Lule D, Ludolph A C, Ludolph A G
Department of Neurology/Neurophysiology, Oberer Eselsberg 47, University of Ulm, 89081 Ulm, Germany.
Med Hypotheses. 2008;70(6):1133-8. doi: 10.1016/j.mehy.2007.11.002. Epub 2007 Dec 26.
Attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioural disorder and amyotrophic lateral sclerosis (ALS), the most common adult motoneuron disease, may be two distinct entities on first sight. This paper aims to highlight parallels concerning clinical features and neurobiology. The presence of increased physical and psychological activity and largely non-progressive frontal dysfunction associated with impaired executive control and decreased attention are characteristic clinical features of both, ADHD and ALS. At the neurobiological level, there is evidence for hyperactivity in the glutamatergic system and a - potentially related - dopaminergic hypoactivity in ADHD and ALS. The clinical features of ALS resembling ADHD are particularly characteristic for the premorbid stage of the patient. Therefore, we hypothesize that clinical features of ADHD may be a risk factor for the development of ALS. This hypothesis is currently of unknown pathogenetic, but of potential future therapeutic relevance. Our hypothesis of a link between ADHD and ALS could also be considered as an example how research on neurodevelopmental diseases might influence the understanding and possibly the prevention and treatment of neurodegenerative diseases.
注意力缺陷多动障碍（ADHD）是最常见的神经行为障碍，肌萎缩侧索硬化症（ALS）是最常见的成人运动神经元疾病，乍一看它们可能是两种截然不同的病症。本文旨在强调它们在临床特征和神经生物学方面的相似之处。身体和心理活动增加以及与执行控制受损和注意力下降相关的基本非进行性额叶功能障碍的存在，是ADHD和ALS的共同临床特征。在神经生物学层面，有证据表明ADHD和ALS患者的谷氨酸能系统存在功能亢进以及一种（可能与之相关的）多巴胺能功能减退。ALS中类似ADHD的临床特征在患者病前阶段尤为典型。因此，我们推测ADHD的临床特征可能是ALS发病的一个危险因素。这一假说目前发病机制不明，但可能具有未来治疗意义。我们关于ADHD与ALS之间存在联系的假说，也可被视为神经发育疾病研究如何影响神经退行性疾病的理解以及可能的预防和治疗的一个例证。
