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[注意力缺陷/多动障碍的神经生物学]

[Neurobiology of attention deficit/hyperactivity disorder].

作者信息

Purper-Ouakil Diane, Lepagnol-Bestel Aude-Marie, Grosbellet Edith, Gorwood Philip, Simonneau Michel

机构信息

Inserm U894, Centre de psychiatrie et neurosciences, Equipe 1, Analyse génétique et clinique des comportements addictifs et psychiatriques, 2 ter, rue d'Alesia, Paris, France.

出版信息

Med Sci (Paris). 2010 May;26(5):487-96. doi: 10.1051/medsci/2010265487.


DOI:10.1051/medsci/2010265487
PMID:20510147
Abstract

Attention deficit/hyperactivity disorder (ADHD) is a frequent and disabling condition in school children, with cognitive and behavioral symptoms persisting into adulthood in a majority of patients. Etiology of ADHD is considered multifactorial and heterogenous, with an important contribution of genetic factors. Apart from genetic risk factors, emphasis has been put on the early environment, and prenatal exposure to nicotine, alcohol, prematurity and low birth weight have been associated with subsequent ADHD symptoms. This article reviews recent findings in neurobiology, genetics and neuroimaging of ADHD. Despite their clinical heterogeneity and frequent comorbidities, key symptoms of ADHD, such as impulsivity, hyperactivity and inattention are regularly improved by dopaminergic agonists, leading to consider dopaminergic dysfunction a possibly contributing factor in ADHD. Norepinephrine agonists also have clinical efficacy on ADHD symptoms and several other neurotransmission systems are likely involved in the etiology of ADHD. Dysfunction of neurotransmitter systems have been related to impairments of sustained attention, inhibitory control and working memory. Cognitive tasks focusing on reaction time and verbal working memory fit certain criteria for ADHD endophenotypes, offering a pathway to bridge the gap between observed traits and genetic vulnerability. Despite ADHD being a highly heritable disorder, most candidate genes with replicated findings across association studies only account for a small proportion of genetic variance. Neuroimaging studies using treatment effect or cognitive tasks show differential activation patterns in ADHD patients, with trends towards normalization under treatment. Further insight into neurobiological mechanisms involved in ADHD will arise from collaborative networks and combination of imaging, genetic and neurobiological techniques with consideration of the developmental aspects of ADHD.

摘要

注意力缺陷多动障碍(ADHD)是学龄儿童中常见的致残性疾病,大多数患者的认知和行为症状会持续到成年期。ADHD的病因被认为是多因素且异质性的,遗传因素起了重要作用。除了遗传风险因素外,早期环境也受到了重视,产前接触尼古丁、酒精、早产和低体重与随后出现的ADHD症状有关。本文综述了ADHD在神经生物学、遗传学和神经影像学方面的最新研究结果。尽管ADHD存在临床异质性且常伴有共病,但多巴胺能激动剂通常能改善ADHD的关键症状,如冲动、多动和注意力不集中,这使得人们认为多巴胺能功能障碍可能是ADHD的一个促成因素。去甲肾上腺素能激动剂对ADHD症状也有临床疗效,并且其他几种神经传递系统可能也参与了ADHD的病因。神经递质系统功能障碍与持续注意力、抑制控制和工作记忆的损害有关。关注反应时间和言语工作记忆的认知任务符合ADHD内表型的某些标准,为弥合观察到的性状与遗传易感性之间的差距提供了一条途径。尽管ADHD是一种高度可遗传的疾病,但在多项关联研究中发现的大多数候选基因仅占遗传变异的一小部分。使用治疗效果或认知任务的神经影像学研究显示,ADHD患者存在不同的激活模式,治疗后有趋于正常化的趋势。通过合作网络以及将影像学、遗传学和神经生物学技术相结合,并考虑ADHD的发育方面,将进一步深入了解ADHD所涉及的神经生物学机制。

相似文献

[1]
[Neurobiology of attention deficit/hyperactivity disorder].

Med Sci (Paris). 2010-5

[2]
Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology.

Ambul Pediatr. 2007

[3]
[ADHD and attachment processes: are they related?].

Encephale. 2009-6

[4]
Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology.

J Pediatr Psychol. 2007-7

[5]
Attention-deficit/hyperactivity disorder: a selective overview.

Biol Psychiatry. 2005-6-1

[6]
[Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)].

Encephale. 2009-4

[7]
Executive dysfunction in attention-deficit/hyperactivity disorder: cognitive and neuroimaging findings.

Psychiatr Clin North Am. 2004-3

[8]
[How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child].

Fortschr Neurol Psychiatr. 2011-9

[9]
Stimulant effects in attention deficit hyperactivity disorder: theoretical and empirical issues.

J Clin Child Psychol. 2001-3

[10]
Overview and neurobiology of attention-deficit/hyperactivity disorder.

J Clin Psychiatry. 2002

引用本文的文献

[1]
ADGRL3 genomic variation implicated in neurogenesis and ADHD links functional effects to the incretin polypeptide GIP.

Sci Rep. 2022-9-23

[2]
Epigenetics in Developmental Disorder: ADHD and Endophenotypes.

J Genet Syndr Gene Ther. 2011-6-30

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