Sowell Elizabeth R, Thompson Paul M, Welcome Suzanne E, Henkenius Amy L, Toga Arthur W, Peterson Bradley S
University of California at Los Angeles, Laboratory of Neuro Imaging, Department of Neurology, 710 Westwood Plaza, Room 4-238, Los Angeles, CA 90095-1769, USA.
Lancet. 2003 Nov 22;362(9397):1699-707. doi: 10.1016/S0140-6736(03)14842-8.
Results of structural brain imaging studies of patients with attention-deficit hyperactivity disorder have shown subtle reductions in total brain volume and in volumes of the right frontal lobe and caudate nucleus. Although various conventional volumetric and voxel-based methods of image analysis have been used in these studies, regional brain size and grey-matter abnormalities have not yet been mapped over the entire cortical surface in patients with this disorder. We aimed to map these features in patients with attention-deficit hyperactivity disorder.
We used high-resolution MRI and surface-based, computational image analytic techniques to map regional brain size and grey-matter abnormalities at the cortical surface in a group of 27 children and adolescents with attention-deficit hyperactivity disorder and 46 controls, who were group-matched by age and sex.
Abnormal morphology was noted in the frontal cortices of patients with attention-deficit hyperactivity disorder, with reduced regional brain size localised mainly to inferior portions of dorsal prefrontal cortices bilaterally. Brain size was also reduced in anterior temporal cortices bilaterally. Prominent increases in grey matter were recorded in large portions of the posterior temporal and inferior parietal cortices bilaterally.
The frontal, temporal, and parietal regions are heteromodal association cortices that constitute a distributed neural system, which subserves attention and behavioural inhibition. We have identified region-specific anatomical abnormalities in cortical components of attentional systems, which may help better account for the symptoms of attention-deficit hyperactivity disorder.
注意力缺陷多动障碍患者的脑结构成像研究结果显示，全脑体积以及右侧额叶和尾状核体积有细微减小。尽管这些研究中使用了各种传统的基于体积和体素的图像分析方法，但该疾病患者的区域脑大小和灰质异常尚未在整个皮质表面进行映射。我们旨在绘制注意力缺陷多动障碍患者的这些特征。
我们使用高分辨率MRI和基于表面的计算图像分析技术，对一组27名患有注意力缺陷多动障碍的儿童和青少年以及46名对照者（按年龄和性别进行组匹配）的皮质表面区域脑大小和灰质异常进行映射。
注意缺陷多动障碍患者的额叶皮质存在异常形态，区域脑大小减小主要局限于双侧背侧前额叶皮质的下部。双侧颞叶前部皮质的脑大小也减小。双侧颞叶后部和顶叶下部的大部分区域灰质显著增加。
额叶、颞叶和顶叶区域是异模态联合皮质，构成一个分布式神经系统，负责注意力和行为抑制。我们已经确定了注意力系统皮质成分中特定区域的解剖学异常，这可能有助于更好地解释注意力缺陷多动障碍的症状。
