Oner Ozgür, Oner Pinar, Aysev Ayla, Küçük Ozlem, Ibis Erkan
NIMH Fogarty International Mental Health and Developmental Disabilities Program, 34742 Istanbul, Turkey.
Brain Dev. 2005 Jun;27(4):279-85. doi: 10.1016/j.braindev.2004.07.010.
The aim of this study was to investigate the changes in regional cerebral blood flow (rCBF) with age in patients with attention deficit hyperactivity disorder (ADHD). Twenty-nine drug-naive ADHD subjects (24 boys, 5 girls; age 7-13; mean+/-SD=age 9.2+/-2.1) and 12 subjects with epilepsy (all diagnosed as having complex partial seizure, 6 boys, 6 girls; age 7-14; mean+/-SD=8.5+/-2.1) were included in the study. All cases of ADHD were diagnosed according to DSM-IV criteria. Cerebral blood flow was evaluated with Tc-99m-hexamethylpropyleneamine oxime (Tc99m HMPAO) brain single photon emission tomography (SPECT) during standard resting condition in all of the cases. Asymmetry indices for each region of interest were calculated. Absolute rCBF values were normalized as the absolute rCBF values divided by the whole brain absolute value. The prefrontal lobe asymmetry indices were significantly negatively correlated with age in ADHD cases (r=-0.408, P=0.025), which indicated the increased prefrontal rCBF lateralization from the right to the left side with age. When ADHD cases older than 7 years of age were compared with those with epilepsy, the ADHD cases had lower right prefrontal and frontal rCBF and higher left parietal rCBF. The epilepsy group showed no significant correlations between age and asymmetry indices and showed a different developmental trajectory for prefrontal asymmetry and right prefrontal rCBF values. The results indicated that the left hemisphere dominance in the prefrontal cortex significantly increases with age in ADHD cases.
本研究旨在调查注意缺陷多动障碍（ADHD）患者脑血流区域（rCBF）随年龄的变化。29名未服用过药物的ADHD受试者（24名男孩，5名女孩；年龄7 - 13岁；平均±标准差= 9.2±2.1岁）和12名癫痫患者（均诊断为复杂部分性发作，6名男孩，6名女孩；年龄7 - 14岁；平均±标准差= 8.5±2.1岁）被纳入研究。所有ADHD病例均根据DSM - IV标准进行诊断。在所有病例的标准静息状态下，采用锝- 99m - 六甲基丙烯胺肟（Tc99m HMPAO）脑单光子发射断层扫描（SPECT）评估脑血流量。计算每个感兴趣区域的不对称指数。将绝对rCBF值标准化为绝对rCBF值除以全脑绝对值。ADHD病例中前额叶不对称指数与年龄呈显著负相关（r = - 0.408，P = 0.025），这表明随着年龄增长，前额叶rCBF从右侧到左侧的偏侧化增加。将7岁以上的ADHD病例与癫痫患者进行比较时，ADHD病例右侧前额叶和额叶rCBF较低，左侧顶叶rCBF较高。癫痫组年龄与不对称指数之间无显著相关性，且前额叶不对称和右侧前额叶rCBF值呈现不同的发育轨迹。结果表明，ADHD病例中前额叶皮质的左侧半球优势随年龄显著增加。
