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婴儿期脑结构、执行功能与学龄前儿童注意缺陷多动障碍问题:一项前瞻性研究。

Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study.

机构信息

The Generation R Study Group, Erasmus MC Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.

出版信息

J Child Psychol Psychiatry. 2013 Jan;54(1):96-104. doi: 10.1111/j.1469-7610.2012.02590.x. Epub 2012 Aug 28.

Abstract

BACKGROUND

Neuroimaging findings have provided evidence for a relation between variations in brain structures and attention deficit/hyperactivity disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age.

METHODS

In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the behavior rating inventory of executive function-preschool version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention deficit/hyperactivity problems were assessed at ages 3 and 5 years using the child behavior checklist.

RESULTS

A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict attention deficit/hyperactivity problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention deficit/hyperactivity problem.

CONCLUSIONS

Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD.

摘要

背景

神经影像学研究结果为大脑结构变化与注意力缺陷多动障碍(ADHD)之间的关系提供了证据。然而,纵向神经影像学研究通常仅限于已经被诊断为 ADHD 的儿童。在一项基于人群的研究中,我们旨在描述婴儿期测量的大脑结构与学龄前评估的执行功能和注意力缺陷/多动问题之间的前瞻性关联。

方法

在 Generation R 研究中,使用颅后超声在 784 名 6 周大的儿童中测量胼胝体长度、神经节-丘脑卵圆形直径(包含基底节和丘脑)和脑室体积。父母在 4 岁时使用行为评定量表的执行功能-学前版(5 个维度:抑制、转换、情绪控制、工作记忆和计划/组织)评定执行功能。在 3 岁和 5 岁时使用儿童行为检查表评估注意力缺陷/多动问题。

结果

婴儿期胼胝体长度较小与 4 岁时执行功能障碍较大相关。这是由于抑制和情绪控制方面的问题得分较高所致。在控制混杂因素后,婴儿期胼胝体长度与 3 岁和 5 岁时的注意力缺陷/多动问题无相关性。我们未发现神经节-丘脑卵圆形直径与执行功能或注意力缺陷/多动问题之间存在任何关系。

结论

在婴儿期可检测到的大脑结构变化可预测抑制和情绪控制方面的细微障碍。然而,在这项基于人群的研究中,我们无法证明早期的结构性大脑变化先于 ADHD 症状。

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