Groenman Annabeth P, Oosterlaan Jaap, Greven Corina U, Vuijk Pieter Jelle, Rommelse Nanda, Franke Barbara, Hartman Catharina A, Hoekstra Pieter J, Sergeant Joseph, Faraone Stephen V, Buitelaar Jan
Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands; Centre for Neuroscience, Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Child Psychol Psychiatry. 2015 May;56(5):521-9. doi: 10.1111/jcpp.12315. Epub 2014 Aug 19.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a risk factor for substance use disorders (SUDs) and nicotine dependence (ND). Neurocognitive deficits may predict the increased risk of developing SUDs and nicotine dependence.
This study comprised three groups derived from the Dutch part of the International Multicenter ADHD Genetics (IMAGE) study: ADHD probands (n = 294), unaffected siblings (n = 161), and controls (n = 214). At baseline (age = 12.2), a range of neurocognitive functions was assessed including executive functions (inhibition, working memory, timing), measures of motor functioning (motor timing and tracking) and IQ. After a mean follow-up of 4.2 years, SUDs and ND were assessed.
None of the neurocognitive functions predicted later SUDs or ND in ADHD probands, even after controlling for medication use and conduct disorder. Slower response inhibition predicted later nicotine dependence in unaffected siblings (OR = 2.06, 95% CI = 1.22-3.48), and lower IQ predicted increased risk for SUDs in controls (OR = 1.96, 95% CI = 1.12-3.44).
Cold executive functions, motor functioning, and IQ did not predict the elevated risk of SUDs and ND in ADHD. Future studies should target 'hot' executive functions such as reward processing as risk factors for SUDs or ND.
注意力缺陷多动障碍（ADHD）是物质使用障碍（SUDs）和尼古丁依赖（ND）的一个风险因素。神经认知缺陷可能预示着发生物质使用障碍和尼古丁依赖的风险增加。
本研究包括来自国际多中心ADHD遗传学（IMAGE）研究荷兰部分的三组人群：ADHD先证者（n = 294）、未受影响的同胞（n = 161）和对照组（n = 214）。在基线时（年龄 = 12.2岁），评估了一系列神经认知功能，包括执行功能（抑制、工作记忆、计时）、运动功能测量（运动计时和追踪）以及智商。平均随访4.2年后，评估物质使用障碍和尼古丁依赖情况。
即使在控制了药物使用和品行障碍之后，没有一种神经认知功能能够预测ADHD先证者后来的物质使用障碍或尼古丁依赖。反应抑制较慢预示着未受影响的同胞后来会出现尼古丁依赖（OR = 2.06，95% CI = 1.22 - 3.48），而智商较低预示着对照组发生物质使用障碍的风险增加（OR = 1.96，95% CI = 1.12 - 3.44）。
冷静的执行功能、运动功能和智商并不能预测ADHD患者物质使用障碍和尼古丁依赖的风险升高。未来的研究应将“热”执行功能（如奖励处理）作为物质使用障碍或尼古丁依赖的风险因素进行研究。
