KISEP Original Articles 8 2 1997 Korean J Child & Adol Psychiatr 8273~286 주의력결핍 과잉행동장애아동에서 Methylphenidate 에의한사건관련전위와 연속과제수행변화사이의상관성 RELATIONSHIP BETWEEN CHANGES IN EVENT-RELATED POTENTIALS AND CHANGES IN CONTINUOUS PERFORMANCE TEST UNDER THE INFLUENCE OF METHYLPHENIDATE IN ATTENTION-DEFICITHYPERACTIVITY DISORDER 이미숙 * 최영 * 이무석 * Mi Suk Lee, M.D.,* Young Choi, M.D.,* Mu Suk Lee, M.D.* 요약 중심단어 서 론 Department of Psychiatry, Chonnam National University Hospital, Kwangju Corresponding author 273
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1. 연구대상 연구대상및방법 2. 연구절차 275
3. 도구 1) 부모평정척도 2) 신경심리학적검사 3) 사건관련전위 276
4. 자료의분석 결 1. 사건관련전위 1) 잠복기 과 Table 1. Characteristics of the subjects SexMaleFemale N11 110 Median2575% HandednessRtLt 110 Previous stimulant therapyyesno 101 Family historyyesno 011 Physical illness history yesno 011 Agemonth 100.00 89.00103.00 Educationyear 2.00 1.00 3.00 KEDI-WISC Full scale IQ* 109.00 95.00120.00 KEDI-WISC Verbal IQ* 118.00100.00125.00 KEDI-WISC Performance IQ* 107.00 93.00119.00 CAPRS 16.00 16.00 16.00 Methylphenidate dosage 12.50 12.50 14.00 *Korean Wechsler Intelligent Scale for Children Conner s Abbreviated Parent Rating Scale 277
2) 진폭 Table 2. Effects of methylphenidate on latencies of N1, P2, N2, P3 waves to the nontarget stimuli at Cz, Fz, Pz, Oz leads SubjectsN11 LeadsERP waves N1 P2 N2 P3 Median2575% Cz Before 94.00 158.00 232.00 402.00 82.00150.00 130.00204.00 222.00296.00 350.00466.00 94.00 136.00 236.00 348.00 84.00162.00 124.00214.00 210.00270.00 300.00428.00 Fz Before 140.00 158.00 240.00 402.00 90.00154.00 128.00202.00 210.00262.00 346.00460.00 112.00 176.00 238.00 342.00* 82.00162.00 124.00248.00 202.00264.00 310.00416.00 Pz Before 102.00 170.00 256.00 444.00 78.00150.00 158.00204.00 232.00284.00 324.00476.00 118.00 172.00 300.00 416.00 86.00166.00 140.00218.00 236.00338.00 348.00436.00 Oz Before 120.00 172.00 288.00 408.00 90.00136.00 158.00208.00 240.00328.00 370.00468.00 98.00 156.00 244.00 378.00 70.00124.00 136.00178.00 222.00316.00 318.00-428.00 *.01 Note:ERP waves:event-related potential waves Table 3. Effects of methylphenidate on latencies of N1, P2, N2, P3 waves to the target stimuli at Cz, Fz, Pz, Oz leads SubjectsN11 LeadsERP waves N1 P2 N2 P3 Median2575% Cz Before 118.00 180.00 246.00 406.00 80.00150.00 152.00232.00 232.00308.00 360.00422.00 124.00 176.00 246.00 350.00 88.00148.00 160.00228.00 216.00190.00 304.00428.00 Fz Before 120.00 184.00 246.00 408.00 100.00158.00 160.00220.00 200.00310.00 354.00438.00 118.00 170.00 244.00 376.00 84.00148.00 138.00238.00 224.00302.00 346.00430.00 Pz Before 114.00 178.00 272.00 408.00 80.00150.00 150.00208.00 246.00310.00 348.00464.00 98.00 168.00 240.00 360.00 88.00134.00 154.00218.00 206.00298.00 306.00382.00 Oz Before 110.00 170.00 256.00 370.00 86.00118.00 148.00222.00 226.00308.00 328.00418.00 98.00 150.00 260.00 342.00 82.00124.00 140.00176.00 232.00288.00 316.00378.00 Note:ERP waves:event-related potential waves 278
2. 연속과제수행검사 Table 4. Effects of methylphenidate on amplitudes of N1, P2, N2, P3 waves to the nontarget stimuli at Cz, Fz, Pz, Oz leads SubjectsN11 LeadsERP waves V Cz Before Fz Before Pz Before Oz Before N1 P2 N2 P3 Median2575% 1.89 2.45 3.98 4.59 2.57 0.13 1.104.18 6.490.55 2.815.51 0.86 2.45 4.04 4.85 3.18 0.24 1.224.16 5.940.95 2.386.12 1.60 1.40 3.55 3.67 5.51 0.79 1.223.00 7.591.47 3.185.15 2.57 1.34 5.14 3.06 6.030.12 1.962.95 7.720.42 1.226.12 0.61 1.53 1.96 3.55 2.27 0.29 0.183.61 4.270.91 2.244.28 0.49 2.51 1.96 4.82 1.92 0.67 0.614.41 4.16 2.08 2.696.86 0.76 2.30 2.69 2.90 2.230.24 1.283.11 3.920.12 2.513.43 1.47 2.32 2.09 2.69 3.43 0.49 0.125.02 4.53 0.25 1.476.98 Note:ERP waves:event-related potential waves Table 5. Effects of methylphenidate on amplitudes of N1, P2, N2, P3 waves to the target stimuli at Cz, Fz, Pz, Oz leads SubjectsN11 LeadsERP waves N1 P2 N2 P3 V Median2575% Cz Before 2.20 2.57 1.83 5.75 5.880.61 1.835.51 4.04 1.47 3.43 9.92 0.61 4.10 1.10 8.21** 4.28 0.49 2.326.63 2.32 1.47 5.5112.37 Fz Before 1.83 0.55 3.43 6.31 10.79 0.30 5.454.53 5.750.36 2.94 9.31 3.18 1.65 2.45 8.08 4.410.11 0.492.45 5.630.61 3.1811.27 Pz Before 0.24 1.59 1.22 3.43 2.45 0.12 0.492.94 4.770.12 2.75 6.98 0.67 4.16* 0.24 5.63 3.92 0.98 1.837.10 1.71 0.36 4.16 8.82 Oz Before 0.85 2.69 1.61 5.14 5.140.85 1.965.75 8.940.85 1.99 6.12 0.00 6.61* 1.22 6.00 4.41 2.08 3.188.21 6.00 1.10 3.7311.51 *.05 **.01 Note:ERP waves:event-related potential waves 279
Table 6. Effects of methylphenidate on continuous performance test CPT SubjectsN11 Paradigm OE CE Hit RT Hits d X Before 12.00 23.00 438.78 312.00 1.10 0.23 4.0020.00 13.0028.00 384.92517.50 304.00320.00 0.671.77 0.130.39 1.00** 18.00* 420.07 323.00* 3.01** 0.15 0.0010.00 1.0024.00 348.55485.67 314.00324.00 1.443.93 0.120.34 AX Before 2.00 7.50 405.31 37.50 3.61 1.86 1.00 3.50 4.7516.50 358.45487.12 36.50 39.00 2.944.36 0.503.68 0.50 2.50 385.25 39.50 4.77** 1.56 0.00 3.25 1.00 5.75 324.68483.85 36.75 40.00 4.275.61 1.217.08 *.05 **.01 Note:CPT:Continuous performance test OE:Omission error CE:Commission error Hits:The number of responses to targets Hit RT:Hit reaction time d :Sensitivity β:criterion bias Table 7. Correlation between changes in event-related po-tential and changes in continuous performance test ERP changescpt changes X Paradigm AX Paradigm OE CE Hits d CE d CTAP3.014.409.028.82.080.249 FSLP3.303.105.330.345.037.598* OTAP2.433.055.432.096.448.000 PTAP2.406.173.340.569*.239.049 *.05 Note:CPT:Continuous performance test X-Paradigm:CPT X-Paradigm AX-Paradigm:CPT AX-Pardigm OE:Omission Error CE:Commission Error Hits:The number of correct response to targets d :Perceptual sensitivity β:criterion bias ERP:Event related potential CTAP3:P3 amplitude to target stimuli at Cz FSLP3:P3 latency to nontarget stimuli at Fz OTAP2:P2 amplitude to target stimuli at Oz PTAP2:P2 amplitude to target stimuli at Pz 3. 사건관련전위변화와연속과제수행변화사이의관계 고찰 280
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ABSTRACT Korean J Child & Adol Psychiatr 8273~286, 1997 RELATIONSHIP BETWEEN CHANGES IN EVENT-RELATED POTENTIALS AND CHANGES IN CONTINUOUS PERFORMANCE TEST UNDER THE INFLUENCE OF METHYLPHENIDATE IN ATTENTION-DEFICITHYPERACTIVITY DISORDER Mi Suk Lee, M.D., Young Choi, M.D., Mu Suk Lee, M.D. Department of Psychiatry, Chonnam National University Hospital, Kwangju ObjectiveThis study was designed to evaluate effects of methylphenidatemph on event-related potentialserp and continuous performance testcpt in attention-deficit hyperactivity disorder ADHD and to see the correlation between changes in ERP and changes in performance. MethodERP and CPT were used to examine the acute effects of MPH0.5mgkg in eleven ADHD boys89103 months old. Results 1 MPH administration, P3 latency to nontarget stimuli at Fz was significantly decreased p0.01 and P2 amplitudes to target stimuli at Pz and at Oz and P3 amplitude to target stimuli at Cz were significantly increasedp0.05. 2 Commission error and omission error in the CPT-X and commission error in the CPT-AX were decreasedp0.01, and hits and perceptual sensitivityd in the CPT-X and din the CPT-AX were increasedp0.01. 3 The change of P3 latency to nontarget stimuli at Fz and the change of din the CPT-X were negatively correlatedp0.05, and the change of P2 amplitude to target stimuli at Pz and din the CPT-AX were positively correlatedp0.05. ConclusionMPH improves change orienting reaction, the delivery of task relevant information, accuracy and perceptual sensitivity in ADHD. And the increase of ability to discriminate targets from non-targets reflects reduced evaluation time in large memory component task and enhanced change orienting reaction in simple task. KEY WORDSAttention-deficithyperactivity disorder Event-related potentials Continuous performance test Methylphenidate. 286