Electrophysiological Characteristics And Cognitive Function Of Children With TD And ADHD

With the rapid development of social economy and the change of children’s disease spectrum,children’s developmental behavioral diseases have become the concern of more and more parents.Tic disorder(TD)is a kind of neuropsychiatric disease that starts in childhood and its main clinical manifestation is tic.Generally,more than half of TD children suffer from one or more kinds of psychobehavioral disorders,including attention deficit hyperactivity disorder(ADHD)and obsessive-compulsive disorder,OCD)is the most common.In children and adults,TD co suffering from ADHD accounts for more than 60,and it is increasing year by year.Co suffering from ADHD is a part of the whole tic disorder,and it is the source of tic disorder functional damage.Co suffering from ADHD not only increases the complexity and severity of the disease,but also children are prone to more emotional,behavioral and learning problems,cognitive dysfunction,etc.,which can give children social benefits The healthy development of adaptability,personality and psychological quality brings many difficulties to the treatment and management,even affects the healthy growth of children.ObjectiveThe diagnosis and classification of TD common ADHD,ADHD,TD and healthy children were carried out by Conners parents questionnaire and integrated visual and audit continuous performance test,IVA-CPT)and quantitative electroencephalogram(QEEG)and event-related potential P300 were analyzed to further explore the characteristics of neuroelectr-ophysiology and cognitive function in children with TD and ADHD.MethodFrom October 2018 to April 2020,138 Han children aged 5-14 who met the diagnostic criteria of TD and ADHD in DSM-V were selected in this study,and 47 healthy children aged 5-14 were screened in the same period.They were divided into four groups: TD group,TD group,ADHD group and healthy children group.With the informed consent of the parents,please fill in the Conners parents questionnaire,and test the IVA-CPT and event-related potential P300 of the children over 6 years old,and record the amplitude and latency value.All children were examined with quantitative EEG,and the absolute and relative power values of θ,δ,α,β were recorded.Statistical MethodSPSS 23.0 software was used to verify the normal distribution of the collected measurement data.Single factor analysis of variance and multiple ratio analysis were used to verify the normal distribution,and rank sum test and multiple ratio analysis were used to compare the non normal distribution,P < 0.05.The difference was statistically significant.Result1.General data185 children were enrolled in the study,including 48 children with TD(39 males,9 females),44 children with TD(38 males,6 females),46 children with ADHD(40 males,6 females)and 47 healthy children(33 males,13 females).Quantitative EEG was performed in all groups,with age(H=0.536 P=0.547>0.05)and gender(H = 3.534 P = 0.316 > 0.05).P300 was recorded in 34 children with TD,30 children with ADHD,34 children with TD and 30 healthy children.There was no significant difference in gender(H=3.024 P=0.388>0.05)and age(H=7.682 P=0.053>0.05)between the groups.Because P300 and IVA-CPT tests need children’s cooperation,children over 6 years old complete them.The majority of TD patients with ADHD,TD and ADHD were male.The male to female ratio of TD patients with ADHD is about 6:1.2.Quantitative EEG results:The frequency of θ wave in left anterior temporal area,left prefrontal area and right temporal area of TD patients with ADHD was higher than that of healthy children,the frequency of left posterior temporal area and left frontal area was higher than that of ADHD group,and the frequency of right frontal area was higher than that of TD group(P < 0.05).The frequency of delta wave of relative power in the forehead area of TD patients with ADHD was higher than that of healthy children,the frequency of left posterior temporal area and left frontal area was higher than that of ADHD group,and the frequency of right frontal area was higher than that of TD group(P < 0.05).The frequency of β wave of relative power in right temporal area of TD patients with ADHD was higher than that of healthy children(P < 0.05).The frequency of α wave in left prefrontal area,right middle temporal area and right temporal area of TD patients with ADHD was lower than that of healthy children,the frequency of left frontal area was lower than that of TD patients,and the frequency of right temporal area was lower than that of ADHD patients(P < 0.05)3.The frequency of absolute power θ wave in left posterior temporal area and left prefrontal area in TD co ADHD group was higher than that in healthy children group(P < 0.05);the frequency of absolute power β wave in middle anterior temporal area,right posterior temporal area,left prefrontal area and frontal area in TD co ADHD group was higher than that in TD group / ADHD group,and the difference was statistically significant(P < 0.05)The frequency of right prefrontal area was significantly higher than that of healthy children(P.The frequency of absolute power α wave in forehead area of TD patients with ADHD was higher than that of healthy children(P < 0.05).3.Event related potential P300 results:The latency of P300 in TD group was longer than that in healthy children,and the amplitude of P300 was lower than that in healthy children(P < 0.05),There was no significant difference(P > 0.05)between TD group and ADHD group.The amplitude of TD group was lower than that of TD group(P < 0.05).4.Conners parents questionnaire results:The scores of behavior problems,learning problems,psychosomatic disorders,impulsive hyperactivity,hyperactivity index and anxiety in TD / ADHD group were significantly higher than those in TD / ADHD group(P < 0.05).5.IVA-CPT test results:There were 8 attention deficit,12 impulsive hyperactivity and 10 mixed ADHD in TD group,10 attention deficit,13 impulsive hyperactivity and 11 mixed ADHD in ADHD group.Conclusion1.The majority of TD patients with ADHD are male,and they are more prone to learning,behavior and conduct problems than TD / ADHD patients.2.There is a difference between the quantitative EEG of TD children with ADHD and that of normal children.After excluding the influence of gender,age and other factors,the study found that the quantitative EEG of TD children with ADHD changed into asymmetric,focal distribution in the frontal and temporal areas,with the increase of slow waves δ,θ.3.There is a difference between quantitative EEG and TD / ADHD in children with TD and ADHD.The main changes are the focal distribution of frontal and temporal areas,but further study is needed.4.Excluding the influence of gender,age and other factors,this study found that children with TD co suffering from ADHD had longer latency and lower amplitude of P300,and children with TD co suffering from ADHD had cognitive impairment.There was no significant difference between TD group and TD / ADHD group,which may be related to the common disease of ADHD and TD.There are not enough samples in the study,the results are different,the difference is not statistically significant,so we need to increase the sample size for further study.5.Although quantitative EEG and P300 can not be used as the objective criteria for independent diagnosis,they can be used as an important auxiliary examination for this kind of disease.At present,iva-pct test results can not be used as the diagnostic criteria for ADHD and TD,but their results are helpful for the evaluation of ADHD and TD.