重新思考注意缺陷多动障碍中的右脑功能缺陷
Rethinking a right hemisphere deficit in ADHD.
作者信息
Hale T Sigi, Loo Sandra K, Zaidel Eran, Hanada Grant, Macion James, Smalley Susan L
机构信息
UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA.
出版信息
J Atten Disord. 2009 Jul;13(1):3-17. doi: 10.1177/1087054708323005. Epub 2008 Aug 27.
INTRODUCTION
Early observations from lesion studies suggested right hemisphere (RH) dysfunction in ADHD. However, a strictly right-lateralized deficit has not been well supported. An alternatively view suggests increased R > L asymmetry of brain function and abnormal interhemispheric interaction. If true, RH pathology in ADHD should reflect interhemispherically networked and overactivated functioning. The authors evaluated these assertions.
METHOD
Four elements of lateralized brain function were measured: LH specialized, RH specialized, LH with interhemispheric processing (LH/IH), and RH with interhemispheric processing (RH/IH). Next, the authors tested their association with cognitive ability, psychiatric comorbidity, and sibling correlations in 79 children with ADHD.
RESULTS
RH/IH processing was uniquely associated with other outcome measures. There were no associations for independent RH or LH function alone.
CONCLUSION
Interhemispherically networked RH processing is critical in ADHD. In addition, lack of association between LH specialized processing and cognitive ability (especially for verbal cognitive tasks) supports increased RH mediation of task processing.
引言
损伤研究的早期观察结果表明注意缺陷多动障碍（ADHD）存在右半球（RH）功能障碍。然而，严格的右侧化缺陷并未得到充分支持。另一种观点认为，大脑功能的R>L不对称性增加以及半球间相互作用异常。如果属实，ADHD中的右半球病理应反映半球间网络连接和功能过度激活。作者对这些观点进行了评估。
方法
测量了大脑功能侧化的四个要素：左半球专门化、右半球专门化、具有半球间加工的左半球（LH/IH）和具有半球间加工的右半球（RH/IH）。接下来，作者测试了它们与79名ADHD儿童的认知能力、精神共病和同胞相关性之间的关联。
结果
RH/IH加工与其他结果指标具有独特的相关性。单独的右半球或左半球功能与其他指标均无关联。
结论
半球间网络连接的右半球加工在ADHD中至关重要。此外，左半球专门化加工与认知能力（尤其是语言认知任务）之间缺乏关联，这支持了右半球在任务加工中的调节作用增强。
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