School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Hum Brain Mapp. 2014 Jan;35(1):199-212. doi: 10.1002/hbm.22169. Epub 2012 Aug 30.
The frontostriatal circuit has been postulated to account for the core symptoms such as inattention in attention deficit/hyperactivity disorder (ADHD). This study investigated the white matter integrity of frontostriatal fiber tracts using diffusion spectrum imaging (DSI) tractography and its correlations with measures of multi-dimensional aspects of inattention based on psychiatric interview and attention tasks in 25 children with ADHD and 25 matched typically developing (TD) children. All the subjects were assessed with comprehensive psychiatric interviews and the Conner's Continuous Performance Test (CCPT). DSI data were acquired on a 3-Tesla MRI system. The frontostriatal fiber pathways were reconstructed by deterministic tractography, and generalized fractional anisotropy values were measured along individual targeted tracts to investigate alterations in microstructure integrity. Children with ADHD performed worse than TD children in the dimensions of focused attention, sustained attention, impulsivity, and vigilance of the CCPT, and showed impaired integrity in four bilateral frontostriatal tracts, namely the dorsolateral-caudate, medial prefrontal-caudate, orbitofrontal-caudate, and ventrolateral-caudate tracts, and in global white matter as well. The integrity of the left orbitofronto-caudate tract was associated with the symptom of inattention in children with ADHD, compatible with the attention deficit and motivational dysfunction theories in ADHD. The integrity of the frontostriatal tracts was associated with the attention performance only in TD children, suggestive of possible recruitment of tracts other than the frontostriatal tracts implicated in attention deficits in children with ADHD. In conclusion, our results demonstrate the functional involvement of the frontostriatal circuit with respect to clinical symptoms and attention performance.
额眶部-纹状体环路被认为与注意缺陷多动障碍(ADHD)的核心症状(如注意力不集中)有关。本研究使用弥散张量成像(DTI)纤维束追踪技术,调查了前额叶-纹状体纤维束的白质完整性,并基于精神科访谈和注意力任务,将其与多维注意力不集中测量指标进行了相关性分析,研究对象为 25 名 ADHD 儿童和 25 名匹配的正常发育(TD)儿童。所有受试者均接受了全面的精神科访谈和康纳连续表现测试(CCPT)评估。DTI 数据在 3T MRI 系统上采集。通过确定性纤维束追踪技术重建额眶部-纹状体纤维通路,并测量各个靶向通路的广义各向异性分数值,以研究微观结构完整性的变化。ADHD 患儿在 CCPT 的专注注意力、持续注意力、冲动性和警觉性维度上的表现均劣于 TD 患儿,且在 4 条双侧额眶部-纹状体纤维束(即背外侧-尾状核、内侧前额叶-尾状核、眶额部-尾状核和腹外侧-尾状核纤维束)以及全脑白质的完整性方面也存在损伤。左眶额部-尾状核纤维束的完整性与 ADHD 患儿的注意力不集中症状有关,这与 ADHD 中的注意力缺陷和动机功能障碍理论一致。只有 TD 儿童的额眶部-纹状体纤维束完整性与注意力表现相关,这提示在 ADHD 患儿中,可能涉及额眶部-纹状体纤维束以外的纤维束来代偿注意力缺陷。总之,我们的研究结果表明,额眶部-纹状体环路与临床症状和注意力表现有关。
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