Kronenberg Golo, Ende Gabriele, Alm Barbara, Deuschle Michael, Heuser Isabella, Colla Michael
Center for ADHD Research, Department of Psychiatry, Charité-University Medicine Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany.
Eur Arch Psychiatry Clin Neurosci. 2008 Oct;258(7):446-50. doi: 10.1007/s00406-008-0810-2. Epub 2008 Mar 11.
The anterior cingulate cortex (ACC) is crucially involved in executive control of attention. Here, seven medication-naïve adult patients suffering from attention deficit/hyperactivity disorder (ADHD) were studied with 2D (1)H-magnetic resonance spectroscopic imaging (MRSI) of the ACC [Brodmann areas 24b'-c' and 32'] twice, once before initiation of stimulant treatment and once after 5-6 weeks of methylphenidate. Upon retest, all patients demonstrated marked clinical improvement. Analysis of regional brain spectra revealed a significantly decreased signal of choline containing compounds as well as increased N-acetyl-aspartate (NAA) levels following treatment with methylphenidate whereas total creatine remained unchanged. Our results add to a growing body of evidence implicating the ACC in the pathophysiology of ADHD and suggest that subtle structural changes might be associated with aspects of clinical improvement under stimulant treatment.
前扣带回皮质（ACC）在注意力的执行控制中起着关键作用。在此，对7名未服用过药物的成年注意力缺陷多动障碍（ADHD）患者进行了ACC[布罗德曼区24b'-c'和32']的二维（1）H磁共振波谱成像（MRSI）研究，在开始使用兴奋剂治疗前进行了一次，在使用哌甲酯5-6周后又进行了一次。再次测试时，所有患者均表现出明显的临床改善。对局部脑波谱的分析显示，使用哌甲酯治疗后，含胆碱化合物的信号显著降低，而N-乙酰天门冬氨酸（NAA）水平升高，而总肌酸保持不变。我们的结果进一步证明了ACC与ADHD病理生理学之间的联系，并表明细微的结构变化可能与兴奋剂治疗下的临床改善有关。
