【作者】 程大志； 闫秀贤； 高志杰； 周新林； 许克铭； 陈倩；

【Author】 Dazhi Cheng;Xiuxian Yan;Zhijie Gao;Xinlin Zhou;Keming Xu;Qian Chen;Department of Pediatric Neurology,Children’s Hospital affiliated to Capital Institute of Pediatrics;National Key Laboratory of Cognitive Neuroscience and Learning,Institute of Cognitive Neuroscience and Learning,Beijing Normal University;

【机构】 首都儿科研究所附属儿童医院神经内科； 北京师范大学认知神经科学与学习国家重点实验室；

【摘要】 目的:观察新诊断尚未治疗的失神癫痫(CAE)儿童的认知特征。方法:采用计算机化认知任务测试的方法(CCTE)对2010年10月至2015年9月首都儿科研究所门诊35例新诊断尚未服用抗癫痫药物的CAE患儿进行测试。其中男19例、女16例;平均年龄7.3±1.6岁,起病年龄5.0—9.4岁。对35例患儿进行11项认知心理测试,并选择35名2013年8月至2014年6月北京市普通小学募集的年龄性别相匹配的健康儿童作为对照,其中男14名、女21名,平均年龄7.5:1:1.6岁。采用SPSS 19.0统计软件对两组儿童认知任务测试(选择反应时测验分析反应时间)的答题正确数作为原始数据进行处理,采用独立样本t检验。结果:两组儿童1 1项认知任务测验所得原始数据为连续变量,经检验均符合正态分布,CAE组患儿数字数量大小比较、简单减法、视觉追踪和威斯康星卡片分类4项任务测验的成绩显着低于对照组[(54.74±29.74)比(67.20:1:10.47)分、(23.26:1:10.3T)比(30.89±:10.99)分、(6.11:1:5.64)比(9.57:1:5.20)分、(45.00±29.15)比(65.69±:18.61)分,t=2.34、2.99、2.67、3.54,P<0.05、<0.01、<0.05、<0.01];选择反应时、三维心理旋转、言语工作记忆、词语辨析、瑞文图形推理、配对联结学习(语言)和配对联结学习(数学)共7项任务测试的成绩两组问差异均无统计学意义[(619.40±174.41)比(541.71±244.02)ms、(10.14:±9.31)比(12.51±10.21)分.80:±3.33)比(4.83:1:3.44)分、(9.34±9.44)比(12.34:±:1 1.57)分、(10.94±7.96)比(14.17:1:8.10)分、(19.14:1:6.81)比(18.86±5.47)分、(18.71±6.54)比(18.86:1:5.47)分,P均>0.05]。结论:新诊断未服用抗癫痫药物的失神癫痫患儿存在数学认知、注意力和执行功能的损害,视觉空间、记忆及部分语言等认知功能表现正常。更多还原

【Abstract】 Childhood absence epilepsy an commonly idiopathic form of generalized epilepsy,which affect approximately 8-15%of school children with epilepsy.CAE are clinically characterized with 3-Hz generalized spike and wave discharges in the electroencephalogram(EEG).Recent neuropsychological studies report that children with CAE have cognitive dysfunctions in attention and executive function,which affect their academic achievement and social prognosis.The current study recruited the children with new-onset CAE,investigate what aspect of the academic cognitive disabilities they have,and cognitive mechanism of academic cognitive disabilities.Computerized cognitive test battery was used to assess 35 children with new-onset CAE recruited from Children’s Hospital affiliated to Capital Institute of Pediatrics,35 control children recruited from primary schools in Beijing matching with the CAE children in age and gender.All participants received 11 cognitive tasks.Independent-samples T test in SPSS 19.0 was used to analyze the corrected scores(For the choice reaction time test,the median reaction time was calculated).The results showed that new-onset CAE exhibited cognitive deficits in mathematics,intelligence,attention and executive function.In contrast,there were no significant between-group differences for other cognitive tests.Furthermore,attention deficit measured with visual tracing could only account for the mathematical processing deficit in new-onset CAE group.The results suggest that new-onset CAE group have cognitive deficits in mathematics,attention and executive function,attention impairment other than intelligence and executive function is the fundamental cognitive mechanism underlying the achievement problem in new-onset CAE.更多还原