Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States.
Psychiatry Res. 2011 Jul 30;193(1):7-16. doi: 10.1016/j.pscychresns.2011.01.006. Epub 2011 May 18.
Alterations in working memory, default-mode network (DMN), and dopamine transporter have all been proposed as endophenotypes for attention-deficit/hyperactivity disorder (ADHD). Despite evidence that these systems are interrelated, their relationship to each other has never been studied in the context of ADHD. In order to understand the potential mediating effects of task-positive and task-negative networks between DAT1 and diagnosis, we tested effects of genotype and diagnosis on regions of positive and negative BOLD signal change (as measured with fMRI) in 53 adults with ADHD and 38 control subjects during a working memory task. We also examined the relationship of these responses to ADHD symptoms. Our results yielded four principal findings: 1) association of the DAT1 9R allele with adult ADHD, 2) marginal DAT1 association with task-related suppression in left medial PFC, 3) marginal genotype×diagnosis interaction in the dorsal anterior cingulate cortex, and 4) correlation of DMN suppression to ADHD symptoms. These findings replicate the association of the 9R allele with adult ADHD. Further, we show that DMN suppression is likely linked to DAT1 and to severity of inattention in ADHD. DMN may therefore be a target of DAT1 effects, and lie on the path between the gene and inattention in ADHD.
工作记忆、默认模式网络 (DMN) 和多巴胺转运体的改变都被提出作为注意力缺陷多动障碍 (ADHD) 的内表型。尽管有证据表明这些系统是相互关联的,但它们在 ADHD 背景下彼此之间的关系从未被研究过。为了了解 DAT1 与诊断之间正任务和负任务网络的潜在中介作用,我们在一项工作记忆任务中测试了 53 名 ADHD 成年患者和 38 名对照受试者的基因型和诊断对正性和负性 BOLD 信号变化(通过 fMRI 测量)的区域的影响。我们还研究了这些反应与 ADHD 症状之间的关系。我们的结果产生了四个主要发现:1)DAT1 9R 等位基因与成人 ADHD 的关联,2)左内侧额上回与任务相关的抑制与 DAT1 呈边缘关联,3)背侧前扣带皮层的基因型与诊断的边缘交互作用,4)DMN 抑制与 ADHD 症状的相关性。这些发现复制了 9R 等位基因与成人 ADHD 的关联。此外,我们表明 DMN 抑制可能与 DAT1 和 ADHD 中的注意力不集中严重程度有关。DMN 因此可能是 DAT1 作用的靶点,位于基因与 ADHD 中的注意力不集中之间的路径上。