Oner Pinar, Oner Ozgür, Aysev Ayla, Küçük Ozlem, Ibiş Erkan
Atatürk Eğitim ve Araştirma Hastanesi, Cocuk Psikiyatri Bl.
Turk Psikiyatri Derg. 2008 Spring;19(1):13-8.
It has been reported that both obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) might be related to impairments in frontal-striatal brain circuits. Besides, these two disorders are frequently comorbid. However, there are no published studies directly comparing the neurobiological findings in these two disorders. The objective of the study was to investigate the differences in cortical blood flow between patients with OCD and ADHD.
Thirteen drug-naive OCD subjects (mean age +/- SD: 10.4 +/- 2.8), and 13 drug-naive ADHD subjects (mean age +/- SD: 10.5 +/- 2.2) were included in the study. Cerebral blood flow (CBF) was evaluated with Tc-99m-hexamethylpropyleneamine oxime (Tc99m HMPAO) brain single photon emission tomography (SPECT) during standard resting conditions in all cases. P value was set to <.006 after Bonferroni correction.
OCD cases had significantly higher right prefrontal (p=.003) CBF than ADHD cases. There were no significant CBF differences in other brain regions. OCD symptom severity was not related to CBF.
This is one of the very few studies which directly investigated brain imaging in pediatric OCD subjects. Results are consistent with previous studies reporting increased prefrontal CBF in OCD subjects. We also found that, consistent with the previous literature, ADHD subjects had lower prefrontal cortex CBF. Studies which compare subjects with comorbid ADHD and OCD with pure forms of these disorders are necessary to have a better understanding of similarities and differences of these two disorders.
据报道，强迫症（OCD）和注意力缺陷多动障碍（ADHD）都可能与额叶纹状体脑回路受损有关。此外，这两种疾病常合并存在。然而，尚无已发表的研究直接比较这两种疾病的神经生物学研究结果。本研究的目的是调查强迫症患者和注意力缺陷多动障碍患者之间皮质血流的差异。
本研究纳入了13名未服用过药物的强迫症受试者（平均年龄±标准差：10.4±2.8）和13名未服用过药物的注意力缺陷多动障碍受试者（平均年龄±标准差：10.5±2.2）。在所有病例的标准静息状态下，用锝-99m-六甲基丙烯胺肟（Tc99m HMPAO）脑单光子发射断层扫描（SPECT）评估脑血流量（CBF）。经Bonferroni校正后，P值设定为<0.006。
强迫症患者右侧前额叶CBF显著高于注意力缺陷多动障碍患者（p = 0.003）。其他脑区的CBF无显著差异。强迫症症状严重程度与CBF无关。
这是极少数直接对儿童强迫症受试者进行脑成像研究的研究之一。结果与先前报道强迫症受试者前额叶CBF增加的研究一致。我们还发现，与先前文献一致，注意力缺陷多动障碍受试者的前额叶皮质CBF较低。有必要开展将合并注意力缺陷多动障碍和强迫症的受试者与这些疾病的单纯形式进行比较的研究，以便更好地了解这两种疾病的异同。
