Hulvershorn Leslie A, Mennes Maarten, Castellanos F Xavier, Di Martino Adriana, Milham Michael P, Hummer Tom A, Roy Amy Krain
Indiana University School of Medicine, Riley Hospital for Children; Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, New York University Child Study Center.
Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, New York University Child Study Center; Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen Medical Centre.
J Am Acad Child Adolesc Psychiatry. 2014 Mar;53(3):351-61.e1. doi: 10.1016/j.jaac.2013.11.012. Epub 2013 Dec 14.
OBJECTIVE: A substantial proportion of children with attention-deficit/hyperactivity disorder (ADHD) also display emotion regulation deficits manifesting as chronic irritability, severe temper outbursts, and aggression. The amygdala is implicated in emotion regulation, but its connectivity and relation to emotion regulation in ADHD has yet to be explored. The purpose of this study was to examine the relationship between intrinsic functional connectivity (iFC) of amygdala circuits and emotion regulation deficits in youth with ADHD. METHOD: Bilateral amygdala iFC was examined using functional magnetic resonance imaging in 63 children with ADHD, aged 6 to 13 years. First, we examined the relationship between amygdala IFC and parent ratings of emotional lability (EL) in children with ADHD. Second, we compared amygdala iFC across subgroups of children with ADHD and high EL (n = 18), ADHD and low EL (n = 20), and typically developing children (TDC), all with low EL (n = 19). RESULTS: Higher EL ratings were associated with greater positive iFC between the amygdala and rostral anterior cingulate cortex in youth with ADHD. EL scores were also negatively associated with iFC between bilateral amygdala and posterior insula/superior temporal gyrus. Patterns of amygdala-cortical iFC in ADHD participants with low EL were not different from the comparison group, and the effect sizes for these comparisons were smaller than those for the trend-level differences observed between the high-EL and TDC groups. CONCLUSIONS: In children with ADHD and a range of EL, deficits in emotion regulation were associated with altered amygdala-cortical iFC. When comparing groups that differed on ADHD status but not EL, differences in amygdala iFC were small and nonsignificant, highlighting the specificity of this finding to emotional deficits, independent of other ADHD symptoms.
目的:相当一部分注意力缺陷多动障碍(ADHD)儿童也表现出情绪调节缺陷,表现为慢性易怒、严重的情绪爆发和攻击行为。杏仁核与情绪调节有关,但其在ADHD中的连接性及其与情绪调节的关系尚未得到探索。本研究的目的是探讨ADHD青少年杏仁核回路的内在功能连接(iFC)与情绪调节缺陷之间的关系。 方法:使用功能磁共振成像对63名6至13岁的ADHD儿童的双侧杏仁核iFC进行检查。首先,我们研究了ADHD儿童杏仁核iFC与父母对情绪不稳定(EL)评分之间的关系。其次,我们比较了ADHD伴高EL(n = 18)、ADHD伴低EL(n = 20)以及发育正常儿童(TDC,均为低EL,n = 19)亚组之间的杏仁核iFC。 结果:在患有ADHD的青少年中,较高的EL评分与杏仁核与喙前扣带回皮层之间更强的正向iFC相关。EL得分也与双侧杏仁核与后岛叶/颞上回之间的iFC呈负相关。低EL的ADHD参与者的杏仁核 - 皮质iFC模式与对照组没有差异,这些比较的效应大小小于高EL组和TDC组之间观察到的趋势水平差异。 结论:在患有ADHD且EL程度不同的儿童中,情绪调节缺陷与杏仁核 - 皮质iFC改变有关。当比较在ADHD状态不同但EL相同的组时,杏仁核iFC的差异很小且不显著,这突出了这一发现对情绪缺陷的特异性,独立于其他ADHD症状。
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