Clinical application of the integrated visual and auditory continuous performance test on Tourette syndrome children with attention deficit hyperactivity disorder / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the value of the integrated visual and audio continuous performance test (IVA-CPT) in the diagnosis of Tourette syndrome(TS) patients who have comorbid attention deficit hyperactivity disorder(ADHD).Methods IVA-CPT was performed in 519 TS patients with comorbid ADHD (observation group)and 857 patients with pure ADHD (control group).The gold standard for the diagnosis of ADHD was based on the Diagnostic and Statistical Manual of Mental Disorders (4th version,USA) (DSM-Ⅳ).Results (1) When DSM-Ⅳ was used as the gold standard,the sensitivity,specificity and coincidence rate of IVA-CPT were 62.4％,81.9％ and 75.7％,respectively.(2) IVA-CPT misdiagnosed 62 cases in TS + ADHD group,including 30.3％ (10/33 cases) inattentive subtype (ADHD-I),51.4％ (37/72 cases) hyperactive subtype (ADHD-H) and 25.0％ (15/60 cases) combined subtype (ADHD-C).Significant difference in misdiagnosis rate was found among ADHD-H and ADHD-I and ADHD-C (x2=10.646,P＜0.05).(3) There were 449 cases in which 2 diagnostic methods were both positive in both observation group and control group,including 103 cases in observation group and 346 cases in control group.The full scale response control quotient,visual reaction control,auditory reaction control in observation group and control group were 89.0±19.5/77.4±18.2,92.4±19.0/84.3±18.9,89.6±16.8/77.4±19.7,and there were significant differences between 2 groups (t=-5.024,-3.533,-5.255,all P＜0.05).The full scale response control quotient,visual response control quotient,full scale attention quotient and visual attention quotient between the 2 groups were statistically significant (t=2.510,-2.836,-1.402,-2.501,all P＜0.05).Conclusions (1) IVA-CPT can be used as an effective and objective tool for the diagnosis of TS children with comorbid ADHD.(2)Comparcd with TS childrcn with comorbid ADHD,pure ADHD children have a higher attention and control impairment.