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成瘾患者的血浆高香草酸(HVA)水平与注意力缺陷多动及童年期受忽视程度呈负相关。

Homovanillic acid (HVA) plasma levels inversely correlate with attention deficit-hyperactivity and childhood neglect measures in addicted patients.

作者信息

Gerra G, Leonardi C, Cortese E, Zaimovic A, Dell'agnello G, Manfredini M, Somaini L, Petracca F, Caretti V, Saracino M A, Raggi M A, Donnini C

机构信息

Servizio Tossicodipendenze, AUSL Parma, Parma, Italy.

出版信息

J Neural Transm (Vienna). 2007;114(12):1637-47. doi: 10.1007/s00702-007-0793-6. Epub 2007 Aug 10.

Abstract

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) seems to be a risk condition for substance use disorders, possibly in relationship to common neurobiological changes, underlying both addictive and externalising behaviour susceptibility. Although this vulnerability has been primarily attributed to gene variants, previous studies suggest that also adverse childhood experiences may influence neurotransmission, affecting in particular brain dopamine (DA) system and possibly concurring to the development of behavioural disorders. Therefore, we decided to investigate ADHD symptoms and plasma concentrations of the DA metabolite homovanillic acid (HVA) in abstinent addicted patients, in comparison with healthy control subjects, evaluating whether ADHD scores were related with HVA levels, as expression of DA turnover, and whether HVA values, in turn, were associated with childhood emotional neglect.

METHODS

Eighty-two abstinent drug dependent patients, and 44 normal controls, matched for age and sex, completed the Wender Utah Rating Scale (WURS), measuring ADHD symptoms, and the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). Blood samples were collected to determine HVA plasma levels.

RESULTS

Addicted individuals showed significantly higher ADHD scores and lower HVA levels respect to control subjects. ADHD scores at WURS in addicted patients negatively correlated with plasma HVA values. In turn, plasma HVA levels were inversely associated with childhood neglect measures, reaching statistical significance with "mother-antipathy" and "mother neglect" scores.

CONCLUSIONS

These findings suggest the possibility that childhood experience of neglect and poor mother-child attachment may have an effect on central dopamine function as an adult, in turn contributing to both ADHD and substance abuse neurobiological vulnerability.

摘要

背景

注意缺陷多动障碍(ADHD)似乎是物质使用障碍的一个风险因素,这可能与常见的神经生物学变化有关,这些变化是成瘾行为和外化行为易感性的基础。尽管这种易感性主要归因于基因变异,但先前的研究表明,童年不良经历也可能影响神经传递,尤其会影响大脑多巴胺(DA)系统,并可能促使行为障碍的发展。因此,我们决定对已戒除成瘾的患者与健康对照者进行比较,调查ADHD症状以及DA代谢产物高香草酸(HVA)的血浆浓度,评估ADHD评分是否与作为DA周转率指标的HVA水平相关,以及HVA值是否又与童年期情感忽视相关。

方法

82名已戒除药物依赖的患者和44名年龄及性别匹配的正常对照者完成了用于测量ADHD症状的温德犹他评定量表(WURS)以及童年期关爱与虐待经历问卷(CECA-Q)。采集血样以测定血浆HVA水平。

结果

与对照者相比,成瘾个体的ADHD评分显著更高,HVA水平更低。成瘾患者WURS中的ADHD评分与血浆HVA值呈负相关。反过来,血浆HVA水平与童年期忽视指标呈负相关,与“母亲反感”和“母亲忽视”评分达到统计学显著水平。

结论

这些发现表明,童年期忽视经历和不良的母婴依恋关系可能会对成年后的中枢多巴胺功能产生影响,进而导致ADHD和物质滥用的神经生物学易感性。

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