Clinic for Child and Adolescents Psychiatry, Goethe-University, Frankfurt, Germany.
Brain Topogr. 2012 Jul;25(3):332-44. doi: 10.1007/s10548-012-0221-6. Epub 2012 Mar 4.
Response cost and token approach (RCT) within the scope of a summer camp training is an effective treatment program for attention deficit hyperactivity disorder (ADHD). It is likely that intensive RCT training influences networks responsible for ADHD symptoms. Functional magnetic resonance imaging (fMRI) was carried out in 12 children with ADHD before and after the RCT program and in 12 healthy control children twice. For fMRI, a Go/No-go paradigm was used to investigate the influence of RCT training on attention and impulsivity. The No-go condition revealed only weak activation in the dorsal part of the anterior cingulate cortex (ACC), parietal and dorsolateral prefrontal cortex (DLPFC) before the training in children with ADHD compared to healthy children. However, this activation in these brain regions was significantly more pronounced after the training. This increase in hemodynamic response cannot be attributed merely to repetition of the measurement since the effect was not observed in healthy children. The increase in hemodynamic response in the ACC and right DLPFC was significantly associated with a reduction in response time variability and clinical symptoms in ADHD patients. After the RCT training, the children with ADHD demonstrated more pronounced activation of cortical structures which are typically related to response monitoring and self-control. It seems likely that children with ADHD learned more cognitive control in a continuous performance task as was revealed by both neuropsychological outcome and fMRI.
在夏令营培训范围内，反应代价和代币法（RCT）是一种治疗注意力缺陷多动障碍（ADHD）的有效方法。密集的 RCT 训练可能会影响到负责 ADHD 症状的网络。对 12 名 ADHD 儿童和 12 名健康对照儿童在 RCT 项目前后进行了两次功能性磁共振成像（fMRI）。对于 fMRI，使用 Go/No-go 范式来研究 RCT 训练对注意力和冲动性的影响。与健康儿童相比，ADHD 儿童在训练前的背侧前扣带皮层（ACC）、顶叶和背外侧前额叶皮层（DLPFC）的 No-go 条件下，激活较弱。然而，经过训练后，这些脑区的激活明显更为显著。这种血液动力学反应的增加不能仅仅归因于测量的重复，因为在健康儿童中没有观察到这种效应。ACC 和右 DLPFC 中的血液动力学反应增加与 ADHD 患者的反应时变异性和临床症状的减少显著相关。经过 RCT 训练后，ADHD 儿童表现出更明显的皮质结构激活，这些结构通常与反应监测和自我控制有关。似乎 ADHD 儿童在连续作业任务中学会了更多的认知控制，这一点既可以从神经心理学结果中也可以从 fMRI 中得到证实。
