Department of Psychiatry and Biobehavioral Science, University of California Los Angeles, Los Angeles, CA, USA.
Neuropsychol Rev. 2010 Mar;20(1):103-20. doi: 10.1007/s11065-009-9126-x. Epub 2010 Feb 18.
Often, there is diagnostic confusion between bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD) in youth due to similar behavioral presentations. Both disorders have been implicated as having abnormal functioning in the prefrontal cortex; however, there may be subtle differences in the manner in which the prefrontal cortex functions in each disorder that could assist in their differentiation. Executive function is a construct thought to be a behavioral analogy to prefrontal cortex functioning. We provide a qualitative review of the literature on performance on executive function tasks for BD and ADHD in order to determine differences in task performance and neurocognitive profile. Our review found primary differences in executive function in the areas of interference control, working memory, planning, cognitive flexibility, and fluency. These differences may begin to establish a pediatric BD profile that provides a more objective means of differential diagnosis between BD and ADHD when they are not reliably distinguished by clinical diagnostic methods.
由于行为表现相似，青少年的双相情感障碍（BD）和注意缺陷多动障碍（ADHD）之间常常存在诊断混淆。这两种疾病都被认为存在前额叶皮层功能异常；然而，前额叶皮层在每种疾病中的功能可能存在细微差异，这可能有助于对其进行区分。执行功能是一种被认为与前额叶皮层功能具有行为相似性的结构。我们对 BD 和 ADHD 执行功能任务表现的文献进行了定性综述，以确定任务表现和神经认知特征的差异。我们的综述发现，在干扰控制、工作记忆、计划、认知灵活性和流畅性等方面的执行功能存在主要差异。这些差异可能开始为儿科 BD 建立一个特征，当它们不能通过临床诊断方法可靠地区分时，为 BD 和 ADHD 之间提供一种更客观的鉴别诊断手段。
