Smith Anna B, Taylor Eric, Brammer Michael, Halari Rozmin, Rubia Katya
Centre for Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College, London, UK.
J Child Psychol Psychiatry. 2008 Sep;49(9):977-85. doi: 10.1111/j.1469-7610.2008.01870.x. Epub 2008 Aug 27.
Patients with attention deficit hyperactivity disorder (ADHD) under-perform when discriminating between durations differing by several hundred milliseconds. This function involves right prefrontal and anterior cingulate (AC) brain regions, which are structurally and functionally compromised in this patient group during executive tasks. We investigated the neuro-anatomical substrates mediating fine temporal discrimination in adolescents with ADHD compared with controls, using functional magnetic resonance imaging (fMRI).
Twenty-one male medication-naïve adolescents aged 10-15 years with a DSM-IV diagnosis of ADHD (combined subtype) and without comorbid Axis I disorders (except conduct disorder) were compared to a group of 17 age- and IQ-matched healthy adolescents. Using fMRI on a 1.5T scanner, we compared brain activation and performance between adolescents with ADHD and controls during a time discrimination task contrasted with a temporal order task.
Despite comparable performance, patients with ADHD showed decreased activation in right dorsolateral and inferior prefrontal cortex and AC during time discrimination compared with controls.
Right hemispheric fronto-cingulate abnormalities in ADHD, previously observed during inhibitory and executive functions, are also associated with temporal perception. Furthermore, recruitment of medication-naïve patients precludes the possibility that deficits are attributable to stimulant exposure.
注意缺陷多动障碍(ADHD)患者在区分相差几百毫秒的时长时表现不佳。该功能涉及右侧前额叶和前扣带回(AC)脑区,在执行任务期间,该患者群体的这些脑区在结构和功能上存在缺陷。我们使用功能磁共振成像(fMRI)研究了与对照组相比,患有ADHD的青少年中调节精细时间辨别能力的神经解剖学基础。
将21名年龄在10 - 15岁、未服用药物、诊断为ADHD(混合型)且无共病I轴障碍(品行障碍除外)的男性青少年与17名年龄和智商匹配的健康青少年进行比较。在1.5T扫描仪上使用fMRI,我们比较了ADHD青少年和对照组在时间辨别任务与时间顺序任务对比时的大脑激活情况和表现。
尽管表现相当,但与对照组相比,ADHD患者在时间辨别过程中右侧背外侧和前额叶下部皮质以及AC的激活减少。
ADHD患者右侧半球额扣带回异常,先前在抑制和执行功能中观察到,也与时间感知有关。此外,纳入未服用药物的患者排除了缺陷归因于兴奋剂暴露的可能性。