Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland 20892, USA.
Biol Psychiatry. 2011 May 1;69(9):839-46. doi: 10.1016/j.biopsych.2010.11.024. Epub 2011 Jan 17.
It was recently found that the development of typical patterns of prefrontal, but not posterior, cortical asymmetry is disrupted in right-handed youth with attention-deficit/hyperactivity disorder (ADHD). Using longitudinal data, we tested the hypothesis that there would be a congruent disruption in the growth of the anterior corpus callosum, which contains white matter tracts connecting prefrontal cortical regions.
Areas of five subregions of the corpus callosum were quantified using a semiautomated method from 828 neuroanatomic magnetic resonance scans acquired from 236 children and adolescents with ADHD (429 scans) and 230 typically developing youth (399 scans), most of whom had repeated neuroimaging. Growth rates of each diagnostic group were defined using mixed-model linear regression.
Right-handed participants with ADHD showed a significantly higher rate of growth in the anterior-most region of the corpus callosum (estimated annual increase in area of .97%, SEM .12%) than their typically developing peers (annual increase in area of .32% SEM .13%; t = 3.64, p = .0003). No significant diagnostic differences in growth rates were found in any other regions in right-handed participants, and no significant diagnostic differences were found in non-right-handed participants.
As hypothesized, we found anomalous growth trajectories in the anterior corpus callosum in ADHD. This disrupted anterior callosal growth may reflect, or even drive, the previously reported disruption in the development of prefrontal cortex asymmetry. The finding documents the dynamic, age-dependent nature of callosal and congruent prefrontal cortical abnormalities characterizing ADHD.
最近发现，右利手青少年注意力缺陷多动障碍（ADHD）患者的额皮质而非后皮质的典型不对称发育模式被破坏。使用纵向数据，我们检验了这样一个假设，即在前连合的生长中会存在一致的破坏，前连合包含连接前额皮质区域的白质束。
使用半自动方法，从 236 名 ADHD 儿童和青少年（429 次扫描）和 230 名正常发育的青少年（399 次扫描）的 828 次神经解剖磁共振扫描中量化了胼胝体的五个亚区的面积，这些扫描大多数都进行了重复的神经影像学检查。使用混合模型线性回归定义了每个诊断组的生长率。
ADHD 右利手参与者的胼胝体最前部区域的生长速度明显高于其正常发育的同龄人（面积的年增长率为 0.97%，SEM 为 0.12%；t=3.64，p=0.0003）。在右利手参与者的任何其他区域，生长率均无显著的诊断差异，而在非右利手参与者中，生长率也无显著的诊断差异。
正如假设的那样，我们在 ADHD 患者中发现了胼胝体前部的异常生长轨迹。这种破坏的前连合生长可能反映甚至驱动了先前报道的前额皮质不对称发育的破坏。这一发现记录了胼胝体和一致的前额皮质异常的动态、年龄依赖性特征，这些特征是 ADHD 的特征。
