Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
권호 표지
DOI QR코드

DOI QR Code

Correlation of Executive Function and Quantitative Electroencephalography in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

주의력결핍 과잉행동장애 소아청소년의 실행기능과 정량화 뇌파의 상관성 연구

  • Jeong, Yu-jin (Graduate Program in Cognitive Science, Yonsei University, Department of Psychiatry and Institution of Behavioral Science in Medicine, Yonsei University College Of Medicine) ;
  • Park, Jin Young (Department of Psychiatry, Gangnam Severance Hospital, Department of Psychiatry and Institution of Behavioral Science in Medicine, Yonsei University College Of Medicine) ;
  • Kim, Hyunjung (Major of clinical psychology, Graduate school of psychological service, Chungang university) ;
  • Choi, Jungwon (Department of Child and Adolescent Psychiatry, National Center for Health) ;
  • Jhung, Kyungun (Department of Psychiatry & Behavioral Neuroscience, International St. Mary's Hospital, Catholic Kwandong University)
  • 정유진 (연세대학교 대학원 인지과학 협동과정, 연세대학교 의과대학 의학행동과학연구소) ;
  • 박진영 (강남세브란스병원 정신건강의학과, 의학행동과학연구소) ;
  • 김현중 (중앙대학교 심리서비스대학원 임상심리학전공) ;
  • 최정원 (국립정신건강센터 소아청소년정신과) ;
  • 정경운 (가톨릭관동대학교 국제성모병원 정신건강의학과)
  • Received : 2017.04.28
  • Accepted : 2017.06.24
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : Attention-deficit hyperactivity disorder(ADHD) is characterized by significant impairments in executive functions, with a prevalence of approximately 3-5% of all children worldwide. The goal of this study was to examine the relationship between executive functions and electrophysiological activities in children and adolescents with ADHD. Methods : In 31 patients with ADHD, resting-state EEG was recorded, and Comprehensive Attention Test(CAT), Stroop Color-Word Inference Test(Stroop CWIT), Trail Making Test(TMT), and Wisconsin Card Sorting Test(CST) were administered. Korean version of the ADHD Rating Scale(K-ARS) was assessed. Results : Alpha and beta power positively correlated with the Attention Quotient(AQ), while delta power negatively correlated with AQ from CAT. In the Stroop CWIT, decreased delta power and increased beta power were related to higher performance. Power of the alpha band increased with higher TMT performance. Moreover, delta power negatively correlated with good performance on the CST, while alpha and high gamma band showed a positive correlation. Correlation with the parent-rating of ADHD symptoms showed a negative correlation between alpha power and higher scores on the K-ARS. Conclusions : These findings indicate that relative power in higher frequency bands of EEG is related to the higher executive function in children and adolescents with ADHD, while the association with the relative power in lower frequency bands of EEG seem to be vice versa. Furthermore, the findings suggest that QEEG may be a useful adjunctive tool in assessing patients with ADHD.

연구목적 본 연구는 주의력결핍 과잉행동장애(attention-deficit/hyperactivity disorder, ADHD) 환자들을 대상으로 다양한 실행기능과 정량화 뇌파간의 상관성을 알아보고자 하였다. 방법 31명의 소아청소년 ADHD 환자를 대상으로 정량화 뇌파를 측정하였다. 종합주의력검사(Comprehensive Attention Test, CAT), 스트룹 색-단어 추론 검사(Color-Word Inference Test, CWIT), 선추적 검사(Trail Making Test, TMT), 카드분류검사(Card Sorting Test, CST)가 시행되었고 한국어판 주의력결핍 과잉행동장애 평정척도(Korean version of the ADHD Rating Scale, K-ARS)가 측정되었다. 결과 CAT 검사 점수와 알파, 베타 파워가 양적 상관이 있는 반면, 델타 파워와는 부적 상관이 있었다. CWIT 검사에서는 감소된 델타 파워와 증가된 베타 파워가 높은 수행수준과 관련 있었다. 높은 TMT 검사 점수는 증가된 알파 대역 파워와 관련이 있었으며, CST 검사에서 델타 파워는 높은 수행수준과 부적 상관이 있는 반면 알파, 하이 감마파의 파워와는 양적 상관을 보였다. K-ARS 점수는 알파 파워와 부적 상관을 보였다. 결론 정량화 뇌파는 ADHD 환자들의 실행기능과 상관성을 보이며 신경생리학적 지표로서의 유용성이 시사된다.

Keywords

References

  1. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry 2015;56:345-365. https://doi.org/10.1111/jcpp.12381
  2. Hansen C, Weiss D, Last CG. ADHD boys in young adulthood: psychosocial adjustment. J Am Acad Child Adolesc Psychiatry 1999;38:165-171. https://doi.org/10.1097/00004583-199902000-00015
  3. Chabot RJ, Serfontein G. Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological Psychiatry 1996;40:951-963. https://doi.org/10.1016/0006-3223(95)00576-5
  4. Clarke AR, Barry RJ, McCarthy R, Selikowitz M. EEG analysis in attention-deficit/hyperactivity disorder: a comparative study of two subtypes. Psychiatry Research 1998;81:19-29. https://doi.org/10.1016/S0165-1781(98)00072-9
  5. Clarke AR, Barry RJ, McCARTHY RORY, Selikowitz M. Electroencephalogram differences in two subtypes of attention-deficit/hyperactivity disorder. Psychophysiology 2001;38:212-221. https://doi.org/10.1111/1469-8986.3820212
  6. Posner MI, Petersen SE. The attention system of the human brain. Annual Review of Neuroscience 1990;13:25-42. https://doi.org/10.1146/annurev.ne.13.030190.000325
  7. 유한익, 이중선, 강성희, 박은희, 정재석, 김붕년, 손정우, 박태원, 김봉석, 이영식. 국내 아동 및 청소년 주의력 평가를 위한 종합주의력검사의 표준화 연구. 소아청소년정신의학 2009;20:68-75.
  8. Savitz JB, Jansen P. The Stroop Color-Word Interference Test as an indicator of ADHD in poor readers. The Journal of Genetic Psychology 2003;164:319-333. https://doi.org/10.1080/00221320309597986
  9. Holmes J, Gathercole SE, Place M, Alloway TP, Elliott JG, Hilton KA. The diagnostic utility of executive function assessments in the identification of ADHD in children. Child and Adolescent Mental Health 2010;15:37-43. https://doi.org/10.1111/j.1475-3588.2009.00536.x
  10. Hermens DF, Soei EX, Clarke SD, Kohn MR, Gordon E, Williams LM. Resting EEG theta activity predicts cognitive performance in attention-deficit hyperactivity disorder. Pediatric Neurology 2005;32:248-256. https://doi.org/10.1016/j.pediatrneurol.2004.11.009
  11. Shi T, Li X, Song J, Zhao N, Sun C, Xia W, Wu L, Tomoda A. EEG characteristics and visual cognitive function of children with attention deficit hyperactivity disorder(ADHD). Brain and Development 2012;34:806-811. https://doi.org/10.1016/j.braindev.2012.02.013
  12. Swartwood JN, Swartwood MO, Lubar JF, Timmermann, DL. EEG differences in ADHD-combined type during baseline and cognitive tasks. Pediatric Neurology 2003;28:199-204. https://doi.org/10.1016/S0887-8994(02)00514-3
  13. Delis DC, Kaplan E, Kramer JH. Delis-Kaplan executive function system(D-KEFS). Psychological Corporation;2001.
  14. 이정희, 강연옥, 나덕렬. Stroop 간섭 지표들의 효율성 비교: 정상노인집단과 치매 집단을 대상으로. 한국심리학회지: 임상 2000;19:807-818
  15. Stuss DT, Bisschop SM, Alexander MP, Levine B, Katz D, Izukawa D. The Trail Making Test: a study in focal lesion patients. Psychological Assessment 2001;13:230. https://doi.org/10.1037/1040-3590.13.2.230
  16. Heaton RK. A manual for the Wisconsin card sorting test. Western Psycological Services;1981.
  17. DuPaul GJ. Parent and teacher ratings of ADHD symptoms: psychometric properties in a community-based sample. Journal of Clinical Child and Adolescent Psychology 1991;20:245-253. https://doi.org/10.1207/s15374424jccp2003_3
  18. So YK, Noh JS, Kim YS, Ko SG, Koh YJ. The reliability and validity of Korean parent and teacher ADHD rating scale. Journal of Korean Neuropsychiatric Association 2002;41:283-289.
  19. Chatrian GE, Lettich E, Nelson PL. Modified Nomenclature for the "10%" Electrode System1. Journal of Clinical Neurophysiology 1988;5:183-186. https://doi.org/10.1097/00004691-198804000-00005
  20. Lazzaro I, Gordon E, Li W, Lim CL, Plahn M, Whitmont S, Clarke RJ, Barry A, Dosen R, Meares R. Simultaneous EEG and EDA measures in adolescent attention deficit hyperactivity disorder. International Journal of Psychophysiology 1999;34:123-134. https://doi.org/10.1016/S0167-8760(99)00068-9
  21. Barry RJ, Clarke AR, Johnstone SJ. A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clinical neurophysiology 2003;114:171-183. https://doi.org/10.1016/S1388-2457(02)00362-0
  22. Klimesch W. EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Research Reviews 1999;29:169-195. https://doi.org/10.1016/S0165-0173(98)00056-3
  23. Mann CA, Lubar JF, Zimmerman AW, Miller CA, Muenchen RA. Quantitative analysis of EEG in boys with attention-deficit-hyperactivity disorder: Controlled study with clinical implications. Pediatric Neurology 1992;8:30-36. https://doi.org/10.1016/0887-8994(92)90049-5
  24. Lubar JF. Discourse on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity disorders. Biofeedback and Self-Regulation 1991;16:201-225. https://doi.org/10.1007/BF01000016
  25. Mostofsky SH, Cooper KL, Kates WR, Denckla MB, Kaufmann WE. Smaller prefrontal and premotor volumes in boys with attention-deficit/hyperactivity disorder. Biological Psychiatry 2002;52:785-794. https://doi.org/10.1016/S0006-3223(02)01412-9
  26. Hesslinger B, Van Elst LT, Thiel T, Haegele K, Hennig J, Ebert D. Frontoorbital volume reductions in adult patients with attention deficit hyperactivity disorder. Neuroscience Letters 2002;328:319-321. https://doi.org/10.1016/S0304-3940(02)00554-2
  27. Zametkin AJ, Nordahl TE, Gross M, King AC, Semple WE, Rumsey J, Hamburger S, Cohen RM. Cerebral glucose metabolism in adults with hyperactivity of childhood onset. New England Journal of Medicine 1990;323:1361-1366. https://doi.org/10.1056/NEJM199011153232001
  28. Zametkin AJ, Liebenauer LL, Fitzgerald GA, King AC, Minkunas DV, Herscovitch P, Yamada EM, Cohen RM. Brain metabolism in teenagers with attention-deficit hyperactivity disorder. Archives of General Psychiatry 1993;50:333-340. https://doi.org/10.1001/archpsyc.1993.01820170011002
  29. Lubar JF, Swartwood MO, Swartwood JN, O'Donnell PH. Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in TOVA scores, behavioral ratings, and WISC-R performance. Applied Psychophysiology and Biofeedback 1995;20:83-99.
  30. White JN, Hutchens TA, Lubar JF. Quantitative EEG assessment during neuropsychological task performance in adults with attention deficit hyperactivity disorder. Journal of Adult Development 2005;12:113-121. https://doi.org/10.1007/s10804-005-7027-7
  31. DeFrance JF, Smith S, Schweitzer FC, Ginsberg L, Sands S. Topographical analyses of attention disorders of childhood. International Journal of Neuroscience 1996;87:41-61. https://doi.org/10.3109/00207459608990752
  32. Loo SK, Teale PD, Reite ML. EEG correlates of methylphenidate response among children with ADHD: a preliminary report. Biological Psychiatry 1999;45:1657-1660. https://doi.org/10.1016/S0006-3223(98)00250-9
  33. 김준원, 김현진, 한덕현, 이영식, 민경준, 이건석, ...., 이재원. 한국어판 DISC-IV에 따른 주의력결핍 과잉행동장애진단에 서의 정량 뇌파 소견. J Korean Neuropsychiatr Assoc 2013;52:143-149. (저자 이름 모두 풀어주세요) https://doi.org/10.4306/jknpa.2013.52.3.143
  34. Roh SC, Park EJ, Park YC, Yoon SK, Kang JG, Kim DW, Lee SH. Quantitative electroencephalography reflects inattention, visual error responses, and reaction times in male patients with Attention Deficit Hyperactivity Disorder. Clinical Psychopharmacology and Neuroscience 2015;13:180. https://doi.org/10.9758/cpn.2015.13.2.180