Chang Jane Pei-Chen, Lane Hsien-Yuan, Tsai Guochuan E
Department of Psychiatry, Harbor-UCLA Medical Center, and the Los Angeles Biomedical Research Institute, Torrance, CA, USA.
Curr Pharm Des. 2014;20(32):5180-5. doi: 10.2174/1381612819666140110115227.
Attention deficit hyperactivity disorder (ADHD) is a long recognized and common childhood disorder. ADHD adolescents tend to encounter more difficulties in school and peer relationships, whereas ADHD adults have more occupational and interpersonal difficulties. However, with the treatment of central nervous system (CNS) stimulants, 10-20 % of the patients still remain poor responders to treatment. Among hypotheses for ADHD, dysfunction of N-methyl-D-aspartate (NMDA)-type glutamate receptors has recently been suggested by accumulating genetic and animal studies. This article systemically reviews evidence supporting NMDA dysfunction as a potential ADHD pathogenesis from perspectives of neurodevelopment, attentional circuitry, and impulse inhibition. The review also addresses the development of novel treatments for ADHD via modulation of glutamatergic system, particularly the NMDA/glycine site. These so-called NMDA enhancers may provide a new treatment option for patients with ADHD.
注意缺陷多动障碍（ADHD）是一种早已被认识的常见儿童疾病。患有ADHD的青少年在学校和同伴关系中往往会遇到更多困难，而患有ADHD的成年人则在职业和人际关系方面有更多困难。然而，使用中枢神经系统（CNS）兴奋剂治疗后，仍有10%-20%的患者对治疗反应不佳。在关于ADHD的各种假说中，越来越多的遗传学和动物研究表明N-甲基-D-天冬氨酸（NMDA）型谷氨酸受体功能障碍与之相关。本文从神经发育、注意力回路和冲动抑制的角度，系统地综述了支持NMDA功能障碍作为ADHD潜在发病机制的证据。该综述还探讨了通过调节谷氨酸能系统，特别是NMDA/甘氨酸位点来开发ADHD新治疗方法的情况。这些所谓的NMDA增强剂可能为ADHD患者提供一种新的治疗选择。
