Schulz Kurt P, Fan Jin, Tang Cheuk Y, Newcorn Jeffrey H, Buchsbaum Monte S, Cheung Angeles M, Halperin Jeffrey M
Department of Psychiatry, Box 1230, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029, USA.
Am J Psychiatry. 2004 Sep;161(9):1650-7. doi: 10.1176/appi.ajp.161.9.1650.
Frontostriatal neural abnormalities have been implicated in the response inhibition impairments that are characteristic of attention deficit hyperactivity disorder (ADHD). However, reports of such abnormalities in adolescents are inconsistent. The present study used behavioral and functional neuroimaging techniques to examine inhibitory control processes in adolescents who had been diagnosed with ADHD during childhood.
The authors used functional magnetic resonance imaging (fMRI) during performance of a Go/No-Go task to scan 10 male adolescents who were diagnosed with DSM-III-R ADHD when they were 7 to 11 years old and nine age-, sex-, and IQ-matched comparison subjects with no history of ADHD. Response inhibition was tested by contrasting neural activation during No-Go trials with that during Go trials.
The inhibition of a prepotent tendency to respond produced markedly greater activation of the left anterior cingulate gyrus, bilateral frontopolar regions, bilateral ventrolateral prefrontal cortex, and left medial frontal gyrus in the adolescents with childhood ADHD than in the adolescents with no history of ADHD. Activity in the first two regions was inversely related to task performance across the study group.
Compared with adolescents who had no history of ADHD, adolescents who were diagnosed with ADHD during childhood exhibited enhanced responses during inhibition in ventrolateral prefrontal cortical areas that subserve response inhibition, as well as in anterior cingulate and frontopolar regions implicated in other executive functions.
额纹状体神经异常与注意缺陷多动障碍（ADHD）的特征性反应抑制受损有关。然而，关于青少年此类异常的报告并不一致。本研究采用行为和功能神经影像学技术，对童年期被诊断为ADHD的青少年的抑制控制过程进行研究。
作者在执行一项Go/No-Go任务期间使用功能磁共振成像（fMRI），对10名在7至11岁时被诊断为DSM-III-R ADHD的男性青少年以及9名年龄、性别和智商匹配且无ADHD病史的对照受试者进行扫描。通过对比No-Go试验与Go试验期间的神经激活来测试反应抑制。
与无ADHD病史的青少年相比，童年期患ADHD的青少年在抑制优势反应倾向时，左侧前扣带回、双侧额极区、双侧腹外侧前额叶皮质和左侧内侧额叶回的激活明显更强。在前两个区域的活动与整个研究组的任务表现呈负相关。
与无ADHD病史的青少年相比，童年期被诊断为ADHD的青少年在负责反应抑制的腹外侧前额叶皮质区域以及与其他执行功能相关的前扣带回和额极区域，在抑制过程中表现出更强的反应。
