Jacob Christian, Lesch Klaus-Peter
Department of Psychiatry and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080, Wuerzburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2006 Sep;256 Suppl 1:i12-20. doi: 10.1007/s00406-006-1002-6.
Although the neurobiological basis of the clinical entity of attention-deficit/hyperactivity disorder (ADHD) is evident, data from studies on pathomechanism-phenotype correlations are inconsistent. There are several obvious limitations of the DSM-IV diagnostic criteria to describe an adequate phenotype of adult ADHD. A dimensional model of neurobiologically based endophenotypes is therefore more likely to be compatible with the genetic model of quantitative trait loci. The primary goal of the Wuerzburg Research Initiative on Adult Attention-Deficit/Hyperactivity Disorder (WURIN-AADHD) is to test the validity of two endophenotypes, deficit in response inhibition and impairment of working memory, using various psychometric and neurobiological strategies of investigation in adult patients with ADHD. An additional objective is the investigation of the long-term course of adult ADHD. The conclusive description of valid endophenotypes of ADHD is an ongoing process that may result in a comprehensive neurobiological model for ADHD or its symptom dimensions integrating genetic, neural, cognitive, and behavioral mechanisms. This model will eventually facilitate description of complete causal connections occurring across the lifespan from early development to adulthood and is also likely to accelerate development of more specific and efficient therapeutic strategies in adult ADHD.
尽管注意力缺陷多动障碍(ADHD)临床实体的神经生物学基础是明确的,但关于发病机制与表型相关性的研究数据并不一致。《精神疾病诊断与统计手册》第四版(DSM-IV)的诊断标准在描述成人ADHD的适当表型方面存在若干明显局限性。因此,基于神经生物学的内表型维度模型更有可能与数量性状基因座的遗传模型相兼容。维尔茨堡成人注意力缺陷多动障碍研究计划(WURIN-AADHD)的主要目标是,运用各种心理测量和神经生物学研究策略,对成人ADHD患者的两种内表型——反应抑制缺陷和工作记忆损伤——进行效度检验。另一个目标是研究成人ADHD的长期病程。对ADHD有效的内表型进行确凿描述是一个持续的过程,这可能会形成一个综合的神经生物学模型,用于解释ADHD或其症状维度,整合遗传、神经、认知和行为机制。该模型最终将有助于描述从早期发育到成年整个生命周期中发生的完整因果关系,也可能会加速成人ADHD更具针对性和高效治疗策略的开发。