摘要
目的探讨注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)患儿执行功能与血清胶质源性神经营养因子(glial-derived neurotrophic factor,GDNF)浓度的相关性。方法入组32例未用药的ADHD患儿和34例性别、年龄及智商相匹配的正常儿童。利用数字倒背测验(DSB-T)、连线测试(TMT)、语义流畅性测验(SFT)、和Stroop色词测试(SCW-T)评估受试者的执行功能,采用Elisa法测定受试者的外周血清GDNF浓度。比较两组间执行功能测试得分和血清GDNF浓度,Spearman相关和Pearson相关分析血清GDNF浓度与执行功能的相关性。结果(1)ADHD组DSB-T和SFT得分均低于正常对照组[DSB-T:4(2)分,5(1)分;SFT(13.66±2.34)分,(15.21±2.13)分],差异具有统计学意义(Z=3.16,t=2.82,均P<0.05);TMT-A和TMT-B耗时均高于正常对照组[TMT-A:(61.12±19.03)s,(48.76±21.06)s;TMT-B(158.66±63.78)s,(123.62±45.24)s],差异具有统计学意义(t=2.50、2.59,均P<0.05);SCW-T字色耗时、字义干扰时和字色错误数均高于正常对照组[字色耗时(56.41±21.65)s,(45.97±13.42)s;字义干扰时27(25)s,20(15)s;字色错误数4(3)分,2(1)分],差异具有统计学意义(t=2.37,Z=2.31、2.11,均P<0.05)。(2)ADHD组血清GDNF浓度([(481.59±68.74)pg/ml]低于正常对照组[(552.47±110.13)pg/ml],差异具有统计学意义(t=3.11,P<0.05))。(3)ADHD组血清GDNF浓度与TMT-A、TMT-B耗时以及SCW-T字义干扰时呈显著负相关(r=-0.512、r=-0.578、r=-0.432,均P<0.05),与DSB-T得分呈显著正相关(r=0.381,P<0.05)。结论ADHD患儿执行功能广泛受损,GDNF可能参与了ADHD执行功能损害的病理生理机制。
Objective To explore the correlation between executive dysfunction and serum glial-derived neurotrophic factor(GDNF)levels in children with attention deficit hyperactivity disorder(ADHD).Methods 32 drug-free ADHD patients and 34 normal children matched in gender,age and IQ were included.The executive function was assessed using Digital Span Back Test(DSB-T),Trail Making Test(TMT),Semantic Fluency Test(SFT)and Stroop Color Word Test(SCW-T),and peripheral GDNF levels were measured by the enzyme linked immunosorbent assay(ELISA).The executive functional test scores and serum GDNF levels were compared between groups,and then the correlation between executive dysfunction and GDNF was analyzed by Spearman or pearson correlation analysis.Results(1)In the ADHD group,the DSB-T and SFT scores were lower than those in the normal control group(DSB-T4:(2)vs 5(1);SFT(13.66±2.34)vs(15.21±2.13)(Z=3.16,t=2.82,both P<0.05)and the TMT-A and TMT-B time-consuming were higher than those in the normal control group(TMT-A(61.12±19.03)s vs(48.76±21.06)s;TMT-B(158.66±63.78)s vs(123.62±45.24)s,t=2.50,2.59,both P<0.05).The Word color consumption,word interference and word color errors of SCW-T in ADHD group were higher than those in the normal control group(Word color consumption(56.41±21.65)s vs(45.97±13.42)s;word interference 27(25)s vs 20(15)s;word color errors 4(3)vs 2(1)),and the differences were statistically significant(t=2.37,Z=2.31,2.11,all P<0.05).(2)Serum levels of GDNF in the ADHD group were lower than that in the normal control group((481.59±68.74)pg/ml vs(552.47±110.13)pg/ml),and the difference was statistically significant(t=3.11,P<0.05).(3)In the ADHD group,serum GDNF levels were negatively correlated with TMT-A,TMT-B and SCW-T word interference performance(r=-0.512,r=-0.578,r=-0.432,all P<0.05),and positively correlated with DSB-T performance(r=0.381,P<0.05).Conclusion Executive function is extensively damaged in ADHD patients,and GDNF may be involved in the pathophysiology of executive impairment.
作者
刘娜
桑艳
陈娇
刘晓鸣
Liu Na;Sang Yan;Chen Jiao;Liu Xiaoming(Neurology Department,Children’s Hospital of Xuzhou Medical University,Xuzhou 221002,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2020年第1期56-60,共5页
Chinese Journal of Behavioral Medicine and Brain Science
基金
江苏省妇幼健康科研项目(F201726)。
关键词
注意缺陷多动障碍
胶质源性神经营养因子
执行功能
儿童
Attention deficit hyperactivity disorder
Glial-derived neurotrophic factor
Executive function
Children
作者简介
通信作者:刘晓鸣,Email:xzlrlxm@163.com。
