Neuropsychological Deficits Associated With Heavy Prenatal Alcohol Exposure Are Not Exacerbated by ADHD
Neuropsychological Deficits Associated With Heavy Prenatal Alcohol Exposure Are Not Exacerbated by ADHD
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DOI：
10.1037/a0033994
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发表时间：
2013-11-01
期刊：
影响因子：
2.4
通讯作者：
Mattson, Sarah N.
中科院分区：
文献类型：
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作者：
Glass, Leila;Ware, Ashley L.;Mattson, Sarah N.
目的：注意力缺陷多动障碍（ADHD）或产前酒精暴露严重的个体的神经心理功能已被独立记录。本研究探讨了这两个因素之间的相互作用对儿童的认知表现。方法：作为多中心研究的一部分，344名儿童（8-16岁，M = 12.28，SD = 2.52）完成了综合神经心理电池。测试了四个受试者组：有产前酒精暴露（AE）和ADHD（AE+，n = 90），酒精暴露无ADHD（AE，n = 38），非暴露ADHD（ADHD，n = 80），和非暴露无ADHD（CON，n = 136）。结果如下：单独的2（AE）× 2（ADHD）MANCOVA揭示了ADHD和AE对整体WISC-IV，D-KEFS和CANTAB表现的显著主效应和交互效应。个体方差分析显示2个WISC-IV指标[言语理解（VCI），知觉推理（PRI）]和4个D-KEFS和CANTAB子测试[设计流畅性，言语流畅性，线索制作，空间工作记忆]的显着相互作用。随访分析表明，AE+和AE组在这些指标上无差异。合并AE+/-组在VCI和PRI方面比ADHD组表现出更严重的损害，但临床组之间没有其他差异。结论：这些结果支持联合AE+/-组的神经心理学研究，并表明，在某些情况下，在ADHD中看到的神经心理学影响被产前酒精暴露改变。酒精暴露对言语理解和知觉推理的影响大于那些与ADHD无酒精暴露相关的影响，尽管与对照组相比，这两种情况独立导致认知障碍。在临床上，这些发现证明了任务依赖型的损害模式在临床疾病。
Objective: Neuropsychological functioning of individuals with attention-deficit/hyperactivity disorder (ADHD) or heavy prenatal alcohol exposure has been well documented independently. This study examined the interaction between both factors on cognitive performance in children. Method: As part of a multisite study, 344 children (8-16 y, M = 12.28, SD = 2.52) completed a comprehensive neuropsychological battery. Four subject groups were tested: children with histories of heavy prenatal alcohol exposure (AE) and ADHD (AE+, n = 90), alcohol-exposed without ADHD, (AE, n = 38), nonexposed with ADHD (ADHD, n = 80), and nonexposed without ADHD (CON, n = 136). Results: Separate 2(AE) X 2(ADHD) MANCOVAs revealed significant main and interactive effects of ADHD and AE on overall WISC-IV, D-KEFS, and CANTAB performance. Individual ANOVAs revealed significant interactions on 2 WISC-IV indices [Verbal Comprehension (VCI), Perceptual Reasoning (PRI)), and four D-KEFS and CANTAB subtests [Design Fluency, Verbal Fluency, Trail Making, Spatial Working Memory]. Follow-up analyses demonstrated no difference between AE+ and AE groups on these measures. The combined AE+/- group demonstrated more severe impairment than the ADHD group on VCI and PRI, but there were no other differences between clinical groups. Conclusions: These results support a combined AE+/- group for neuropsychological research and indicate that, in some cases, the neuropsychological effects seen in ADHD are altered by prenatal alcohol exposure. The effects of alcohol exposure on verbal comprehension and perceptual reasoning were greater than those related to having ADHD without alcohol exposure, although both conditions independently resulted in cognitive impairment compared to controls. Clinically, these findings demonstrate task-dependent patterns of impairment across clinical disorders.