Brieber Sarah, Neufang Susanne, Bruning Nicole, Kamp-Becker Inge, Remschmidt Helmut, Herpertz-Dahlmann Beate, Fink Gereon R, Konrad Kerstin
Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Germany.
J Child Psychol Psychiatry. 2007 Dec;48(12):1251-8. doi: 10.1111/j.1469-7610.2007.01799.x.
Although autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are two distinct neurodevelopmental diseases, they share behavioural, neuropsychological and neurobiological characteristics. For the identification of endophenotypes across diagnostic categories, further investigations of phenotypic overlap between ADHD and autism at the behavioural, neurocognitive, and brain levels are needed.
We examined regional grey matter differences and similarities in children and adolescents with ASD and ADHD in comparison to healthy controls using structural magnetic resonance imaging (MRI) and voxel-based morphometry.
With regard to clinical criteria, the clinical groups did not differ with respect to ADHD symptoms; however, only patients with ASD showed deficits in social communication and interaction, according to parental rating. Structural abnormalities across both clinical groups compared to controls became evident as grey matter reductions in the left medial temporal lobe and as higher grey matter volumes in the left inferior parietal cortex. In addition, autism-specific brain abnormalities were found as increased grey matter volume in the right supramarginal gyrus.
While the shared structural deviations in the medial temporal lobe might be attributed to an unspecific delay in brain development and might be associated with memory deficits, the structural abnormalities in the inferior parietal lobe may correspond to attentional deficits observed in both ASD and ADHD. By contrast, the autism-specific grey matter abnormalities near the right temporo-parietal junction may be associated with impaired 'theory of mind' abilities. These findings shed some light on both similarities and differences in the neurocognitive profiles of ADHD and ASD patients.
尽管自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)是两种不同的神经发育疾病,但它们具有行为、神经心理学和神经生物学特征。为了识别跨诊断类别的内表型,需要在行为、神经认知和大脑水平上进一步研究ADHD与自闭症之间的表型重叠。
我们使用结构磁共振成像(MRI)和基于体素的形态测量法,比较了患有ASD和ADHD的儿童及青少年与健康对照者的区域灰质差异和相似性。
根据临床标准,各临床组在ADHD症状方面无差异;然而,根据家长评分,只有ASD患者在社交沟通和互动方面存在缺陷。与对照组相比,两个临床组的结构异常表现为左侧颞叶内侧灰质减少以及左侧顶下小叶灰质体积增加。此外,还发现了自闭症特有的大脑异常,即右侧缘上回灰质体积增加。
虽然颞叶内侧的共同结构偏差可能归因于大脑发育的非特异性延迟,并可能与记忆缺陷有关,但顶下叶的结构异常可能与ASD和ADHD中观察到的注意力缺陷相对应。相比之下,右侧颞顶交界处附近自闭症特有的灰质异常可能与“心理理论”能力受损有关。这些发现揭示了ADHD和ASD患者神经认知特征的异同。