性和AUC分别为88.68%、97.14%和0.938（95%CI：0.885 - 0.990，P < 0.001）。结论 使用oddball范式进行ERP测量在区分ADHD与ADHD&ASD方面具有很大潜力，能够通过精确的神经生理标记物开发更具针对性的治疗方法。
