Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University and Martin University Hospital, Martin, Slovakia; Institute of Physiology, Faculty of Medicine, Comenius University, Sasinkova 2, 813 72 Bratislava, Slovakia.
Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
Psychiatry Res. 2014 Apr 30;222(1-2):75-83. doi: 10.1016/j.pscychresns.2014.03.003. Epub 2014 Mar 15.
Attention deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral childhood disorder. Dysfunction of prefrontal neural circuits which are responsible for executive and attentional functions has been previously shown in ADHD. We investigated the neurometablite changes in areas included in dorsolateral prefrontal neural circuits after 2 months of long-acting methylphenidate or atomoxetine medication in children with ADHD who were responders to treatment. Twenty-one ADHD children were examined by single voxel (1)H-magnetic resonance spectroscopy (MRS) before and after 2 months of medication with OROS methylphenidate (n=10) or atomoxetine (n=11). The spectra were taken from the dorsolateral prefrontal cortex (DLPFC, 8ml) and white matter behind the DLPFC (anterior semioval center, 7.5ml), bilaterally. NAA and NAA/Cr (N-acetylaspartate/creatine) decreased in the left DLPFC and Cho/Cr (choline/creatine) increased in the right DLPFC after atomoxetine medication. Glu+Gln and Glu+Gln/Cr (glutamate/glutamine) increased in the left white matter after methylphenidate medication. We hypothesize that atomoxetine could decrease hyperactivation of DLPFC neurons and methylphenidate could lead to increased activation of cortical glutamatergic projections with the consequences of increased tonic dopamine release in the mesocortical system.
注意缺陷多动障碍（ADHD）是最常见的儿童神经行为障碍。前额神经回路的功能障碍负责执行和注意力功能，以前在 ADHD 中已经显示出来。我们研究了对治疗有反应的 ADHD 儿童在接受长效哌甲酯或托莫西汀治疗 2 个月后，包括背外侧前额神经回路在内的区域的神经代谢变化。21 名 ADHD 儿童在接受 OROS 哌甲酯（n=10）或托莫西汀（n=11）治疗 2 个月前后接受了单体素（1）H 磁共振波谱（MRS）检查。频谱取自背外侧前额皮质（DLPFC，8ml）和 DLPFC 后面的白质（前半卵圆中心，7.5ml），双侧。托莫西汀治疗后，左 DLPFC 中的 NAA 和 NAA/Cr（N-乙酰天冬氨酸/肌酐）降低，右 DLPFC 中的 Cho/Cr（胆碱/肌酐）增加。哌甲酯治疗后，左白质中的 Glu+Gln 和 Glu+Gln/Cr（谷氨酸/谷氨酰胺）增加。我们假设托莫西汀可以降低 DLPFC 神经元的过度激活，而哌甲酯可以导致皮质谷氨酸能投射的激活增加，从而导致中皮质系统中多巴胺的释放增加。
