Martín Fernández-Mayoralas D, Fernández-Jaén A, García-Segura J M, Quiñones-Tapia D
Hospital Quiron, Madrid, España.
Rev Neurol. 2010 Mar 3;50 Suppl 3:S125-33.
Advances in neuroimaging in the last decade have allowed a number of new findings about attention deficit hyperactivity disorder (ADHD) to be obtained. Quickly developing technology, together with the progress being made in genetics and neurochemical research, suggests a dysfunction of the fronto striatal circuit that involves the prefrontal cortex and its relationship with the basal, thalamic and cerebellar nuclei as the pathophysiological foundation of this disorder. On the other hand, neuroimaging in the future may complement clinical evaluation, which will favour more accurate diagnoses and allow the subtypes and even the mode of treatment and its monitoring to be identified.
The aim of this study was to review the more significant literature on neuroimaging and ADHD and to discuss the usefulness and drawbacks of the different modes of neuroimaging techniques that can be applied with a view to gaining an improved and deeper knowledge of ADHD in the future.
Although the development of neuroimaging in ADHD is a promising area, at the present time its diagnostic value is very restricted. One of the greatest difficulties in this respect concerns the clinical, genetic and pathophysiological heterogeneity of the disorder. Hence, given the inexistence of a specific marker, future studies will have to search for several markers that have a suitable value in the diagnosis, prognosis and/or treatment of the different subtypes of ADHD.
过去十年神经影像学的进展使人们获得了许多关于注意力缺陷多动障碍(ADHD)的新发现。快速发展的技术,以及遗传学和神经化学研究取得的进展,表明涉及前额叶皮质的额叶纹状体回路功能障碍及其与基底核、丘脑和小脑核的关系是该疾病的病理生理基础。另一方面,未来的神经影像学可能会补充临床评估,这将有助于更准确的诊断,并能够确定亚型,甚至确定治疗方式及其监测。
本研究的目的是回顾关于神经影像学与ADHD的更重要文献,并讨论可应用的不同神经影像技术模式的有用性和缺点,以期在未来对ADHD有更深入和全面的了解。
尽管ADHD神经影像学的发展是一个有前景的领域,但目前其诊断价值非常有限。这方面最大的困难之一涉及该疾病的临床、遗传和病理生理异质性。因此,鉴于不存在特定标志物,未来的研究将不得不寻找在ADHD不同亚型的诊断、预后和/或治疗中具有合适价值的多种标志物。