中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (4): 920-928.doi: 10.4103/1673-5374.322464

• 原著:神经损伤修复保护与再生 • 上一篇    

儿童社会能力和精神病理学表现与自主神经功能有关

  

  • 出版日期:2022-04-15 发布日期:2021-10-18

Social skills and psychopathology are associated with autonomic function in children: a cross-sectional observational study

Elisa Cainelli1, 2, Luca Vedovelli3, *, Daniele Bottigliengo3, Dario Boschiero4, Agnese Suppiej1, 5   

  1. 1Child Neurology and Clinical Neurophysiology,  University Hospital of Padova, Padova, Italy; 2Department of General Psychology, University of Padova, Padova, Italy; 3Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy; 4BioTekna Biomedical Technologies, Marcon (VE), Italy; 5Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy
  • Online:2022-04-15 Published:2021-10-18
  • Contact: Luca Vedovelli, PhD, luca.vedovelli@unipd.it.

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摘要：

身体和情绪经历塑造行为、情绪和神经精神健康的机制与中枢自主神经系统（ANS）（脑干）和边缘系统之间的复杂相互作用有关，但关于自主神经系统发展和神经精神健康之间关系的临床研究仍然很少。为了解儿童自主神经系统与社会能力和精神病理学表现之间的关系，此次开展的横断面观察研究纳入2011年1月至2013年6月于帕多瓦大学医院新生儿重症监护室收治的早产儿14例，缺氧缺血性脑病新生儿19例，其均无严重后遗症（如脑瘫），同时以健康儿17名为对照。在儿童6-9岁时对其心率变异性（HRV）进行检测，以反映自主神经系统状态，并对儿童的社会能力（情感识别和心智理论，NEPSY-II）进行评估；同时还对儿童进行了广泛的认知、神经心理学和社会心理评估，对其父母进行了精神病理学访谈和问卷调查（CBCL 6-18）评估。以稳健的贝叶斯框架分析揭示心率变异、社会能力和精神病理学功能之间的依赖性。社会能力评估与心率变异成分中可反映副交感神经活动并与呼吸周期相关的心率变化相对应的心率变异性高频率频带是最一致的。心率变异波段也与心理病理学表现有关。只有标准化的心率变异性高频率频带能够辨别情感识别任务评估障碍的儿童。以上数据表明，心率变异性与儿童的社会能力和精神病理学之间可能存在联系，而无关产前/产后危险因素。

https://orcid.org/0000-0003-4847-2333 (Luca Vedovelli)

Abstract: In recent years, the increase of psychopathological disorders in the population has become a health emergency, leading to a great effort to understand psychological vulnerability mechanisms. In this scenario, the role of the autonomic nervous system (ANS) has become increasingly important. This study investigated the association between ANS, social skills, and psychopathological functioning in children. As an ANS status proxy, we measured heart rate variability (HRV). Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study. We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks (affect recognition and theory of mind, NEPSY-II) in 50 children (mean age 7.4 ± 1.4 years) with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae. Children also completed extensive cognitive, neuropsychological, and psychosocial assessment. Parents were assessed with psychopathological interviews and a questionnaire (CBCL 6-18). Analysis in a robust Bayesian framework was used to unearth dependencies between HRV, social skills, and psychopathological functioning. Social task scores were associated with HRV components, with high frequency the most consistent. HRV bands were also associated with the psychopathological questionnaire. Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task. Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity. We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology. The study was approved by the Ethics Committee of the University Hospital of Padova (Comitato Etico per la Sperimentazione, Azienda Opedaliera di Padova, approval No. 1693P).

Key words: affect recognition, autonomic nervous system, children, hypoxic-ischemic encephalopathy, impairment, neonatal, prematurity, psychopathology, recovery, theory of mind

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