1 McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA2 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
1 McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA2 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Brain. 2014 Sep;137(Pt 9):2423-8. doi: 10.1093/brain/awu137. Epub 2014 Jun 10.
Previous resting state studies examining the brain basis of attention deficit hyperactivity disorder have not distinguished between patients who persist versus those who remit from the diagnosis as adults. To characterize the neurobiological differences and similarities of persistence and remittance, we performed resting state functional magnetic resonance imaging in individuals who had been longitudinally and uniformly characterized as having or not having attention deficit hyperactivity disorder in childhood and again in adulthood (16 years after baseline assessment). Intrinsic functional brain organization was measured in patients who had a persistent diagnosis in childhood and adulthood (n = 13), in patients who met diagnosis in childhood but not in adulthood (n = 22), and in control participants who never had attention deficit hyperactivity disorder (n = 17). A positive functional correlation between posterior cingulate and medial prefrontal cortices, major components of the default-mode network, was reduced only in patients whose diagnosis persisted into adulthood. A negative functional correlation between medial and dorsolateral prefrontal cortices was reduced in both persistent and remitted patients. The neurobiological dissociation between the persistence and remittance of attention deficit hyperactivity disorder may provide a framework for the relation between the clinical diagnosis, which indicates the need for treatment, and additional deficits that are common, such as executive dysfunctions.
先前的静息态研究考察了注意缺陷多动障碍的大脑基础，但并未区分成年后仍持续存在该诊断和已缓解的患者。为了描述持续性和缓解性的神经生物学差异和相似性，我们对在儿童期和成年期（基线评估后 16 年）均经过纵向和统一特征描述为患有或不患有注意缺陷多动障碍的个体进行了静息态功能磁共振成像。在儿童期和成年期均持续诊断为注意缺陷多动障碍的患者（n=13）、儿童期诊断但成年期未诊断的患者（n=22）和从未患有注意缺陷多动障碍的对照组参与者（n=17）中测量了内在功能大脑组织。仅在成年后诊断仍持续的患者中，后扣带回和内侧前额叶皮质之间的正向功能相关性降低，内侧前额叶皮质和背外侧前额叶皮质之间的负向功能相关性降低。注意缺陷多动障碍持续性和缓解性之间的神经生物学分离可能为临床诊断（表明需要治疗）与常见的额外缺陷（如执行功能障碍）之间的关系提供框架。
