Correlation Analysis Of Neurological Soft Signs In Children With Attention Deficit Hyperactivity Disorder

Objective:1.To investigate the differences in Cognitive function and eurological soft signs (NSS) between Attention Deficit Hyperactivity Disorder (ADHD) and healthy controls Chinese children.2.To investigate the prevalence and characteristics of NSS in the subtypes of ADHD.3.To study he correlation between neurological soft signs and cognitive impairment in children with ADHD.Methods:All subjects were divided into two groups, the Study group(n=74boy=70, girl=4), children who suffered from ADHD meeting a criterion of DSM-IV-TR, the control group are healthy children randomly selected according to age, sex, from the first grade to the sixth grade of the second primary school of Datong in Changsha, Hunan province. All subjects are6-12years old, right handed, there are48Predominantly inattentive type children,13Predominantly hyperactive type, and13Combined-type. All the subjects were evaluated by the Cambridge Neurological Inventory (CNI) and underwent a series of neural psychological tests:Continuous Performance Task(CPT), Wisconsin Card Sorting Test (WCST), China-Wechsler Intelligence Scale of Children (C-WISC), Digital Span Test (DST), Verbal fluency test (VFT).The SPSS16.0were used to establish database and make statistical analysis.Results: 1. All the parameters in CPT, WCST were different between ADHD and the control group, and all the differences were significant (P<0.01); In the VFT the total score and the correct number of the ADHD were significantly reduced, the error number was increased, the difference was statistically significant (P<0.05), but there wasn’t statistically difference in repeat number (P=0.87); In the DST, recitenumber and the total number were reduced, the difference were statistically significant (P <0.01).2. Compared to the control group the prevalence of children with ADHD are higher in DiadockinesiaL, Mirror2L, Go-nogo, Mirror1L FgthumbOPPR, Oseretsky, Fist-Edge-PalmL, Fist-Edge-PalmR, Extinction, FgagnosiaL, StereognosiaR, GraphesthesiaL, GraphesthesiaR, Point to, Wink, Mirror1R, the differences were significant (P<0.05).3. Compared to the control group the children with ADHD scored higher in the total scored of NSS, Motor Coordination, sensory integration, disinhibition, FgthumbOPPL, FgthumbOPPR, Oseretsky Fist-edge-palmL, Fist-edge-palmR, Sensory-integration, StereognsiaR, Graphesthesia L, Graphesthesia R, Point to, Disinibition, wink, MirrorlL, Mirrorl R, Diadockinesia L, Extinction, Fgagnsia L, Go-nogo, Mirror2L, the difference is statistically significant (P<0.05)。4.There was no significant difference in Sensory-integration between the control group and the children with Predominantly hyperactive type (P>0.05). There was also no significant in the total score of NSS, Motor Coordination, sensory integration and disinhibition among the three type of ADHD (P>0.05).There were no statistically difference (P> 0.05) among the score of neurological soft signs in the subtypes of patients with ADHD, and the prevalence of the items of NSS weren’t have statistical difference (P>0.05).5. In the study group, CPT response error, CPT reaction time, verbal fluency total number, correct number, WCST complete categories, total classification number of responders, a continuity error, Response Administere, Perseverative Errors, response correct were significant correlated with and the total score and subscale of CNI (P<0.05). Three factors of digit span test were significantly negatively correlated with score of CNI and motor coordination(P<0.05), with the number back, back number and sensory score negatively correlated(P<0.05). Non-perseverative errors was correlated with motor coordination of sensory integration factor, correct thinking time was correlated to CNI score, motor coordination and sensory integration (P<0.05).Conclusion:1.The prevalence of neurological soft signs is higher in ADHD patients than control group, ADHD children may have a motor coordination damaged, sensory integration disorder and disinhibition defects, and a potential nervous system dysfunction may under the NSS.2.There weren’t differences of the prevalence and characteristics among the subtype of ADHD patients.3.ADHD children exist significant response inhibition defects, transfer of cognitive ability and conceptualization ability, abstraction ability, working memory, verbal fluency and cognitive abilities defects. There may be a common neural pathophysiological mechanisms between Neurological soft sign abnormalities and cognitive impairment in ADHD patients.