Neurocentre, Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, Homburg, Germany.
Psychiatry Res. 2010 Jul 30;183(1):75-84. doi: 10.1016/j.pscychresns.2010.04.005. Epub 2010 Jun 16.
Attention deficit hyperactivity disorder (ADHD) is a common, genetically transmitted common childhood-onset disorder with a high rate of persistence in adulthood. Although many studies have shown anatomical and functional abnormalities in children and adolescents, studies with adult patients are rare. Nineteen adults with ADHD (11 ADHD, combined type; 8 ADHD, partially remitted) and 17 controls were included in this functional magnetic resonance imaging (fMRI) study. Brain activation was investigated with a continuous performance test (CPT). Impaired activation of a fronto-striatal and a parietal attentional network was observed during the NoGo condition in ADHD subjects. Correlations of reduced activity of the caudate nuclei, the anterior cingulate cortex, and parietal cortical structures, as well as increased activity in the insular cortex, with inattention and impulsivity symptom scores were found. The activation patterns were similar to those known from children and adolescents with ADHD. In conclusion we found not only a widespread dysfunction of brain regions that are involved in cognitive processing in adults with ADHD compared with controls, but also correlations between symptom severity and dysfunction of neuronal systems across adult subjects with a history of ADHD in childhood but whose symptoms did (persistent ADHD) and did not (not persistent ADHD) qualify for a full diagnosis of ADHD in adulthood.
注意缺陷多动障碍(ADHD)是一种常见的、具有遗传易感性的儿童期起病的疾病,在成年期有很高的持续率。虽然许多研究已经显示出儿童和青少年的解剖和功能异常,但对成年患者的研究很少。本功能磁共振成像(fMRI)研究纳入了 19 名 ADHD 成年患者(11 名 ADHD 混合型,8 名 ADHD 部分缓解型)和 17 名对照者。使用连续作业测试(CPT)研究大脑激活情况。在 ADHD 受试者的 NoGo 条件下观察到额纹状体和顶叶注意网络的激活受损。发现尾状核、前扣带回皮质和顶叶皮质结构活性降低,岛叶皮质活性增加,与注意力不集中和冲动症状评分相关。激活模式与已知的 ADHD 儿童和青少年相似。总之,我们不仅在 ADHD 成年患者与对照组相比发现了大脑区域参与认知加工的广泛功能障碍,而且还发现了具有 ADHD 儿童期病史但症状符合(持续性 ADHD)和不符合(非持续性 ADHD)成人 ADHD 完整诊断标准的成年 ADHD 患者的症状严重程度与神经元系统功能障碍之间的相关性。
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