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成人注意力缺陷多动障碍(ADHD)的脑解剖学和功能成像——神经学视角

Anatomical and functional brain imaging in adult attention-deficit/hyperactivity disorder (ADHD)--a neurological view.

作者信息

Schneider Marc, Retz Wolfgang, Coogan Andrew, Thome Johannes, Rösler Michael

机构信息

Neurocentre/Institute of Forensic Psychology and Psychiatry, University of the Saarland, Building 90.3, 66421, Homburg/Saar, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2006 Sep;256 Suppl 1:i32-41. doi: 10.1007/s00406-006-1005-3.

Abstract

In this review, we discuss current structural and functional imaging data on ADHD in a neurological and neuroanatomical framework. At present, the literature on adult ADHD is somewhat sparse, and so results from imaging have to therefore be considered mainly from the childhood or adolescence perspective. Most work has considered the impairment of executive functions (motor execution, inhibition, working memory), and as such a number of attention networks and their anatomical correlates are discussed in this review (e.g. the cerebello-(thalamo-)-striato-cortical network seems to play a pivotal role in ADHD pathology from childhood to adulthood). The core findings in ADHD imaging are alterations in the architecture and function of prefrontal cortex and cerebellum. The dorsal part of anterior cingulated cortex (dACC) is an important region for decision making, and executive control is impaired in adult ADHD. Finally, dysfunction of basal ganglia is a consistent finding in childhood and adulthood ADHD, reflecting dysregulation of fronto-striatal circuitry. The cerebellum, and its role in affect and cognition, is also persistently implicated in the pathology of ADHD.

摘要

在本综述中,我们在神经学和神经解剖学框架下讨论当前有关注意力缺陷多动障碍(ADHD)的结构和功能成像数据。目前,关于成人ADHD的文献较为稀少,因此成像结果主要需从儿童期或青少年期的角度来考虑。大多数研究关注执行功能(运动执行、抑制、工作记忆)的损害,因此本综述将讨论一些注意力网络及其解剖学关联(例如,小脑 -(丘脑 -)- 纹状体 - 皮质网络似乎在从儿童期到成年期的ADHD病理过程中起关键作用)。ADHD成像的核心发现是前额叶皮质和小脑的结构与功能改变。前扣带回皮质背侧部分(dACC)是决策的重要区域,成人ADHD患者的执行控制受损。最后,基底神经节功能障碍在儿童期和成年期ADHD中均是一致的发现,反映了额叶 - 纹状体回路的调节异常。小脑及其在情感和认知中的作用也一直与ADHD的病理过程相关。

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