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注意力缺陷多动障碍的神经影像学:临床医生的当前神经科学启示观点。

Neuroimaging of attention-deficit/hyperactivity disorder: current neuroscience-informed perspectives for clinicians.

机构信息

Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA.

出版信息

Curr Psychiatry Rep. 2012 Oct;14(5):568-78. doi: 10.1007/s11920-012-0310-y.

Abstract

The neuroimaging literature on attention-deficit/hyperactivity disorder (ADHD) is growing rapidly. Here, we provide a critical overview of neuroimaging studies published recently, highlighting perspectives that may be of relevance for clinicians. After a comprehensive search of PubMed, Ovid, Web of Science, and EMBASE, we located 41 pertinent papers published between January 2011 and April 2012, comprising both structural and functional neuroimaging studies. This literature is increasingly contributing to the notion that the pathophysiology of ADHD reflects abnormal interplay among large-scale brain circuits. Moreover, recent studies have begun to reveal the mechanisms of action of pharmacological treatment. Finally, imaging studies with a developmental perspective are revealing the brain correlates of ADHD over the lifespan, complementing clinical observations on the phenotypic continuity and discontinuity of the disorder. However, despite the increasing potential to eventually inform clinical practice, current imaging studies do not have validated applications in day-to-day clinical practice. Although novel analytical techniques are likely to accelerate the pace of translational applications, at the present we advise caution regarding inappropriate commercial misuse of imaging techniques in ADHD.

摘要

注意缺陷多动障碍(ADHD)的神经影像学文献正在迅速增长。在这里,我们对最近发表的神经影像学研究进行了批判性综述,强调了可能与临床医生相关的观点。通过对 PubMed、Ovid、Web of Science 和 EMBASE 进行全面检索,我们找到了 41 篇发表于 2011 年 1 月至 2012 年 4 月之间的相关论文,包括结构和功能神经影像学研究。这一文献越来越多地证明 ADHD 的病理生理学反映了大脑大回路之间异常的相互作用。此外,最近的研究开始揭示药物治疗的作用机制。最后,具有发展观的影像学研究揭示了 ADHD 一生中的大脑相关性,补充了关于该疾病表型连续性和不连续性的临床观察。然而,尽管有越来越大的潜力最终为临床实践提供信息,但目前成像研究在日常临床实践中没有经过验证的应用。虽然新的分析技术可能会加速转化应用的步伐,但目前我们建议对 ADHD 中成像技术的不当商业滥用保持谨慎。

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