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儿童注意缺陷多动障碍中神经准备和反应控制的家族性。

Familiality of neural preparation and response control in childhood attention deficit-hyperactivity disorder.

机构信息

Child and Adolescent Psychiatry, University of Göttingen, Göttingen, Germany.

出版信息

Psychol Med. 2013 Sep;43(9):1997-2011. doi: 10.1017/S003329171200270X. Epub 2012 Dec 3.

Abstract

BACKGROUND

Patients with attention deficit-hyperactivity disorder (ADHD) exhibit difficulties in multiple attentional functions. Although high heritability rates suggest a strong genetic impact, aetiological pathways from genes and environmental factors to the ADHD phenotype are not well understood. Tracking the time course of deviant task processing using event-related electrophysiological brain activity should characterize the impact of familiality on the sequence of cognitive functions from preparation to response control in ADHD. Method Preparation and response control were assessed using behavioural and electrophysiological parameters of two versions of a cued continuous performance test with varying attentional load in boys with ADHD combined type (n = 97), their non-affected siblings (n = 27) and control children without a family history of ADHD (n = 43).

RESULTS

Children with ADHD and non-affected siblings showed more variable performance and made more omission errors than controls. The preparatory Cue-P3 and contingent negative variation (CNV) following cues were reduced in both ADHD children and their non-affected siblings compared with controls. The NoGo-P3 was diminished in ADHD compared with controls whilst non-affected siblings were located intermediate but did not differ from both other groups. No clear familiality effects were found for the Go-P3. Better task performance was further associated with higher CNV and P3 amplitudes.

CONCLUSIONS

Impairments in performance and electrophysiological parameters reflecting preparatory processes and to some extend also for inhibitory response control, especially under high attentional load, appeared to be familially driven in ADHD and may thus constitute functionally relevant endophenotypes for the disorder.

摘要

背景

注意力缺陷多动障碍(ADHD)患者表现出多种注意力功能障碍。尽管高遗传率表明存在强烈的遗传影响,但从基因和环境因素到 ADHD 表型的病因途径尚不清楚。使用事件相关的电生理脑活动跟踪偏差任务处理的时间过程,应该能够描述家族性对 ADHD 中从准备到反应控制的认知功能序列的影响。方法 使用 ADHD 混合型(n=97)男孩、无相关兄弟姐妹(n=27)和无 ADHD 家族史的对照儿童(n=43)的两种提示连续绩效测试版本的行为和电生理参数评估准备和反应控制。结果 ADHD 儿童和无相关兄弟姐妹的表现更具可变性,比对照组更容易出现遗漏错误。与对照组相比,ADHD 儿童和无相关兄弟姐妹的预备 cue-P3 和伴随 cue 的负变(CNV)减少。与对照组相比,ADHD 儿童的 NoGo-P3 减少,而无相关兄弟姐妹的情况则处于中间水平,但与其他两组均无差异。Go-P3 没有明显的家族性效应。更好的任务表现与更高的 CNV 和 P3 振幅进一步相关。结论 在 ADHD 中,表现和反映预备过程的电生理参数的损伤,以及在某种程度上对抑制性反应控制的损伤,似乎具有家族性,因此可能是该疾病的功能相关的内表型。

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