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注意缺陷多动障碍(ADHD)患儿在 6 岁时存在特定神经网络通路的改变。

Inattention and hyperactivity predict alterations in specific neural circuits among 6-year-old boys.

机构信息

National University of Singapore, 9 Engineering Drive 1, Singapore.

出版信息

J Am Acad Child Adolesc Psychiatry. 2012 Jun;51(6):632-41. doi: 10.1016/j.jaac.2012.02.017. Epub 2012 Apr 24.

Abstract

OBJECTIVE

Assessment of inattention and hyperactivity in preschoolers is highly dependent upon parental reports. Such reports are compromised by parental attitudes and mental health. Our study aimed to examine associations of inattention and hyperactivity/impulsivity from maternal reports on the Conners' Parent Rating Scale (CPRS) with brain morphology assessed using structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) in 6-year-old boys.

METHOD

Large deformation diffeomorphic metric brain mapping was used to assess brain morphology on MRI and DTI in 96 six-year-old boys, including cortical thickness, subcortical shapes, and fractional anisotropy (FA) of deep white matter tracts (DWMTs). Linear regression examined associations between these measures of brain structures and mothers' CPRS ratings of their child's inattention and hyperactivity/impulsivity.

RESULTS

Our results revealed that temporal and parietal cortices, as well as posterior white matter and callosal tracts are associated with inattention and hyperactivity/impulsivity symptoms among six-year-old boys. Inattention and hyperactivity/impulsivity symptoms share common neural circuits, but hyperactivity/impulsivity ratings associate with more extensive cortical areas, such as frontal regions, and with white matter tracts emphasizing executive control. There were no associations detected between inattention (or hyperactivity/impulsivity) and the shape of subcortical structures.

CONCLUSIONS

Our results suggested specific rather than widespread neural circuits involved in inattention and hyperactivity/impulsivity in young children, which is congruent with existing findings in older children and adolescents, and in adults with attention-deficit/hyperactivity disorder (ADHD). Hence, our study supported the dimensional view of ADHD, that is, that symptoms of inattention and hyperactivity/impulsivity lie on a continuum.

摘要

目的

学龄前儿童注意力不集中和多动的评估高度依赖于父母的报告。这些报告受到父母态度和心理健康的影响。我们的研究旨在检查母亲对康纳斯父母评定量表(CPRS)报告的注意力不集中和多动/冲动的程度与 6 岁男孩使用结构磁共振成像(MRI)和弥散张量成像(DTI)评估的大脑形态之间的关联。

方法

使用大变形仿射度量脑映射来评估 96 名 6 岁男孩的 MRI 和 DTI 的大脑形态,包括皮质厚度、皮质下形状和深部白质束(DWMT)的各向异性分数(FA)。线性回归检查了这些大脑结构测量值与母亲对孩子注意力不集中和多动/冲动的 CPRS 评分之间的关联。

结果

我们的结果表明,颞叶和顶叶皮层以及后白质和胼胝体束与 6 岁男孩的注意力不集中和多动/冲动症状有关。注意力不集中和多动/冲动症状共享共同的神经回路,但多动/冲动评分与更广泛的皮质区域(如额叶)和强调执行控制的白质束有关。在注意力不集中(或多动/冲动)与皮质下结构的形状之间没有发现关联。

结论

我们的结果表明,在幼儿中涉及注意力不集中和多动/冲动的是特定而不是广泛的神经回路,这与年龄较大的儿童和青少年以及注意力缺陷/多动障碍(ADHD)的成年人中的现有发现一致。因此,我们的研究支持 ADHD 的维度观点,即注意力不集中和多动/冲动的症状位于一个连续体上。

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