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Title: Neuropsychological Profile Related with Executive Function of Chinese Preschoolers with Attention-Deficit/Hyperactivity Disorder: Neuropsychological Measures and Behavior Rating Scale of Executive Function-Preschool Version.
Author: Zhang HF, Shuai L, Zhang JS, Wang YF, Lu TF, Tan X, Pan JX, Shen LX.
Journal: Chin Med J (Engl); 2018 Mar 20; 131(6):648-656. PubMed ID: 29521286.
Abstract:
BACKGROUND:: Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder (ADHD) showed difficulties in neuropsychological function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsychological weakness differed among ADHD presentations in preschool children. METHODS:: The 226 preschoolers (163 with ADHD and 63 controls) with the age of 4-5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version (BRIEF-P) and a series of tests to investigate neuropsychological function. RESULTS: Preschoolers with ADHD showed higher scores in all domains of the BRIEF-P (inhibition: 30.64 ± 5.78 vs.20.69 ± 3.86, P < 0.001; shift: 13.40 ± 3.03 vs.12.41 ± 2.79, P = 0.039; emotional control:15.10 ± 3.53 vs.12.20 ± 2.46, P < 0.001; working memory: 28.41 ± 4.99 vs.20.95 ± 4.60, P < 0.001; plan/organize: 17.04 ± 3.30 vs.13.29 ± 2.40, P < 0.001) and lower scores of Statue (23.18 ± 7.84 vs.28.27 ± 3.18, P = 0.001), Word Generation (15.22 ± 6.52 vs.19.53 ± 7.69, P = 0.025), Comprehension of Instructions (14.00 ± 4.44 vs.17.02 ± 3.39, P = 0.016), Visuomotor Precision (P < 0.050), Toy delay (P = 0.048), and Matrices tasks (P = 0.011), compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P (P < 0.001), and the ADHD-combined symptoms (ADHD-C) group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer performances than the ADHD-predominantly inattentive symptoms (ADHD-I) group on Statue tasks (F = 7.34, η² = 0.12, P < 0.001). Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer performances compared to the ADHD-C group in the Block Construction task (F = 4.89, η² = 0.067, P = 0.003). However, no significant group differences were found between the ADHD-I group and normal control. CONCLUSION:: Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects. 学前注意缺陷多动障碍儿童神经心理功能评估：神经心理学工具和学龄前儿童执行功能行为评定问卷摘要背景：既往研究发现学龄前注意缺陷多动障碍（ADHD）儿童的神经心理功能存在损害。本研究采用神经心理学工具和相关的评定量表，用以评定我国学前ADHD儿童的神经心理功能状况，以及不同ADHD亚型神经心理学弱点的模式和严重程度是否存在差异。 方法：226名年龄为4-5岁的学前儿童包括ADHD患儿163名及正常儿童63名被纳入本研究。所有儿童接受学前儿童执行功能行为评定量表（BRIEF-P）父母版问卷调查和一系列神经心理学测试以评估神经心理学功能。 结果：学前ADHD儿童的BRIEF-P问卷各因子得分均较正常儿童高，且具有统计学意义 (抑制因子: 30.64 ± 5.78 vs.20.69 ± 3.86, P <0.001; 转换因子: 13.40 ± 3.03 vs.12.41 ± 2.79, P =0.039; 情绪控制因子:15.10 ± 3.53 vs.12.20 ± 2.46, P <0.001; 工作记忆因子: 28.41 ± 4.99 vs.20.95 ± 4.60, P <0.001;组织 / 计划因子: 17.04 ± 3.30 vs.13.29 ± 2.40, P <0.001)。在雕塑测试(23.18 ± 7.84 vs.28.27 ± 3.18, P =0.001)、词汇生成(15.22 ± 6.52 vs.19.53 ± 7.69, P =0.025)、指令理解(14.00 ± 4.44 vs.17.02 ± 3.39, P =0.016)、视觉运动(P <0.050)、玩具延迟满足(P =0.048)和矩阵推理神经心理学任务(P=0.011)中，学前ADHD儿童表现较正常儿童差，且具有统计学意义。学前ADHD各亚型儿童在BRIEF-P问卷的抑制因子、工作记忆因子、组织计划因子得分均较正常儿童高 (P<0.001)，且ADHD混合型儿童在抑制因子和组织计划因子上得分最低。在雕塑测试中，ADHD混合型儿童表现较ADHD注意缺陷型儿童差(F=7.34, η²=0.12, P<0.001)。在积木任务中，ADHD冲动型儿童表现较ADHD混合型儿童差(F=4.89, η²=0.067, P=0.003)。在神经心理学任务中，尚未发现ADHD注意缺陷型儿童的表现与正常儿童表现有显著差异。 结论：通过BRIEF-P问卷评估和神经心理学任务评估，本研究发现学前ADHD儿童存在着多方面的神经心理功能损害。.

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