1.Effects of attention deficit hyperactivity disorder core symptoms and behavior problems on sleep of children with attention deficit hyperactivity disorder
Yanhong FU ; Ling QIN ; Wenliu ZHANG ; Hui SUN ; Hong ZHANG ; Hairun LIU ; Siyan HUANG
Chinese Journal of Applied Clinical Pediatrics 2024;39(11):848-852
Objective:To explore the effects of the core symptoms of attention deficit hyperactivity disorder (ADHD) and behavior problems on the sleep of children with ADHD and their correlation.Methods:In this cross-sectional study, a total of 289 children aged 6-12 years with ADHD who visited the Outpatient Department of the Center for Cognition and Sleep at the People′s Hospital of Guangxi Zhuang Autonomous Region from June 2021 to December 2022 were selected.The Swanson, Nolan and Pelham Rating Scale Ⅳ was used to assess ADHD core symptoms (attention deficit and hyperactivity-impulsivity), the Conners Parent Symptom Questionnaire was used to assess behavior problems (conduct, learning, psychosomatic symptoms, and anxiety), and the Sleep Disturbance Scale for Children (SDSC) was used to assess sleep.Multivariate Logistic regression, multivariate linear regression, and path analysis were performed for statistical analysis of the data.Results:Multivariate Logistic regression analysis showed that after controlling age, gender, verbal intelligence quotient and performance intelligence quotient, attention deficit ( P=0.008, OR=2.60, 95% CI: 1.28-5.28), psychosomatic symptoms ( P=0.027, OR=6.77, 95% CI: 1.24-36.93) and anxiety ( P=0.013, OR=3.96, 95% CI: 1.43-11.67) increased the risk of sleep disturbances in children with ADHD (SDSC score >39 points).Path analysis showed that attention deficit ( β=0.244, P=0.001), psychosomatic symptoms ( β=0.114, P=0.046) and anxiety ( β=0.216, P<0.001) directly affected the SDSC score.Hyperactivity-impulsivity indirectly affected the SDSC score through psychosomatic symptoms ( β=0.142, P=0.039), and attention deficit indirectly affected the SDSC score through anxiety ( β=0.321, P<0.001). Conclusions:The severer the core symptoms of ADHD and behavior problems are, the higher the degree of sleep disturbances in children with ADHD is.Psychosomatic symptoms and anxiety are directly associated with the sleep disturbances of ADHD children.Attention deficit has direct or anxiety-mediated indirect impact on the sleep of ADHD children.Hyperactivity-impulsivity indirectly affects the sleep of children with ADHD through psychosomatic symptoms.
2.The relationship among sleep phenotypes, clinical symptoms and cognitive function in children with attention deficit hyperactivity disorder
Yanhong FU ; Ling QIN ; Wenliu ZHANG ; Chan CHEN ; Yuping WU ; Hong ZHANG ; Hairun LIU ; Siyan HUANG
Chinese Journal of Behavioral Medicine and Brain Science 2024;33(10):901-906
Objective:To explore the relationship among sleep phenotypes, attention deficit and hyperactivity impulsivity (ADHD) symptoms and cognitive information processing in children with ADHD.Methods:A total of 244 children with ADHD aged 6-12 were selected from December 2021 to December 2022.Swanson, Nolan and Pelham rating scale Ⅳ(SNAP-Ⅳ) was used to evaluate the core symptoms of ADHD.Sleep disturbance scale for children (SDSC) was used to evaluate six sleep phenotypes((disorders in initiating and maintaining sleep (DIMS), sleep breathing disorders(SDB), sleep-wake transition disorders(SWTD), disorders of arousal(DA), disorders of excessive somnolence (DOES), and Nocturnal hyperhidrosis(SHY)). Das-Naglieri cognitive function assessment system (DN-CAS) was used to evaluate the cognitive information processing (planning, simultaneous processing, attention and successive processing). Descriptive statistical analysis, Spearman correlation analysis, and mediation analysis were conducted by SPSSAU 23.0 and Zstats software, respectively.Results:Correlation analysis showed that DIMS, SDB, SWTD, DA and DOES were significantly and positively correlated with attention deficit ( r=0.190-0.349, all P<0.01).DIMS(2.14(1.71, 2.57)), SWTD(1.67(1.33, 2.00)) and SHY(2.00(1.50, 3.00)) were significantly positively correlated with hyperactive impulsivity (1.44(1.00, 2.00))( r=0.193, 0.242, 0.133, P<0.05). Attention deficit(1.78(1.44, 2.33)) was significantly and negatively correlated with successive processing(105.00(96.00, 112.00)) ( r=-0.127, P<0.05). The results of multiple linear regression analysis showed that after controlling for sex, age, verbal IQ and operational IQ, DIMS ( β=0.152, P<0.05) and SWTD ( β=0.178, P<0.05) had significant positive predictive effects on hyperactive impulsivity symptoms. DOES ( β=0.259, P<0.01) had significant positive predictive effects on attention deficit symptoms. Attention deficit ( β=-0.183, P<0.05) had a significant negative predictive effect on successive processing. Mediation effect analysis showed that attention deficit played a complete mediating role between DOES and successive processing(effect=-0.179, Bootstrap 95% CI=-0.196--0.110). Conclusion:Different sleep phenotypes are associated with ADHD core symptoms and different dimensions of cognitive information processing processes. DOES indirectly affects successive processing capability by attention deficit symptoms.
3.Cognitive information processing characteristics of children with autism spectrum disorder
Hui SUN ; Ling QIN ; Yanhong FU ; Hairun LIU ; Hong ZHANG ; Siyan HUANG
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(11):976-980
Objective:To evaluate the cognitive information processes in children with autism spectrum disorder(ASD)based on the Das-Naglieri Cognitive Assessment System(DN: CAS)and to explore the characteristics of these cognitive processes.Methods:Thirty-two children with ASD and thirty-two healthy controls matched 1∶1 by gender and age were enrolled in this study.The cognition of all individuals was evaluated by the DN: CAS.SPSS 26.0 software was used for statistical analysis and Mann-Whitney U test was conducted to analyze the data. Results:Compared with the healthy control group, children with ASD had significantly lower scores in planning subtest of DN: CAS(23.50(19.00, 25.00) vs 30.50(27.00, 35.75), Z=-5.014, P<0.01), attention subtest of DN: CAS(25.50(20.25, 27.75) vs 33.00(28.00, 36.00), Z=-4.317, P<0.01), and the DN: CAS total score(115.00(106.00, 132.25) vs 139.00(127.00, 143.00), Z=-3.849, P<0.01). And there were significant differences in matching numbers(9.00(6.25, 10.00) vs 12.00(10.00, 13.75), Z=-4.317, P<0.01), planned codes(7.00(5.25, 8.00) vs 9.00(7.00, 11.00), Z=-3.404, P<0.01), planned connections(7.00(4.25, 9.75) vs 10.00(9.00, 12.00), Z=-4.383, P<0.01)in planning and expressive attention(8.00(6.25, 10.75) vs 11.50(8.25, 13.75), Z=-3.251, P<0.01), number detection(8.00(6.25, 10.00) vs 10.00(9.00, 12.00), Z=-3.628, P<0.01), receptive attention(8.00(6.00, 9.00) vs 10.00(9.00, 13.00), Z=-3.351, P<0.01)in attention between ASD children and healthy controls. Conclusion:ASD children have the planning and attention deficits.
4.Influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder
Dan WANG ; Ling QIN ; Hairun LIU ; Dandan LI ; Chunling YAO ; Yanhong FU ; Hong ZHANG ; Siyan HUANG
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(9):819-825
Objective:To explore the influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD).Methods:From January 2018 to July 2021, 62 ADHD children who were treated with tomoxetine hydrochloride for the first time for(8±4) weeks were selected as the ADHD group.And 62 healthy children matched with age and sex were selected as the healthy control group.Pre-test and post-test by the Das-Naglieri: Cognitive Assessment System(DN: CAS) were performed to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group were compared with those in healthy control group.The difference between before and after treatment of ADHD group was also compared.SPSS 26.0 statistical software was adopted for statistical analysis.The scores of ADHD group pre-treatment and post-treatment were compared by paired sample t-test, and the scores of ADHD group pre-treatment and post-treatment were compared with those of healthy control group by independent sample t-test. Results:Compared with healthy control group, there were lower of planning score((18.77±5.92) vs (28.56±5.55)), attention score((22.24±5.93) vs (29.56±6.16)), simultaneous processing ((34.21±7.75) vs (37.61±6.29)), successive processing((30.37±7.12) vs (33.74±5.43)), and the total scores((105.60±21.29) vs (134.84±22.87)) in ADHD group before treatment, and there were significant differences( t=9.49, 6.74, 2.68, 2.96, 7.36, all P<0.05). Compared with healthy control group, there were lower of planning score ((22.13±5.99)s), attention score((25.26±7.11) with significant difference( t=6.20, 3.60, both P<0.05) in ADHD group after treatment.And there was no significant difference in the simultaneous processing test and the successive processing test after treatment compared with the healthy control group(both P>0.05). In ADHD group, the scores of planning, simultaneous processing, attention, successive processing and the total score were significantly higher after treatment than those before treatment and there were significant differences( t=-6.03, -4.13, -4.77, -5.48, -8.59, all P<0.05). (2) Compared with the healthy control group, there were lower of matching number score and other 8 sub-test scales in DN: CAS test in ADHD group before treatment, and the differences were statistically significant (all P<0.05). Meanwhile, there were still lower of matching number score and other 4 sub-test scales in DN: CAS test in ADHD group after treatment, and the differences were statistically significant (all P<0.05). The matching number score and other 10 sub-test scales in DN: CAS test in ADHD group after treatment were all higher than those of before treatment(all P<0.05). Conclusion:The planning, attention, simultaneous processing, successive processing and total cognitive function of ADHD children were significantly improved after treatment with tomoxetine hydrochloride, special for simultaneous processing and successive processing.
5.Sleep and language development in children and adolescents
Siyan HUANG ; Ling QIN ; Hairun LIU ; Dandan LI
Chinese Journal of Behavioral Medicine and Brain Science 2021;30(5):476-480
Sleep takes an important role in maintaining typical development, neural plasticity, and language development. Not only poorer performance in memory and cognitive functions, but also obvious delayed language development are seen in children and adolescents with sleep problem. Previous research found that sleep duration affects children and adolescents' ability in comprehensive vocabulary, expressive vocabulary, and vocabulary retention. Children and adolescents with poor sleep quality usually show language developmental delay, however, there is no integrated evaluation tool for sleep and language, and a consistent conclusion is therefore not reached. Daytime naps are beneficial to consolidate vocabulary learning in infants, and it’s also relevant to vocabulary retention and generalization in children and adolescents. Children with sleep related breathing disorders show lower ability in receptive language comprehension and lower lexical level, and with the increase of their age, the severity of their language disorder becomes higher. Besides, sleep can promote language learning in children with neuro-developmental disorder.The neuro-physiological mechanism underlying sleep and language remains unknown, and one of the possible explanations is that sleep problem harms the information processing in frontal lobe and hippocampus, and interferes with neural plasticity. The injury includes memory, attention, executive function, auditory processing, and so on, and finally language development is damaged. Further research is necessary to clarify the relation and mechanism between these two elements, this will be helpful in finding out an effective way to promote language function in children with language retardation and/or combined with neuro-developmental disorder.
6.Progress of the non-invasive neuromodulation in treating children with attention deficit hyperactivity disorder
Hairun LIU ; Rongshan QIN ; Ling QIN
Chinese Journal of Applied Clinical Pediatrics 2021;36(7):558-560
Attention deficit hyperactivity disorder (ADHD) is the medical treatment, while it does not bring high compliance.Therefore, non-medical therapy is a research focus in this field.Non-invasive neuromodulation can regulate the functional state of central nervous system by electric, magnetic, or chemical approach through invasive equipment that is proved to be highly safe.In the clinical industry, non-invasive neuromodulation is a widely used physiotherapy in various types of neuropsychiatric disorders, and has received satisfying effects.On the contrary, the utilization of this technique on ADHD in clinical settings is still under the research stage.This review aims at elaborating the clinical progress of several non-invasive neuromodulation approaches on ADHD, so as to provide reference to future researches in this field.
7.Correlation between interleukin-27 polymorphisms and coronary heart disease in the Guangxi Zhuang Population
Yan XUE ; Hairun LIU ; Zicong YANG ; Jianyong LU ; Xinshun HUANG ; Ying HUANG ; Yu LIU ; Ling LIU ; Ying SHI
Chinese Journal of Geriatrics 2020;39(6):632-635
Objective:To investigate the correlation between interleukin-27(IL-27)polymorphisms and coronary heart disease(CHD)in the Guangxi Zhuang population.Methods:A total of 1 218 subjects were enrolled in this case-control study, and 571 cases were in the CHD group and 647 were in the control group.The Sequenom MassArray system was used to genotype IL-27 single nucleotide polymorphisms(SNPs), and other biochemical parameters were tested by using the standard protocol in the laboratory of our hospital.The correlation between IL-27 SNPs and CHD was evaluated by Logistic regression analysis, and risk factors including age, smoking, drinking, history of hypertension, history of diabetes mellitus and family history of CHD were adjusted in this model.Methods:Logistic regression analysis results indicated that the risk of CHD was elevated in subjects with the CC genotype of IL-27 rs428253, compared with those with the GG genotype( OR=2.18, 95% CI: 1.09-4.37, P<0.05). After adjustment for the related risk factors, the risk of CHD also increased in subjects with the CC genotype of IL-27 rs428253, compared with those with the GG genotype( R=2.82, 95% CI: 1.31-6.07, P<0.05). IL-27 rs4740, rs17855750, rs181206 and rs40837(all P>0.05)polymorphisms had no correlation with CHD in the Zhuang population, and there were no significant differences in C-reactive protein, total cholesterol, triglyceride or low-density lipoprotein cholesterol levels between CHD patients and controls with different genotypes of IL-27 rs428253(all P>0.05). Conclusions:IL-27 rs428253 polymorphism is correlated with the risk of CHD in the Guangxi Zhuang population.
8.Influence of Methylphenidate Hydrochloride prolonged-release tablets on the cognitive processing of children with attention deficit hyperactivity disorder
Hairun LIU ; Ling QIN ; Hong ZHANG ; Yanhong FU ; Dandan LI ; Chunling YAO ; Zhengyou LIANG
Chinese Journal of Applied Clinical Pediatrics 2017;32(17):1326-1330
Objective To explore the influence of Methylphenidate Hydrochloride prolonged-release tablets on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD).Methods Thirty ADHD children and 30 healthy controls were enrolled in this study,and the ADHD subjects were treated with Methylphenidate Hydrochloride prolonged-release tablets for (28 ± 3) days.Pre-test and post-test by the Das-Naglieri:Cognitive Assessment System(DN:CAS) were done to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group with healthy control group were compared.The difference between before and after treatment of ADHD was also compared.Results Compared with healthy control group,there were lower of planning score [(21.86 ± 4.61) scores vs.(29.33 ± 5.06) scores],attention score [(25.00 ± 4.57) scores vs.(29.83 ± 3.79) scores],and the total scores [(111.93 ± 13.95) scores vs.(127.26 ±15.53) scores] in ADHD group,and there were significant differences (t =-5.976,-4.455,-4.023,all P <0.05).The matching number,planned codes,planned connections,expressive attention,number detection and receptive attention scores were also lower in ADHD group,and there were significant differences (t =-4.787,-3.703,-4.991,-2.216,-2.488,-3.219,all P < 0.05).Compared with healthy control group,there were lower of planning score with significant difference [(25.53 ± 4.98) scores vs.(29.33 ± 5.06) scores,t =-2.931,P < 0.05] in ADHD group after treatment,matching number and planned codes were lower with significant difference (t =-2.654,-2.044,all P < 0.05) in ADHD group after treatment.In ADHD group,the scores of planning [(25.53 ± 4.98)scores vs.(21.86 ± 4.61) scores],simultaneous processing [(36.10 ± 7.10) scores vs.(34.13 ± 6.04) scores],attention [(27.90 ± 5.69) scores vs.(25.00 ± 4.57) scores] and the total score [(121.50 ± 16.55) scores vs.(111.93 ± 13.95) scores] were significantly higher after treatment than that before treatment and there were significant differences (t =-5.679,-2.949,-3.869,-5.963,all P < 0.05);matching number,planned codes,planned connections,nonverbal matrices,number detection,receptive attention and word series were significantly higher after treatment than that before treatment,and there were significant differences (t =-2.528,-3.209,-3.890,-2.276,-4.489,-2.208,-2.373,all P < 0.05).Conclusion The Methylphenidate Hydrochloride prolonged-release tablets can improve the function of cognitive processing in children with ADHD,especially in attention.
9.Study on correlation between plasma homocysteine level and prognosis in patients with acute myocardial infarction
Yan XUE ; Hairun LIU ; Zicong YANG ; Tao ZENG ; Ling LIU ; Nengwen XU ; Ying SHI
Chongqing Medicine 2017;46(31):4342-4344,4347
Objective To investigate the correlation between plasma homocysteine(Hcy) and long term occurrence of main adverse cardiac events(MACE) in the patients with acute myocardial infarction(AMI).Methods A total of 326 inpatients with AMI in the cardiology department of this hospital from Mar.2012 to Dec.2014 were continuously included.The related laboratory biochemical indicators such as Hcy were detected according to the standard flow process by the hospital clinical laboratory department.The Hcy level and MACE occurrence rate were performed the receiver operating characteristic(ROC) curve analysis.The research subjects were divided into the Hcy(L) group and Hcy(H) group according to the cut-off value 11.69μmol/L.The base line data of all subjects were collected and the follow up was conducted for recording MACE.Results The plasma N-terminal pro-brain natriuretic peptide (NT-ProBNP) level in the Hcy(L) group was significantly lower than that in the Hcy(H) group[-(501.46-±-118.35)pg/mL vs.(1 324.11 ± 523.13) pg/mL,P =0.02],while the left ventricular ejection fraction(LVEF) was significantly higher than that in the Hcy(H) group[(55.23 ± 9.48) % vs.(50.79 ± 10.68) %,P =0.03].After 1-year follow up,LVEF in the Hcy(H) group was significantly decreased compared with the base line [(45.32±10.18)% vs.(50.79±10.68)%,P<0.05],moreover the MACE occurrence risk in the Hcy(H) group was significantly higher than that in the Hcy(L) group,the difference after correcting the related confounding factors had statistical significance (P=0.048),but LVEF and minor axis shortening rate of left ventricle(FS) in the Hcy(L) group had no obvious difference compared with the base line data[(54.43 ± 10.68)% vs.(55.23± 9.48) %,(28.56±6.21) % vs.(29.22±5.30) %,P>0.05].Conclusion The risk of long term MACE occurrence in the patients with AMI complicating plasma high Hcy level is obviously increased compared with that in the patients with plasma low Hcy level and the prognosis is poor,prompting that plasma high Hcy level is one of possible independent predicting factors for poor prognosis in the patients with AML But its action mechanism and whether the Hcy interventional therapy improving prognosis of AMI patients still need to further study.
10.Research on assessing the cognitive process in children with attention deficit hyperactivity disorder by using Das-Naglieri Cognitive Assessment System
Hairun LIU ; Ling QIN ; Hong ZHANG ; Yanhong FU ; Dandan LI ; Zhengyou LIANG
Chinese Journal of Applied Clinical Pediatrics 2016;31(7):540-543
Objective To explore the cognitive process in children with attention deficit hyperactivity disorder (ADHD) using Das-Naglieri Cognitive Assessment System (DN:CAS).Methods Sixty-one children with ADHD and sixty-one healthy controls were enrolled in this study.The cognition of all the studies individuals was evaluated by the DN:CAS.Results Compared with the control group,children with ADHD had significantly lower scores in planning[(24.18 ±5.64) scores vs (30.07 ±5.28) scores,t =-6.985,P < 0.01],simultaneous processing[(33.97 ± 7.64) scores vs (36.90 ± 7.20) scores,t =-2.211,P < 0.05],attention [(26.52 ± 6.80) scores vs (31.21 ± 5.86) scores,t =-4.909,P <0.01] in the 4 subtests of DN:CAS,and the total scores [(117.85 ±21.45) scores vs (132.48 ± 17.95) scores,t =-5.286,P < 0.01] are same.And there were significant differences in matching numbers [(8.77 ± 2.33) scores vs (10.87 ± 2.31) scores,t =-5.220,P < 0.01],planned codes [(7.87 ± 2.37) scores vs (9.44 ± 2.61) scores,t =-4.006,P < 0.01],planned connections [(7.54 ± 2.29) scores vs (9.75 ± 2.01) scores,t =-6.643,P <0.01];verbal-spatial relations in simultaneous processing [(10.05 ±2.79) scores vs (11.23 ± 3.19) scores,t =-2.382,P < 0.05] and expressive attention [(9.02 ± 2.47) scores vs (10.34 ± 3.03) scores,t =-2.938,P <0.01],number detection [(8.16 ±2.31) scores vs (10.08 ± 1.86) scores,t =-5.028,P < 0.01],receptive attention [(9.34 ± 3.68) scores vs (10.78 ± 3.20) scores,t =-3.215,P < 0.01] between ADHD group and the control group.There were significant differences of the percentile rank distribution of the scores between ADHD group and the control group in planning,attention and full score (all P < 0.05).Conclusions Children with ADHD have cognitive deficits in the cognitive processing,and planning and attention deficits are the main features.The DN:CAS could be a useful tool in evaluating cognition of children with ADHD.

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