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[睡眠在注意力缺陷多动障碍中的作用:预防注意力缺陷多动障碍的可能性?]

[The role of sleep in ADHD: possibilities for prevention of ADHD?].

作者信息

Arns M

出版信息

Tijdschr Psychiatr. 2013;55(10):773-82.

Abstract

BACKGROUND

Personalized medicine aims to provide the right treatment for the right person at the right time, as opposed to the currently employed ‘one-size-fits-all ' approach. This development relies on identification of ADHD subgroups using biomarkers. One important ADHD subgroup is characterised by impaired vigilance regulation, as quantified by the EEG and this sub-group responds well to stimulant medication and neurofeedback. Recent insights suggest a clear association between reduced sleep duration and ADHD complaints in this sub-group of ADHD patients. A recently published model explains how different treatments e.g. chronobiological treatments and neurofeedback impact on this neural circuitry and mediate ADHD symptom improvement.

AIM

To test this recently published model predicting a relationship between solar intensity and ADHD prevalence.

METHOD

A literature survey on studies using identical methods to estimate the prevalence of ADHD in different geographical areas and compare those to worldwide solar intensity data.

RESULTS

A clear relationship between solar intensity and the worldwide prevalence of ADHD was found, explaining 34-57% of the variance in ADHD prevalence, where a lower prevalence of ADHD was found in areas with high solar-intensity.

CONCLUSION

The preventative effect of high solar intensity may be related to improvement of circadian clock disturbances. These findings likely apply to a substantial sub-group of ADHD patients and have major implications for our understanding of the etiology and possibly prevention of ADHD.

摘要

背景

个性化医疗旨在在恰当的时间为恰当的人提供恰当的治疗,这与当前采用的“一刀切”方法形成对比。这一发展依赖于使用生物标志物来识别注意力缺陷多动障碍(ADHD)亚组。一个重要的ADHD亚组的特征是警觉调节受损,这可通过脑电图进行量化,并且该亚组对兴奋剂药物和神经反馈反应良好。最近的见解表明,在这一亚组的ADHD患者中,睡眠时间缩短与ADHD症状之间存在明显关联。最近发表的一个模型解释了不同的治疗方法,如生物钟治疗和神经反馈,如何影响这一神经回路并介导ADHD症状的改善。

目的

检验最近发表的一个预测太阳强度与ADHD患病率之间关系的模型。

方法

对使用相同方法估计不同地理区域ADHD患病率并将其与全球太阳强度数据进行比较的研究进行文献调查。

结果

发现太阳强度与全球ADHD患病率之间存在明显关系,解释了ADHD患病率差异的34 - 57%,在太阳强度高的地区ADHD患病率较低。

结论

高太阳强度的预防作用可能与昼夜节律紊乱的改善有关。这些发现可能适用于相当一部分ADHD患者亚组,对我们理解ADHD的病因以及可能的预防具有重要意义。

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