Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Apr;52(4):431-440.e4. doi: 10.1016/j.jaac.2013.01.010. Epub 2013 Mar 7.
Previous voxel-based and regions-of-interest (ROI)-based diffusion tensor imaging (DTI) studies have found above-normal mean diffusivity (MD) and below-normal fractional anisotropy (FA) in subjects with attention-deficit/hyperactivity disorder (ADHD). However, findings remain mixed, and few studies have examined the contribution of ADHD familial liability to white matter microstructure.
We used refined DTI tractography methods to examine MD, FA, axial diffusivity (AD), and radial diffusivity (RD) of the anterior thalamic radiation, cingulum, corticospinal tract, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, forceps major, forceps minor, superior longitudinal fasciculus, and uncinate fasciculus in children and adolescents with ADHD (n = 56), unaffected siblings of ADHD probands (n = 31), and healthy controls (n = 17).
Subjects with ADHD showed significantly higher MD than controls in the anterior thalamic radiation, forceps minor, and superior longitudinal fasciculus. Unaffected siblings of subjects with ADHD displayed similar differences in MD as subjects with ADHD. Although none of the tested tracts showed a significant effect of FA, the tracts with elevated MD likewise displayed elevated AD both in subjects with ADHD and in unaffected siblings. Differences in RD between subjects with ADHD, unaffected siblings, and controls were not as widespread as differences in MD and AD.
Our findings suggest that disruptions in white matter microstructure occur in several large white matter pathways in association with ADHD and indicate a familial liability for the disorder. Furthermore, MD may reflect these abnormalities more sensitively than FA.
先前基于体素和基于感兴趣区(ROI)的弥散张量成像(DTI)研究发现,注意力缺陷多动障碍(ADHD)患者的平均弥散度(MD)高于正常水平,各向异性分数(FA)低于正常水平。然而,研究结果仍存在差异,且很少有研究探讨 ADHD 家族易感性对大脑白质微观结构的影响。
我们使用改良的弥散张量成像追踪方法,检测了 56 名 ADHD 患儿和青少年、31 名 ADHD 先证者无患病亲属和 17 名健康对照者的前丘脑辐射、扣带束、皮质脊髓束、下额枕束、下纵束、内囊前肢、内囊后肢、上纵束和钩束的 MD、FA、轴向弥散度(AD)和径向弥散度(RD)。
与对照组相比,ADHD 患者在前丘脑辐射、内囊后肢和上纵束的 MD 值明显升高。ADHD 患者的无患病亲属的 MD 值与 ADHD 患者相似。虽然测试的所有轨迹均未显示 FA 有显著影响,但 MD 升高的轨迹在 ADHD 患者和无患病亲属中同样显示 AD 升高。ADHD 患者、无患病亲属和对照组之间的 RD 差异并不像 MD 和 AD 差异那样广泛。
我们的研究结果表明,与 ADHD 相关的大脑白质微观结构在几个较大的白质通路上发生了破坏,提示该疾病存在家族易感性。此外,MD 可能比 FA 更敏感地反映这些异常。