这项工作得到了阿斯图里亚斯公国 (FC-15-GRUPIN14-053) 的一个项目的支持, 并得到了 Severo 奥乔亚计划 (BP14-030) 的 predoctoral 赠款。我们要感谢安娜 Bujnowska 为她的贡献和希瑟沼泽和奈杰尔沼泽为他们的帮助。

本研究是根据《赫尔辛基宣言》进行的, 它确立了涉及人的研究的伦理原则。该研究的目标、范围和程序也得到了奥维耶大大学和阿斯图里亚斯大学医院伦理委员会的批准。
1. 家长报告
<ol><li>在开始评估议定书之前, 请取得签署的父母同意, 以便对该儿童进行评估。</li>
	<li>与参加者的家人进行有条理的访谈。 注: 结构化访谈已作为附录提供。</li>
	<li>有参加者的家庭和/或教师完成对 ADHD13的评估的规模。这一比例包括20个项目, 提供信息, 说明存在的症状与注意缺陷和多动/冲动, 在诊断和统计手册中提到的精神疾病。<ol>
<li>在本节中, 让治疗师给出以下说明: "现在, 为了获得关于你孩子的重要信息, 你必须完成这份问卷, 指的是可能代表你孩子行为的症状。你必须对你观察这20症状的频率进行分类。</li>
	</ol>
</li>
</ol>2. 认知措施
<ol><li>测量注意力变量, 管理认知量表。<ol>
<li>管理认知尺度14 (按照手册中的《议定书》) 评估儿童和青少年在6岁至16岁11月之间的个人智力。</li>
		<li>深入分析由尺度获得的认知轮廓。 注: 考虑到认知量表手册中所包含的信息, 韦克斯勒的结果可能受多动症的影响, 在处理速度和工作记忆方面, 与感性推理和言语相比得分较低。理解.</li>
	</ol>
</li>
</ol>3. 采用连续性能测试的执行措施
<ol><li>使用两个 CPTs 分析儿童的性能: 一个基于虚拟现实的 cpt15 , 另一个由传统的 cpt16组成。</li>
	<li>管理基于虚拟现实的 CPT15。这是一个基于虚拟现实环境的 CPT, 它再现了正规教室的条件。它评估6岁至16岁儿童和青少年的注意力、冲动、处理速度和运动活动。构成测试的活动是预设的, 无法更改任务的任何特定特性。<ol>
<li>双击虚拟现实的 CPT 应用程序启动程序。</li>
		<li>输入程序许可证提供的用户名和密码。</li>
		<li>输入参与者信息 (姓名、姓氏和出生日期), 然后点击 "进入虚拟教室" 窗口。</li>
		<li>请参加者佩戴头部安装显示器 (头盔) 眼镜和耳机, 并告知他们在整个测试中佩戴它的重要性。有治疗师说: "现在你需要戴这些特殊的眼镜在虚拟现实的任务, 如果你看不太好或有任何问题, 请告诉我, 我帮助你解决它"。 注: 这些眼镜连接到 PC, 因此治疗师可以看到参与者正在查看的图像, 以确保他们理解测试 (图 2)。</li>
		<li>在开始虚拟注意力任务之前, 请参与者用其主导的手握住按钮。让治疗师说: "你需要按住并按下你写的同一只手的按钮。</li>
		<li>让参与者探索虚拟环境 (一个典型的教室), 并从一个学生坐在黑板上看十五年代的一张桌子 (图 3) 的角度。由虚拟教师执行此部分虽然这些说明: "你好, 你戴的眼镜, 你可以看到整个教室: 向左, 向右, 向上, 向下。你可以看到一切。注意房间里的所有东西, 看看墙壁和其他人, 看看你想要什么。</li>
		<li>让参与者跟随虚拟教师, 指导他们完成任务。参与者执行的第一部分是训练, 它由视觉定位气球和按下按钮弹出。让虚拟教师在本部中指示以下内容: "既然你已经检查了一切, 你就开始做一些有趣的事情。我们在你周围放了一些闪亮的红色气球。你需要通过移动你的头来找到气球。当你找到一个, 仔细看它, 并按下按钮, 使它弹出。你必须找到4气球。我们走吧！挑战现在开始!</li>
		<li>让参与者继续下一步, 这是第一个练习。这是基于 "x 不" 范式 (传统上称为 "不去"), 当参与者在没有看到或听到刺激 "苹果" 时, 必须按下按钮。让虚拟老师说: "现在, 你会看到黑板上的一些图画。我还要跟你说几句话。你必须注意, 并点击按钮, 尽可能快, 当你看到或听到任何东西不是苹果。但要小心!你需要在每次看到或听到其他事情时按下按钮。例如, 如果您听到 "云" 或在黑板上出现云的绘图, 则必须按下该按钮。记住: 当你看到或听到苹果时, 千万不要按按钮!挑战开始了..。现在! 注意: 由于活动是由程序预设的, 因此不可能改变目标刺激 (在这种情况下, 苹果)。</li>
		<li>让参与者完成最后一个练习, 按照指示按下按钮, 每当他/她看到或听到数字 "七"。这一部分由一个 "X" 范式 (或 "去" 任务) 组成。说这些说明: "现在你要处理数字。你会看到黑板上的数字, 你也会听到数字。每次听到或看到数字 "七" 时, 都必须按下该按钮。不要按任何其他号码的按钮。例如, 如果您听到或看到数字 "三", 请不要按按钮。记住: 当你看到或听到 "七" 时, 总是按下按钮!测试现在开始! 注意: 由于活动是由程序预设的, 因此不可能改变目标刺激 (在本例中为七)。</li>
		<li>通过测试网站打印测试结果报告, 添加所评估的孩子的姓名和姓氏。此报告为下列变量编译结果: 遗漏、佣金、响应时间和变异性, 并通过区分这些感官方式 (视觉与听觉)、存在/没有干扰物的方法来补充这些信息,和任务类型 (去 vs, 不去), 从而导致不同的执行配置文件。</li>
	</ol></li>
	<li>管理传统的 CPT16。这是一个可用于视觉或听觉版本的 CPT, 但在本协议中只使用视觉版本。此测试包含预设任务。根据年龄和性别, CPT 的视觉规范从4年到80岁。<ol>
<li>确保参与者放松, 注意他们的呼吸, 并确保它被控制。如果看起来参与者没有控制他们的呼吸。说明如下: "你应该专注于腹部收缩和控制呼吸"。</li>
		<li>打开 CPT 应用程序, 输入子项的名称和出生日期, 然后按 "好" 按钮。</li>
		<li>单击 "可视任务" 窗口, 然后单击启动按钮, 计算机将开始加载可视任务。</li>
		<li>确保参与者用他/她的主导手握住按钮 (连接到 PC)。重复虚拟现实的步骤5中的指令: "你需要按住并按下你写的同一只手的按钮"。</li>
		<li>通知参与者以下测试说明: "你必须按下按钮, 当你看到一个黑色方块的上部部分, 这是目标刺激。但是, 当黑色方块位于底部时, 请勿按下该按钮 (图 4)。</li>
		<li>让参加者执行训练部分 (持续大约3分钟), 直到它是清楚的参加者了解任务。在 CPT 的训练部分, 目标 (参与者必须响应的刺激) 和非目标 (参与者必须避免反应的刺激) 在屏幕上随机出现;治疗师应观察参与者是否正确按下按钮。如果参与者不按指示按按钮, 请让治疗师再次解释说明, 然后参与者将需要重复培训部分。</li>
		<li>告诉参与者任务很长, 她/他必须保持静止, 集中精力完成任务。</li>
		<li>让参与者完成 CPT 的活动。它分为两部分。测试的第一部分 ("罕见" 或警戒模式) 的特点是目标: 非目标比率为 1:3. 5。这是由不按下按钮的倾向来证明的。在第二部分 ("频繁" 或高响应需求模式) 提出一个目标: 非目标比率为 3.5: 1, 所以孩子必须抑制反应的倾向。</li>
		<li>在 CPT 完成后, 生成编写以下变量的报告: 遗漏、RT (目标刺激和主题响应的表示之间的响应时间)、佣金、可变性、D 素数 (测试中的浓度质量)根据测试中的错误数) 和多动症指数, 可归因于存在或没有注意缺陷与过度活跃。计算此多动症指数的总和: 前半 + D 素数第二半 + 总变异性, 并解释为由于 ADHD 时, 分数低于-1.80。</li>
	</ol></li>
</ol>4. Fp1 和 Fpz/Cz 地区的皮质活化措施 (Hemoencephalography 和量化脑电图) 17
<ol><li>打开 Bioexplorer 软件, 然后选择设计POCKET_HEG_video_1ch_AI_HEGRatio bxd。<ol>
<li>按时间按钮以查看评估期间的时间 (三十五年代)。</li>
		<li>通知参加者, 他/她不能移动, 必须仍然。治疗师告诉参与者在评估血液氧合过程中仍然保持静止的重要性: "现在, 你仍然是非常重要的血液氧合评估, 因为如果你移动, 系统将失败, 这将是需要再次测量。你准备好了吗？</li>
		<li>单击红色按钮, 输入要测量的主题和皮质点的名称 (Fp1 区域以评估抑制能力和 Fpz 评估注意能力)。</li>
		<li>将乐队放在参与者前额的特定区域: Fp1 (用于评估抑制能力) 和 Fpz (用于评估注意能力), 如图 5所示。</li>
		<li>确保没有外接光进入波段。适当地调整乐队到参与者的头, 在这样的方式, 它是不松散的, 并没有脱落在评估期间。</li>
		<li>把 Hemoencephalography-nirHEG (这是连接到头带) 周围的参与者的脖子, 像一条项链。</li>
		<li>打开硬件将频带连接到 PC。</li>
		<li>在大约三十五年代, 通过近红外 HEG 计划测量特定区域的血液氧合. 按绿色按钮开始测量血液的氧合, 三十五年代以后按白色按钮结束评估。</li>
		<li>打印程序提供的输出, 并分析程序提供的参与者的近红外 HEG 比。该工具的平均值为 100 (SD = 20), 用于校准光度计。此外, 还通过近红外 HEG 的方法得到了一个注意指标 (AI), 显示了参与者提高比例和大脑活化的无能。这对于确定注意力问题和测量浓度的能力是有用的。</li>
	</ol>
</li>
	<li>使用量化脑电图 (Q 脑电图) 测量参与者的皮质活动水平, 这是一种电脑脑电图系统, 通过β/θ比值提供皮质活化水平。它用于测量一般的注意级别, 而不是执行任务。 注: 对 beta/θ比率的分析是根据以前的研究12进行的。<ol>
<li>在测试过程中, 告知参与者正确的腹部呼吸。</li>
		<li>打开 Bioexplorer 软件, 然后选择设计combined_Theta_Beta bxd。屏幕将出现分为两个窗口 (左侧显示的皮质活动 FP1 和右侧显示的皮质活动的 CZ)</li>
		<li>单击红色按钮, 输入要测量的主题和皮质点的名称 (Fp1 区域以评估抑制能力和 Cz 区域以评估注意能力)。</li>
		<li>将红色电极放在 Fp1 区域和蓝电极中, 应用电极凝胶 (使用 "http://neurologiclabs.com/neuromonitoring/eeg/" 中找到的信息, 以确保电极正确放置) (参见图6).</li>
		<li>将两个控制电极 (黑白电极) 放在 participant´s 左右耳垂上, 应用电极凝胶。</li>
		<li>确保参加者在评估过程中睁开眼睛。治疗师必须在整个评估中观察参与者。如果参与者在任何时间闭上眼睛, 结束评估过程, 并在参与者休息后重复它。</li>
		<li>在右前臂放置一个肌电图 (肌电信号) 传感器, 以确定运动的程度。</li>
		<li>通知参与者, 他/她必须保持放松, 尽量不要在任务中移动缓慢的呼吸。参与者必须集中在计算机屏幕上, 而θ和β波正在发射。治疗师说: "你必须仍然和放松, 在三十五年代, 你唯一需要做的是观看的θ/beta 波将出现在计算机屏幕上"。</li>
		<li>按绿色按钮开始测量皮层活动, 三十五年代后按白色按钮结束评估。</li>
		<li>打印从程序生成的结果并对其进行分析。如果 beta/θ比率低于50% 在 Cz, 这证明了持续关注的赤字。另一方面, 如果 Fp1 的比例也较低, 这一结果与执行控制的损害有关, 这是由于多动症所致。</li>
	</ol>
</li>
</ol>

<ol>
	<li>American Psychiatric Association. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Diagnostic and statistical manual of mental disorders. , (2013).</li><li>Steinau, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnostic+criteria+in+attention+deficit+hyperactivity+disorder-Changes+in+DSM+5.">Diagnostic criteria in attention deficit hyperactivity disorder-Changes in DSM 5.</a> Front Psychol. 4 (49), (2013).</li><li>Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., Rohde, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+worldwide+prevalence+of+ADHD:+a+systematic+review+and+metaregression+analysis.">The worldwide prevalence of ADHD: a systematic review and metaregression analysis.</a> Am J Psychiat. 4 (6), 942-948 (2007).</li><li>Willcutt, E. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+prevalence+of+DSM-IV+attention-deficit/hyperactivity+disorder:+a+meta-analytic+review.">The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review.</a> Neurotherapeutics. 9 (3), 490-499 (2012).</li><li>Catal&#225;-L&#243;pez, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence+of+attention+deficit+hyperactivity+disorder+among+children+and+adolescents+in+Spain:+a+systematic+review+and+meta-analysis+of+epidemiological+studies.">Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: a systematic review and meta-analysis of epidemiological studies.</a> BMC psychiatry. 12 (1), 168 (2012).</li><li>Cubillo, A., Halari, R., Smith, A., Taylor, E., Rubia, K. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Review+of+fronto-striatal+and+fronto-cortical+brain+abnormalities+in+children+and+adults+with+Attention+Deficit+Hyperactivity+Disorder+(ADHD)+and+new+evidence+for+dysfunction+in+adults+with+ADHD+during+motivation+and+attention.">Review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention.</a> Cortex. 48 (2), 194-215 (2012).</li><li>Lubar, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discourse+on+the+development+of+EEG+diagnostics+and+biofeedback+for+attention-deficit/hyperactivity+disorders.">Discourse on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity disorders.</a> Appl Psychophys Biof. 16 (3), 201-225 (1991).</li><li>Monastra, V. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+attention+deficit+hyperactivity+disorder+via+Quantified+Electroencephalography:+An+initial+validation+study.">Assessing attention deficit hyperactivity disorder via Quantified Electroencephalography: An initial validation study.</a> Neuropsychol. 13 (3), 424-433 (1999).</li><li>Hall, C. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+clinical+utility+of+the+continuous+performance+test+and+objective+measures+of+activity+for+diagnosing+and+monitoring+ADHD+in+children:+a+systematic+review.">The clinical utility of the continuous performance test and objective measures of activity for diagnosing and monitoring ADHD in children: a systematic review.</a> Eur Child Adolesc Psych. 25 (7), 677-699 (2016).</li><li>Barbaresi, W. J., Katusic, S. K., Colligan, R. C., Weaver, A. L., Jacobsen, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modifiers+of+long-term+school+outcomes+for+children+with+attention-deficit/hyperactivity+disorder:+does+treatment+with+stimulant+medication+make+a+difference?+Results+from+a+population-based+study.">Modifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: does treatment with stimulant medication make a difference? Results from a population-based study.</a> J Dev Behav Pediatr. 28 (4), 274-287 (2007).</li><li>Rodr&#237;guez, C., Gonz&#225;lez-Castro, P., Cueli, M., Areces, D., Gonz&#225;lez-Pienda, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Attention+deficit/hyperactivity+disorder+(ADHD)+diagnosis:+an+activation-executive+model.">Attention deficit/hyperactivity disorder (ADHD) diagnosis: an activation-executive model.</a> Front Psychol. 7, (2016).</li><li>Gonz&#225;lez-Castro, P., Rodr&#237;guez, C., L&#243;pez, &. #. 1. 9. 3. ;., Cueli, M., &#193;lvarez, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Attention+deficit+hyperactivity+disorder,+differential+diagnosis+with+blood+oxygenation,+beta/theta+ratio,+and+attention+measures.">Attention deficit hyperactivity disorder, differential diagnosis with blood oxygenation, beta/theta ratio, and attention measures.</a> Int J Clinical and Health Psycho. 13 (2), 101-109 (2013).</li><li>Farr&#233;, A., Narbona, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> EDAH: Scale for the assessment of attention deficit hyperactivity disorder. , (2001).</li><li>Wechsler, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Wechsler Intelligence Scale for Children- 4th edition. , (2005).</li><li>Climent, G., Banterla, F., Iriarte, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> AULA: Theoretical manual. , (2011).</li><li>Greenberg, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Developmental+normative+data+on+the+Test+of+Variables+of+Attention+(TOVA).">Developmental normative data on the Test of Variables of Attention (TOVA).</a> J Child Psychol Psyc. 34, 1019-1030 (1993).</li><li>Toomim, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intentional+increase+of+cerebral+blood+oxygenation+using+hemoencephalography:+an+efficient+brain+exercise+therapy.">Intentional increase of cerebral blood oxygenation using hemoencephalography: an efficient brain exercise therapy.</a> J Neurother. 8, 5-21 (2005).</li><li>Gonz&#225;lez-Castro, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cortical+activation+and+attentional+control+in+ADHD+subtypes.">Cortical activation and attentional control in ADHD subtypes.</a> Int J Clin Health Psycho. 10 (1), 23-39 (2010).</li><li>Garc&#237;a, T., Gonz&#225;lez-Castro, P., Areces, D., Cueli, M., Rodr&#237;guez, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Executive+functions+in+children+and+adolescents:+The+types+of+assessment+measures+used+and+implications+for+their+validity+in+clinical+and+educational+contexts.">Executive functions in children and adolescents: The types of assessment measures used and implications for their validity in clinical and educational contexts.</a> Papeles del Psic&#243;logo. 35, 215-233 (2014).</li></ol>

以上列出的作者证明, 本研究没有任何金融利益或其他利益冲突。

在这里, 我们提出一个有效的协议, 以评估多动症从6-16 岁。鉴于 ADHD 的症状复杂性及其高患病率, 专业人员必须有可靠和有效的仪器来诊断这种紊乱。通常, 基于行为观察的问卷调查被广泛应用。然而, 使用这些文书作为唯一的评估措施有一定的限制, 包括观察员18部分的潜在主观性。
正如研究结果所显示的, 这个协议强调了一个参与者与 adhd 的区别, 而不是 ad...

本议定书的总目标是制定一个完整的程序或评估模式, 以诊断注意缺陷多动障碍, 否则称为 ADHD。ADHD 是影响学业成绩的问题之一。据了解, 这是一种以注意力、抑制控制和多动症为特点的紊乱, 其性能明显低于对等1,2。最新版本的精神疾病诊断和统计手册 (DSM)1包括来自早期版本的不同更新: ADHD 被归类为神经发育紊乱;症状出现的年龄增加了, 所以现在症状可以在12岁之前表现出来;多动症陈述的期限应该使用而不是亚型 (主要地过度活跃或冲动; 主要地不留神; 并且联合表示法和);最后, 它已被接受为与自闭症频谱紊乱症的共病。
根据分析的国家或地区, 有不同的患病率估计,3,4,5。国际全球系统的3审查观察到平均患病率为5.29%。然而, 根据《精神疾病诊断和统计手册》的标准,4的百分比从5.9 到7.1% 不等。同样, 西班牙人口中 ADHD 的 meta 分析提供了平均 6.8%5。患病率的变化可能是由于使用了不同的评估协议。
虽然有大量的研究表明神经学基础的 ADHD, 这种紊乱的起源仍然不清楚。一些研究将多动症症状与脑皮质 hypoactivation 相关联, 这与多巴胺和肾上腺素能系统中的缺陷有关 6.肾上腺素能系统模块的选择性注意和激活水平需要执行任务。另一方面, 多巴胺能系统负责抑制控制, 无论是在执行和激励水平。与多巴胺和肾上腺素能系统相关的低皮质活化被认为是多动症患者的抑制和注意力缺陷的基础。从这个意义上说, 多动症患儿显示在多巴胺和肾上腺素能系统中皮质活化低, 这是由不同的电皮质活动的外形表现出的休息状态, 证明由增加θ-和减少 beta 活动7、8以及 Fp1 (额叶前左侧) 和 FPz/Cz (前前额皮质中心区) 的血液氧合水平较低。
血液氧合是用近红外光谱测量 HEG, 它使用功能近红外线光谱学测量大脑血液中的颜色变化, 以表明氧饱和度区域;含氧血是鲜红的, 而脱氧血是一种深, 几乎略带紫红色。皮质活化是用量化的脑电图 (Q 脑电图) 来测量的。这是一个电脑脑电图系统, 记录大脑中的电活动, 通过β/θ比值提供皮质活化水平。它从总体上衡量注意力, 独立于正在执行的任务。其他研究集中在多动症人群中存在执行功能 (EF) 损害的问题9, 这将解释患有 adhd 的儿童有控制冲动反应、抵抗干扰或分心的困难,以连续的方式组织活动, 并在执行活动时保持认知努力。
通常, 这些症状的 ADHD 有严重的后果, 导致困难的学术, 社会和家庭环境。患有 adhd 的儿童比没有 adhd 的儿童, 在学校重复评分和/或完成学业成绩的几率较高。此外, 辍学率在青少年中的几率是三倍, 多动症10,11。
考虑到目前版本的精神障碍诊断和统计手册中多动症的修改和新分类1, 有关确定特定大脑皮质活化水平关系的结果区域、执行函数和诊断相关变量7,8,11,12 (i. e, 三种多动症演示文稿之间的差异)。
多动症识别中最常见的问题之一是由于缺乏全球评估协议而导致的疾病过度诊断。专业人士没有基于客观变量的一般协议, 造成多动症的假阳性和假阴性病例占很大比例。这种情况突显出, 专业人士和临床医生需要有一个明确的议定书, 不仅考虑有关的变数, 而且还审议它们之间的关系。
因此, 来自奥维耶大大学的学校学习、困难和学术表现研究小组 (ADIR) 一直致力于制定一项完整的 identifyprofiles 皮质活化和执行控制的协议, 以提供一个比目前使用的多动症更客观的诊断。这个协议是特别重要的, 因为它考虑到的事实, 皮质活化在前额和前额皮质影响执行功能。目前的协议将是有用的临床医生谁有兴趣执行一个完整的评估, 考虑在诊断中的相关变量之间的相互作用。为此, 该议定书基于罗德里格斯et提出的最近一项研究的评估模型。其中考虑到皮层激活和执行变量之间的交互 (图 1)。
总之, 本议定书的目的是为这一发育紊乱提供一个较现有的更客观的诊断程序, 并深入分析激活措施与执行功能措施之间的关系。该程序还将考虑多动症的一些假设决定因素, 无论是在大脑的某些区域激活与执行功能的不同方面 (如遗漏) 的不同表现之间的关系,佣金或响应时间。

<table border="0" cellpadding="0" cellspacing="0" width="1075">
	<tbody>
		<tr height="160">
			<td height="160" style="height:160px;width:216px;">EDAH&#160;</td>
			<td style="width:163px;">TEA Company</td>
			<td style="width:344px;"></td>
			<td style="width:352px;">It is a Scale for the Assessment of ADHD that was administered to families and/or teachers. 
			&#160;It comprises 20 items that provide information on the presence of symptoms relating to attention deficit and hyperactivity/impulsivity, and helps differentiate between the threes subtypes of ADHD. A score above 90% in its subscales indicates attention deficit, hyperactivity/ impulsivity problems, or both.</td>
		</tr>
		<tr height="80">
			<td height="80" style="height:80px;">Wisc-IV R</td>
			<td>TEA Company</td>
			<td></td>
			<td style="width:352px;">The WISC-IV by Wechsler (2005) is a tool that assesses 
			individual intelligence in children and adolescents between 
			the ages of 6 years and 16 years 11 months.</td>
		</tr>
		<tr height="123">
			<td height="123" style="height:123px;">QEEG</td>
			<td>Neurobics pocket</td>
			<td></td>
			<td style="width:352px;">Q-EEG (quantified electroencephalogram) is a computerized EEG system, 
			adapted by Toomin, which provides levels of cortical activation through 
			the beta/theta ratio. It measures attention in general, independently of the task to be performed.</td>
		</tr>
		<tr height="101">
			<td height="101" style="height:101px;">NIR-HEG</td>
			<td>Brain trainer company</td>
			<td></td>
			<td style="width:352px;">it is a tool used to measure blood oxygenation in expressly selected areas. The nir-HEG employs the translucent property of biological tissue, and low-frequency red and infrared lights with light emitting diodes (LED optodes).&#160;</td>
		</tr>
		<tr height="160">
			<td height="160" style="height:160px;">AULA Nesplora</td>
			<td>Nesplora Company</td>
			<td></td>
			<td style="width:352px;">It is a Continuous Performance Test that evaluates attention, impulsivity, processing speed, and motor activity in participants between 6 and 16 years of age. 
			The task is performed in a virtual reality environment, 
			which is shown through three-dimensional (3D) glasses 
			(Head Mounted Display, HMD) equipped with motion 
			sensors and headphones.&#160;</td>
		</tr>
		<tr height="172">
			<td height="172" style="height:172px;">T.O.V.A (Test of Variables of Attention)</td>
			<td>The T.O.V.A.&#160; Company</td>
			<td>T.O.V.A. 8 kit</td>
			<td style="width:352px;">T.O.V.A. is an objective, accurate, and FDA cleared continuous performance test&#160; (CPT) that measures the key components of attention and inhibitory control. 
			The T.O.V.A. is used by qualified healthcare professionals as an aid in the assessment 
			of attention deficits, including attention-deficit/hyperactivity disorder (ADHD), in children and adults.</td>
		</tr>
	</tbody>
</table>

using brain activation (nir-heg/q-eeg) and execution measures (cpts) in a adhd assessment protocol

注意缺陷多动障碍 (ADHD) 是一个影响学业成绩的问题, 并产生严重的后果, 导致在学术, 社会和家庭环境的困难。查明这一疾病的最常见的问题之一是, 由于缺乏全球评估协议, 对疾病的诊断明显过度。来自奥维耶大大学的学校学习、困难和学术表现研究小组 (ADIR) 制定了一项完整的协议, 建议存在一定的皮质活化模式和执行控制, 以确定多动症更客观。本议定书考虑了多动症的一些假设性决定因素, 包括激活大脑中选定区域的关系, 以及在执行职能 (如遗漏) 的各个方面表现上的差异,佣金或响应时间, 使用持续性能测试的创新工具 (基于虚拟现实的 cpt 和传统的 cpt) 和大脑激活措施 (基于 Hemoencephalography-nirHEG 的两种不同的工具, 并量化脑电图-Q 脑电图, 分别)。这种评估模式的目的是提供一个有效的评估 ADHD 症状, 以便设计一个准确的干预, 并提出适当的建议, 为家长和教师。

利用这里提出的评估程序, 有可能对多动症症状进行有效的评估, 以便设计出准确的干预措施, 并为家长和教师提出建议。以下是一个参与者的一系列代表性的结果, 多动症和参与者没有 adhd, 这将使专业人士看到两个侧面的差异。
一旦临床医生得到了家属的知情同意, 就对儿童实施认知量表 (WISC IV), 以排除目前能力低下或高容量...

Watch this Scientific Journal Video about Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol at JoVE.com

Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol

这项工作提出了一个新的协议, 以评估注意缺陷多动障碍 (ADHD) 通过提供一个更客观的诊断程序, 这一发展障碍的基础上使用的创新工具。并分析了活化措施与执行功能测度之间的关系。

使用脑激活 (近红外 HEG/Q 脑电图) 和执行措施 (CPTs) 的 ADHD 评估协议

Attention Deficit Hyperactivity Disorder (ADHD) is a problem that impacts academic performance and has serious consequences that result in difficulties in ...

using-brain-activation-nir-hegq-eeg-execution-measures-cpts-adhd

Research

JoVE Journal

Neuroscience

Using Brain Activation (nir-HEG/Q-EEG) and Execution Measures (CPTs) in a ADHD Assessment Protocol

10.1K 次观看.  Oviedo University. 这项工作提出了一个新的协议, 以评估注意缺陷多动障碍 (ADHD) 通过提供一个更客观的诊断程序, 这一发展障碍的基础上使用的创新工具。并分析了活化措施与执行功能测度之间的关系。

视频: Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol

The Vermicelli and Capellini Handling Tests: Simple quantitative measures of dexterous forepaw function in rats and mice

Previous characterizations of rodent eating behavior have revealed that they use coordinated forepaw movements to manipulate food pieces. We have extended upon this work to develop a simple quantitative measure of forepaw dexterity that is sensitive to lateralized impairments and age-dependent changes. Rodents learn skillful forepaw and digit movements to manage thin pasta pieces, which they eagerly consume. We have previously described methods for quantifying vermicelli handling in rats and showed that the measures are very sensitive to forelimb impairments resulting from unilateral ischemic lesions, middle cerebral artery occlusions and unilateral striatal dopamine depletion [Allred, R.P., Adkins, D.L., Woodlee, M.T., Husbands, L.C., Maldonado M.A., Kane, J.R., Schallert, T. &amp; Jones, T.A. The Vermicelli Handling Test: a simple quantitative measure of dexterous forepaw function in rats. J. Neurosci. Methods 170, 229-244 (2008)]. Here we present a more detailed protocol for this test in rats and compare it with a newly developed version for mice, the Capellini Handling Test. Rats and mice are videotaped while handling short lengths of uncooked vermicelli or capellini pasta, respectively, with a camera positioned to optimize the view of paw movements. Slow motion video playback allows for the identification of forepaw adjustments, defined as any distinct removal and replacement of the paw, or of any number of digits, on the pasta piece after eating commences. Forepaw adjustments per piece are averaged over trials per each testing session. Repeated testing permits sensitive quantitative analysis of changes in forepaw dexterity over time. Protocols for pre-testing habituation and handling practice, as well as procedures for characterizing atypical handling patterns, are described. Because rats and mice perform the pasta handling tests slightly differently, species-specific differences in administration and scoring of these tests are highlighted. All animal use was in accordance with protocols approved by the University of Texas at Austin Animal Care and Use Committee.

The Vermicelli and Capellini Handling Tests of forepaw dexterity take advantage of the natural inclination of rodents to manipulate food items using skillful forepaw and digit movements. Animals are videotaped while handling short strands of uncooked dry pasta. Slow motion video playback allows for the quantification of forepaw adjustments.

粉条和Capellini处理测试：在大鼠和小鼠的灵巧的前爪功能简单的定量措施

Previous characterizations of rodent eating behavior have revealed that they use coordinated forepaw movements to manipulate food pieces. We have extended ...

科研

神经科学

TMS: Using the Theta-Burst Protocol to Explore Mechanism of Plasticity in Individuals with Fragile X Syndrome and Autism

Fragile X Syndrome (FXS), also known as Martin-Bell Syndrome, is a genetic abnormality found on the X chromosome.1,2 Individuals suffering from FXS display abnormalities in the expression of FMR1 - a protein required for typical, healthy neural development.3 Recent data has suggested that the loss of this protein can cause the cortex to be hyperexcitable thereby affecting overall patterns of neural plasticity.4,5
In addition, Fragile X shows a strong comorbidity with autism: in fact, 30% of children with FXS are diagnosed with autism, and 2 - 5% of autistic children suffer from FXS.6
Transcranial Magnetic Stimulation (a non-invasive neurostimulatory and neuromodulatory technique that can transiently or lastingly modulate cortical excitability via the application of localized magnetic field pulses 7,8) represents a unique method of exploring plasticity and the manifestations of FXS within affected individuals. More specifically, Theta-Burst Stimulation (TBS), a specific stimulatory protocol shown to modulate cortical plasticity for a duration up to 30 minutes after stimulation cessation in healthy populations, has already proven an efficacious tool in the exploration of abnormal plasticity.9,10 
Recent studies have shown the effects of TBS last considerably longer in individuals on the autistic spectrum - up to 90 minutes.11 This extended effect-duration suggests an underlying abnormality in the brain's natural plasticity state in autistic individuals - similar to the hyperexcitability induced by Fragile X Syndrome.
In this experiment, utilizing single-pulse motor-evoked potentials (MEPs) as our benchmark, we will explore the effects of both intermittent and continuous TBS on cortical plasticity in individuals suffering from FXS and individuals on the Autistic Spectrum.

In this article, we examine the effects of Theta-Burst TMS stimulation on cortical plasticity in individuals suffering from Fragile X syndrome and individuals on the autistic spectrum.

TMS:使用的Theta突发协议，以探索个人与脆性X综合征与孤独症的可塑性Mechasnism

Fragile X Syndrome (FXS), also known as Martin-Bell Syndrome, is a genetic abnormality found on the X chromosome.1,2 Individuals suffering from FXS ...

Live-cell Measurement of Odorant Receptor Activation Using a Real-time cAMP Assay

The enormous sizes of the mammalian odorant receptor (OR) families present difficulties to find their cognate ligands among numerous volatile chemicals. To efficiently and accurately deorphanize ORs, we combine the use of a heterologous cell line to express mammalian ORs and a genetically modified biosensor plasmid to measure cAMP production downstream of OR activation in real time. This assay can be used to screen odorants against ORs and vice versa. Positive odorant-receptor interactions from the screens can be subsequently confirmed by testing against various odor concentrations, generating concentration-response curves. Here we used this method to perform a high-throughput screening of an odorous compound against a human OR library expressed in Hana3A cells and confirmed that the positively-responding receptor is the cognate receptor for the compound of interest. We found this high-throughput detection method to be efficient and reliable in assessing OR activation and our data provide an example of its potential use in OR functional studies.

Characterizing the function of odorant receptors serves an indispensable part in the deorphanization process. We describe a method to measure the activation of odorant receptors in real time using a cAMP assay.

实时 cAMP 检测气味受体激活的活细胞测量

The enormous sizes of the mammalian odorant receptor (OR) families present difficulties to find their cognate ligands among numerous volatile chemicals. ...

Studying Brain Function in Children Using Magnetoencephalography

Magnetoencephalography (MEG) is a non-invasive neuroimaging technique which directly measures magnetic fields produced by the electrical activity of the human brain. MEG is quiet and less likely to induce claustrophobia compared with magnetic resonance imaging (MRI). It is therefore a promising tool for investigating brain function in young children. However, analysis of MEG data from pediatric populations is often complicated by head movement artefacts which arise as a consequence of the requirement for a spatially-fixed sensor array that is not affixed to the child's head. Minimizing head movements during MEG sessions can be particularly challenging as young children are often unable to remain still during experimental tasks. The protocol presented here aims to reduce head movement artefacts during pediatric MEG scanning. Prior to visiting the MEG laboratory, families are provided with resources that explain the MEG system and the experimental procedures in simple, accessible language. An MEG familiarization session is conducted during which children are acquainted with both the researchers and the MEG procedures. They are then trained to keep their head still whilst lying inside an MEG simulator. To help children feel at ease in the novel MEG environment, all of the procedures are explained through the narrative of a space mission. To minimize head movement due to restlessness, children are trained and assessed using fun and engaging experimental paradigms. In addition, children's residual head movement artefacts are compensated for during the data acquisition session using a real-time head movement tracking system. Implementing these child-friendly procedures is important for improving data quality, minimizing participant attrition rates in longitudinal studies, and ensuring that families have a positive research experience.

This article introduces a child-friendly research protocol designed to improve data quality by reducing head movement during pediatric magnetoencephalography (MEG). We familiarize families with the MEG environment, train children to remain still using an MEG simulator, and correct for residual head movement artefacts using a real-time head movement detection system.

脑磁图在儿童脑功能研究中的应用

Magnetoencephalography (MEG) is a non-invasive neuroimaging technique which directly measures magnetic fields produced by the electrical activity of the ...

Real-time In Vitro Monitoring of Odorant Receptor Activation by an Odorant in the Vapor Phase

Olfactory perception begins with the interaction of odorants with odorant receptors (OR) expressed by olfactory sensory neurons (OSN). Odor recognition follows a combinatorial coding scheme, where one OR can be activated by a set of odorants and one odorant can activate a combination of ORs. Through such combinatorial coding, organisms can detect and discriminate between a myriad of volatile odor molecules. Thus, an odor at a given concentration can be described by an activation pattern of ORs, which is specific to each odor. In that sense, cracking the mechanisms that the brain uses to perceive odor requires the understanding odorant-OR interactions. This is why the olfaction community is committed to &#34;de-orphanize&#34;&#160;these receptors. Conventional in vitro systems used to identify odorant-OR interactions have utilized incubating cell media with odorant, which is distinct from the natural detection of odors via vapor odorants dissolution into nasal mucosa before interacting with ORs. Here, we describe a new method that allows for real-time monitoring of OR activation via vapor-phase odorants. Our method relies on measuring cAMP release by luminescence using the Glosensor assay. It bridges current gaps between in vivo and in vitro approaches and provides a basis for a biomimetic volatile chemical sensor.

Physiologically, odorant receptors are activated by odorant molecules inhaled in the vapor phase. However, most in vitro systems utilize liquid phase odorant stimulation. Here, we present a method that allows real-time in vitro monitoring of odorant receptor activation upon odorant stimulation in vapor phase.

气相臭受体活化的实时体外监测

Olfactory perception begins with the interaction of odorants with odorant receptors (OR) expressed by olfactory sensory neurons (OSN). Odor recognition ...

Assessment of Long-term Depression Induction in Adult Cerebellar Slices

Synaptic plasticity provides a mechanism for learning and memory. For cerebellar motor learning, long-term depression (LTD) of synaptic transmissions from parallel fibers (PF) to Purkinje cells (PC) is considered the basis for motor learning, and deficiencies of both LTD and motor learning are observed in various gene-manipulated animals. Common motor learning sets, such as adaptation of the optokinetic reflex (OKR), the vestibular-ocular reflex (VOR), and rotarod test were used for evaluation of motor learning ability. However, results obtained from the GluA2-carboxy terminus modified knock-in mice demonstrated normal adaptation of the VOR and the OKR, despite lacking PF-LTD. In that report, induction of LTD was only attempted using one type of stimulation protocol at room temperature. Thus, conditions to induce cerebellar LTD were explored in the same knock-in mutants using various protocols at near physiological temperature. Finally, we found stimulation protocols, by which LTD could be induced in these gene-manipulated mice. In this study, a set of protocols are proposed to evaluate LTD-induction, which will more accurately allow examination of the causal relationship between LTD and motor learning. In conclusion, experimental conditions are crucial when evaluating LTD in gene-manipulated mice.

In some gene-manipulated animals, using a single protocol may fail to induce LTD in cerebellar Purkinje cells, and there may be a discrepancy between LTD and motor learning. Multiple protocols are necessary to assess LTD-induction in gene-manipulated animals. Standard protocols are shown.

成人脑切片长期抑郁症诱导评估

Synaptic plasticity provides a mechanism for learning and memory. For cerebellar motor learning, long-term depression (LTD) of synaptic transmissions from ...

Stimulation Location Determination using a 3D Digitizer with High-Definition Transcranial Direct Current Stimulation

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, causal evidence of brain area activation leading to a behavior is often left missing. Transcranial direct current stimulation (tDCS), which can temporarily alter brain cortical excitability and activity, is a noninvasive neurophysiological tool used to study causal relationships in the human brain. High-definition transcranial direct current stimulation (HD-tDCS) is a noninvasive brain stimulation (NIBS) technique that produces a more focal current compared to conventional tDCS. Traditionally, the stimulation location has been roughly determined through the 10-20 EEG system, because determining precise stimulation points can be difficult. This protocol uses a 3D digitizer with HD-tDCS to increase accuracy in determination of stimulation points. The method is demonstrated using a 3D digitizer for more accurate localization of stimulation points in the right temporo-parietal junction (rTPJ).

Presented here is a protocol to achieve higher accuracy in determination of stimulation location combining a 3D digitizer with high-definition transcranial direct current stimulation.

使用具有高清晰度颅内直接电流刺激的 3D 数字化仪确定刺激位置

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, ...

Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics

Anesthetics influence consciousness in part via their actions on thalamocortical circuits. However, the extent to which volatile anesthetics affect distinct cellular and network components of these circuits remains unclear. Ex vivo brain slices provide a means by which investigators may probe discrete components of complex networks and disentangle potential mechanisms underlying the effects of volatile anesthetics on evoked responses. To isolate potential cell type- and pathway-specific drug effects in brain slices, investigators must be able to independently activate afferent fiber pathways, identify non-overlapping populations of cells, and apply volatile anesthetics to the tissue in aqueous solution. In this protocol, methods to measure optogenetically-evoked responses to two independent afferent pathways to neocortex in ex vivo brain slices are described. Extracellular responses are recorded to assay network activity and targeted whole-cell patch clamp recordings are conducted in somatostatin- and parvalbumin-positive interneurons. Delivery of physiologically relevant concentrations of isoflurane via artificial cerebral spinal fluid to modulate cellular and network responses is described.

Ex vivo brain slices can be used to study the effects of volatile anesthetics on evoked responses to afferent inputs. Optogenetics are employed to independently activate thalamocortical and corticocortical afferents to non-primary neocortex, and synaptic and network responses are modulated with isoflurane.

脑切片中传入通路的光遗传学激活和挥发性麻醉剂对反应的调节

Anesthetics influence consciousness in part via their actions on thalamocortical circuits. However, the extent to which volatile anesthetics affect ...

Whole-Brain 3D Activation and Functional Connectivity Mapping in Mice using Transcranial Functional Ultrasound Imaging

Functional ultrasound (fUS) imaging is a novel brain imaging modality that relies on the high-sensitivity measure of the cerebral blood volume achieved by ultrafast doppler angiography. As brain perfusion is strongly linked to local neuronal activity, this technique allows the whole-brain 3D mapping of task-induced regional activation as well as resting-state functional connectivity, non-invasively, with unmatched spatio-temporal resolution and operational simplicity. In comparison with fMRI (functional magnetic resonance imaging), a main advantage of fUS imaging consists in enabling a complete compatibility with awake and behaving animal experiments. Moreover, fMRI brain mapping in mice, the most used preclinical model in Neuroscience, remains technically challenging due to the small size of the brain and the difficulty to maintain stable physiological conditions. Here we present a simple, reliable and robust protocol for whole-brain fUS imaging in anesthetized and awake mice using an off-the-shelf commercial fUS system with a motorized linear transducer, yielding significant cortical activation following sensory stimulation as well as reproducible 3D functional connectivity pattern for network identification.

This protocol describes the quantification of volumetric cerebral hemodynamic variations in the mouse brain using functional ultrasound (fUS). Procedures for 3D functional activation map following sensory stimulation as well as resting-state functional connectivity are provided as illustrative examples, in anesthetized and awake mice.

使用经颅功能超声成像的小鼠全脑3D激活和功能连接映射

Functional ultrasound (fUS) imaging is a novel brain imaging modality that relies on the high-sensitivity measure of the cerebral blood volume achieved by ...

In vivo Assessment of Microtubule Dynamics and Orientation in Caenorhabditis elegans Neurons

In neurons, microtubule orientation has been a key assessor to identify axons that have plus-end out microtubules and dendrites that generally have mixed orientation. Here we describe methods to label, image, and analyze the microtubule dynamics and growth during the development and regeneration of touch neurons in C. elegans. Using genetically encoded fluorescent reporters of microtubule tips, we imaged the axonal microtubules. The local changes in microtubule behavior that initiates axon regeneration following axotomy can be quantified using this protocol. This assay is adaptable to other neurons and genetic backgrounds to investigate the regulation of microtubule dynamics in various cellular processes.