Department of Neuroscience, "Tor Vergata" University of Rome, Italy.
Ital J Pediatr. 2010 Dec 22;36(1):79. doi: 10.1186/1824-7288-36-79.
Attention-Deficit/Hyperactivity Disorder is not a single pathophysiological entity and appears to have a complex etiology. There are multiple genetic and environmental risk factors with small individual effect that act in concert to create a spectrum of neurobiological liability. Structural imaging studies show that brains of children with Attention-Deficit/Hyperactivity Disorder are significantly smaller than unaffected controls. The prefrontal cortex, basal ganglia and cerebellum are differentially affected and evidence indicating reduced connectivity in white matter tracts in key brain areas is emerging. Genetic, pharmacological, imaging, and animal models highlight the important role of dopamine dysregulation in the neurobiology of Attention-Deficit/Hyperactivity Disorder. To date, stimulants are the most effective psychopharmacological treatments available for Attention-Deficit/Hyperactivity Disorder. Currently only immediate release methylphenidate and atomoxetine are approved for the treatment of ADHD in Italy. Drug treatment should always be part of a comprehensive plan that includes psychosocial, behavioural and educational advice and interventions.
注意缺陷多动障碍不是单一的病理生理实体,其发病机制似乎非常复杂。存在多种遗传和环境风险因素,其对个体的影响较小,但共同作用会导致一系列神经生物学易感性。结构影像学研究表明,注意缺陷多动障碍患儿的大脑明显小于无病对照组。前额叶皮层、基底神经节和小脑受到不同程度的影响,并且有证据表明关键脑区的白质束连接减少。遗传学、药理学、影像学和动物模型突出了多巴胺失调在注意缺陷多动障碍神经生物学中的重要作用。迄今为止,兴奋剂是治疗注意缺陷多动障碍最有效的精神药理学治疗方法。目前,只有速释哌甲酯和托莫西汀被批准用于治疗意大利的 ADHD。药物治疗应该始终是包括心理社会、行为和教育咨询和干预在内的综合计划的一部分。