Mulder Martijn J, Baeyens Dieter, Davidson Matthew C, Casey B J, DEN Ban Els VAN, VAN Engeland Herman, Durston Sarah
Drs. Mulder, van den Ban, van Engeland, and Durston are with the Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht; Dr. Baeyens is with the Department of Psychology, Ghent University; Drs. Casey and Durston are with the Sackler Institute for Developmental Psychobiology; and Dr. Davidson is with the Department of Psychology, University of Massachusetts.
Drs. Mulder, van den Ban, van Engeland, and Durston are with the Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht; Dr. Baeyens is with the Department of Psychology, Ghent University; Drs. Casey and Durston are with the Sackler Institute for Developmental Psychobiology; and Dr. Davidson is with the Department of Psychology, University of Massachusetts.
J Am Acad Child Adolesc Psychiatry. 2008 Jan;47(1):68-75. doi: 10.1097/chi.0b013e31815a56dc.
Familial vulnerability to attention-deficit/hyperactivity disorder (ADHD) has been shown to be related to atypical prefrontal activity during cognitive control tasks. However, ADHD is associated with deficits in the cerebellum as well as deficits in frontostriatal circuitry and associated cognitive control. In this study, we investigated whether cerebellar systems are sensitive to familial risk for ADHD in addition to frontostriatal circuitry.
We used an event-related, rapid mixed-trial functional magnetic resonance imaging design. The paradigm was a variation on a go/no-go task, with expected (go) and unexpected (no-go) events at expected and unexpected times. A total of 36 male children and adolescents completed the study, including 12 sibling pairs discordant for ADHD and 12 matched controls.
Children and adolescents with ADHD were less accurate on unexpected events than control subjects. Performance by unaffected siblings was intermediate, between that of children and adolescents with ADHD and controls. Functional neuroimaging results showed dissociation between activation in the cerebellum and anterior cingulate cortex: Activity in the anterior cingulate cortex was decreased for subjects with ADHD and their unaffected siblings compared with controls for manipulations of stimulus type (no-go trials), but not timing. In contrast, cerebellar activity was decreased for subjects with ADHD and their unaffected siblings for manipulations of timing, but not stimulus type.
These findings suggest that activity in both the prefrontal cortex and cerebellum is sensitive to familial vulnerability to ADHD. Unaffected siblings of individuals with ADHD show deficits similar to affected probands in prefrontal areas for unexpected events and in cerebellum for events atunexpected times.
研究表明，家族性注意缺陷多动障碍（ADHD）易感性与认知控制任务期间前额叶活动异常有关。然而，ADHD与小脑功能缺陷以及额纹状体回路功能缺陷和相关认知控制有关。在本研究中，我们调查了除额纹状体回路外，小脑系统是否对ADHD家族风险敏感。
我们采用了一种事件相关的快速混合试验功能磁共振成像设计。该范式是对一个“去/不去”任务的变体，在预期和非预期时间有预期（去）和非预期（不去）事件。共有36名男性儿童和青少年完成了这项研究，包括12对ADHD不一致的同胞对和12名匹配的对照组。
患有ADHD的儿童和青少年在非预期事件上的准确性低于对照组。未受影响的同胞的表现处于中间水平，介于患有ADHD的儿童和青少年与对照组之间。功能神经影像学结果显示，小脑和前扣带回皮质的激活存在分离：与对照组相比，ADHD患者及其未受影响的同胞在前扣带回皮质的活动在刺激类型（不去试验）操作时减少，但在时间操作时未减少。相比之下，ADHD患者及其未受影响的同胞在时间操作时小脑活动减少，但在刺激类型操作时未减少。
这些发现表明，前额叶皮质和小脑的活动对ADHD家族易感性均敏感。ADHD患者未受影响的同胞在处理非预期事件时，在前额叶区域表现出与受影响的先证者相似的缺陷；在处理非预期时间的事件时，在小脑区域表现出相似的缺陷。
