论著

儿童眩晕对认知功能影响的临床研究

  • 接惠群 ,
  • 舒文卓 ,
  • 高德坤 ,
  • 马孝宝 ,
  • 沈佳丽 ,
  • 张帆 ,
  • 汪玮 ,
  • 王璐 ,
  • 金玉莲 ,
  • 杨军 ,
  • 程岚 ,
  • 陈建勇
展开
  • 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海 200092)
* 具有同等贡献

收稿日期: 2024-09-23

  网络出版日期: 2024-12-02

基金资助

国家自然科学基金重点项目(82230035);国家自然科学基金面上项目(82271179);上海市科委项目(21S31900600)

Clinical study on the influence of vertigo on cognitive function in children

  • Huiqun JIE ,
  • Wenzhuo SHU ,
  • Dekun GAO ,
  • Xiaobao MA ,
  • Jiali SHEN ,
  • Fan ZHANG ,
  • Wei WANG ,
  • Lu WANG ,
  • Yulian JIN ,
  • Jun YANG ,
  • Lan CHENG ,
  • Jianyong CHEN
Expand
  • Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University School of Medicine Ear Institute, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200092, China

Received date: 2024-09-23

  Online published: 2024-12-02

摘要

目的 本研究拟通过比较眩晕患儿与正常儿童的事件相关电位(ERPs),探索眩晕对患儿认知功能的影响,为临床治疗提供理论指导。方法 选取2024年1月至8月于听力障碍及眩晕诊治中心就诊的以头晕、眩晕、平衡不稳为主诉症状的6~17岁患儿作为研究对象(眩晕组),另选取同期年龄相仿的正常儿童作为对照组。两组分别采用听觉Oddball范式刺激模式下的ERPs进行认知功能评估,ERPs包括P1、N1、P2、N2和P3共5个波形成分,比较两组间各波形成分的潜伏期和振幅差异。结果 眩晕组33例患儿,男14例、女19例,平均年龄(10.2±2.7)岁;对照组16名,男12名、女4名,平均年龄(9.8±2.5)岁。眩晕组患儿的N1和N2振幅显著低于对照组儿童,差异存在统计学意义(P<0.05),余成分的振幅及各波的潜伏期差异均未见统计学意义(P>0.05)。眩晕组和对照组ERPs各波潜伏期、振幅与年龄无显著相关性(P>0.05)。结论 儿童眩晕会对患儿的认知功能产生影响,主要表现在早期的感知和认知控制阶段,对高级认知处理的影响不明显;提示眩晕会导致儿童对刺激的感知能力、冲突处理能力和认知控制能力减弱。

本文引用格式

接惠群 , 舒文卓 , 高德坤 , 马孝宝 , 沈佳丽 , 张帆 , 汪玮 , 王璐 , 金玉莲 , 杨军 , 程岚 , 陈建勇 . 儿童眩晕对认知功能影响的临床研究[J]. 临床儿科杂志, 2024 , 42(12) : 1015 -1020 . DOI: 10.12372/jcp.2024.24e1007

Abstract

Objective By analyzing the event related potentials (ERPs) of vertigo and normal children, this study aims to explore the effects of vertigo on cognitive function in children, and provide theoretical guidance for clinical intervention. Methods The children aged 6 to 17 years old who presented with symptoms of dizziness, vertigo, and balance disorders at hearing impairment and vertigo diagnosis and treatment center were selected from January to August 2024 as the study subjects (vertigo group), and healthy children of similar age during the same period were selected as the control group. Both groups underwent auditory Oddball paradigm stimulation, and event-related potential (ERPs) components, including P1, N1, P2, N2, and P3, were recorded. The latency and amplitude differences of each component were compared between the two groups. Results There were 33 children (14 boys and 19 girls) in vertigo group, and the average age was (10.2±2.7) years. The control group consisted of 16 children (12 boys and 4 females), with an average age of (9.8±2.5) years. The amplitudes of N1 and N2 in the vertigo group were significantly lower than those in the control group, with statistical significance (P<0.05), while the amplitudes of residual components and latency of all components between the two groups had no statistical significance (P>0.05). The latency and amplitude of all ERPs components in vertigo group and control group had no significant correlation with age (P>0.05). Conclusions Vertigo in children affects their cognitive function, primarily in the early stages of perception and cognitive control, with less impact on higher cognitive processing, indicating that children with vertigo may reduce perception, conflict processing, and cognitive control abilities.

参考文献

[1] Li CM, Hoffman HJ, Ward BK, et al. Epidemiology of dizziness and balance problems in children in the United States: a population-based study[J]. J Pediatr, 2016, 171: 240-247.
[2] Jahn K, Langhagen T, Heinen F. Vertigo and dizziness in children[J]. Curr Opin Neurol, 2015, 28(1): 78-82.
[3] Berg R, Widdershoven J, Bisdorff A, et al. Vestibular migraine of childhood and recurrent vertigo of childhood: diagnostic criteria consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society and the International Headache Society[J]. J Vestib Res, 2021, 31(1): 1-9.
[4] Borsetto D, Corazzi V, Obholzer R, et al. Dizziness, psychological disorders and cognitive decline[J]. Panminerva Med, 2023, 65(1): 84-90.
[5] Smith PF, Zheng Y. From ear to uncertainty: vestibular contributions to cognitive function[J]. Front Integr Neurosci, 2013, 7: 84.
[6] Mast FW, Preuss N, Hartmann M, et al. Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture[J]. Front Integr Neurosci, 2014, 8: 44.
[7] Popp P, Wulff M, Finke K, et al. Cognitive deficits in patients with a chronic vestibular failure[J]. J Neurol, 2017, 264(3): 554-563.
[8] Anson E, Ehrenburg MR, Simonsick EM, et al. Association between vestibular function and rotational spatial orientation perception in older adults[J]. J Vestib Res, 2021, 31(6): 469-478.
[9] Xie D, Welgampola MS, Miller LA, et al. Subjective cognitive dysfunction in patients with dizziness and vertigo[J]. Audiol Neurootol, 2022, 27(2): 122-132.
[10] Agrawal Y, Ward BK, Minor LB. Vestibular dysfunction: prevalence, impact and need for targeted treatment[J]. J Vestib Res, 2013, 23(3): 113-117.
[11] Bigelow RT, Semenov YR, du Lac S, et al. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey[J]. J Neurol Neurosurg Psychiatry, 2016, 87(4): 367-372.
[12] 高帆, 龚树生. 儿童眩晕症的诊断和治疗进展[J]. 中华内科杂志, 2023, 62(7): 876-880.
[13] Baek JH, Zheng Y, Darlington CL, et al. Evidence that spatial memory deficits following bilateral vestibular deafferentation in rats are probably permanent[J]. Neurobiol Learn Mem, 2010, 94(3): 402-413.
[14] Fu L, Xiang D, Subodh D, et al. Auditory P300 study in patients with convalescent bipolar depression and bipolar depression[J]. Neuroreport, 2018, 29(11): 968-973.
[15] Toyoshima K, Toyomaki A, Miyazaki A, et al. Associations between cognitive impairment and P300 mean amplitudes in individuals with bipolar disorder in remission[J]. Psychiatry Res, 2020, 290: 113125.
[16] van Dinteren R, Arns M, Jongsma ML, et al. P300 development across the lifespan: a systematic review and meta-analysis[J]. PLoS One, 2014, 9(2): e87347.
[17] Didone DD, Garcia MV, Oppitz SJ, et al. Auditory evoked potential P300 in adults: reference values[J]. Einstein (Sao Paulo), 2016, 14(2): 208-212.
[18] Ernst LH, Ehlis AC, Dresler T, et al. N1 and N2 ERPs reflect the regulation of automatic approach tendencies to positive stimuli[J]. Neurosci Res, 2013, 75(3): 239-249.
[19] Tomé D, Barbosa F, Nowak K, et al. The development of the N1 and N2 components in auditory oddball paradigms: a systematic review with narrative analysis and suggested normative values[J]. J Neural Transm (Vienna), 2015, 122(3): 375-391.
[20] Song S, Park J, Park YM, et al. The influence of object-location binding mental load effects on the visual N1 and N2 event-related potentials[J]. BMC Res Notes, 2022, 15(1): 217.
[21] Squintani G, Rasera A, Segatti A, et al. Conditioned pain modulation affects the N2/P2 complex but not the N1 wave: a pilot study with laser-evoked potentials[J]. Eur J Pain, 2021, 25(3): 550-557.
[22] Xia L, Mo L, Wang J, et al. Trait anxiety attenuates response inhibition: evidence from an ERP study using the Go/NoGo task[J]. Front Behav Neurosci, 2020, 14: 28.
[23] Tan PZ, Bylsma LM, Silk JS, et al. Neural indices of performance monitoring are associated with daily emotional functioning in youth with anxiety disorders: An ERP and EMA study[J]. Int J Psychophysiol, 2022, 178: 34-42.
[24] Michael JA, Wang M, Kaur M, et al. EEG correlates of attentional control in anxiety disorders: A systematic review of error-related negativity and correct-response negativity findings[J]. J Affect Disord, 2021, 291: 140-153.
[25] Yilmaz FT, Ozkaynak SS, Barcin E. Contribution of auditory P300 test to the diagnosis of mild cognitive impairment in Parkinson's disease[J]. Neurol Sci, 2017, 38(12): 2103-2109.
[26] Nandrajog P, Idris Z, Azlen WN, et al. The use of event-related potential (P300) and neuropsychological testing to evaluate cognitive impairment in mild traumatic brain injury patients[J]. Asian J Neurosurg, 2017, 12(3): 447-453.
[27] 冯晨辉, 杨健, 王昕. 事件相关电位P300在儿童神经系统疾病伴认知障碍中的研究进展[J]. 国际儿科学杂志, 2023, 50(5): 297-301.
[28] Ma X, Shen J, Sun J, et al. P300 event-related potential predicts cognitive dysfunction in patients with vestibular disorders[J]. Biomedicines, 2023, 11(9): 2365.
[29] Liu P, Bai X, Pérez-Edgar KE. Integrating high-density ERP and fMRI measures of face-elicited brain activity in 9-12-year-old children: An ERP source localization study[J]. Neuroimage, 2019, 184: 599-608.
文章导航

/