患有注意力缺陷多动障碍的女孩和男孩的额叶形态各异。
Distinct frontal lobe morphology in girls and boys with ADHD.
作者信息
Dirlikov Benjamin, Shiels Rosch Keri, Crocetti Deana, Denckla Martha B, Mahone E Mark, Mostofsky Stewart H
机构信息
Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA.
Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA ; Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.
出版信息
Neuroimage Clin. 2014 Dec 10;7:222-9. doi: 10.1016/j.nicl.2014.12.010. eCollection 2015.
OBJECTIVE
This study investigated whether frontal lobe cortical morphology differs for boys and girls with ADHD (ages 8-12 years) in comparison to typically developing (TD) peers.
METHOD
Participants included 226 children between the ages of 8-12 including 93 children with ADHD (29 girls) and 133 TD children (42 girls) for which 3T MPRAGE MRI scans were obtained. A fully automated frontal lobe atlas was used to generate functionally distinct frontal subdivisions, with surface area (SA) and cortical thickness (CT) assessed in each region. Analyses focused on overall diagnostic differences as well as examinations of the effect of diagnosis within boys and girls.
RESULTS
Girls, but not boys, with ADHD showed overall reductions in total prefrontal cortex (PFC) SA. Localization revealed that girls showed widely distributed reductions in the bilateral dorsolateral PFC, left inferior lateral PFC, right medial PFC, right orbitofrontal cortex, and left anterior cingulate; and boys showed reduced SA only in the right anterior cingulate and left medial PFC. In contrast, boys, but not girls, with ADHD showed overall reductions in total premotor cortex (PMC) SA. Further localization revealed that in boys, premotor reductions were observed in bilateral lateral PMC regions; and in girls reductions were observed in bilateral supplementary motor complex. In line with diagnostic group differences, PMC and PFC SAs were inversely correlated with symptom severity in both girls and boys with ADHD.
CONCLUSIONS
These results elucidate sex-based differences in cortical morphology of functional subdivisions of the frontal lobe and provide additional evidence of associations among SA and symptom severity in children with ADHD.
目的
本研究调查了8至12岁患注意缺陷多动障碍（ADHD）的男孩和女孩与发育正常（TD）的同龄人相比，其额叶皮质形态是否存在差异。
方法
参与者包括226名8至12岁的儿童，其中93名患有ADHD（29名女孩），133名发育正常儿童（42名女孩），均接受了3T MPRAGE序列的磁共振成像扫描。使用全自动额叶图谱生成功能上不同的额叶分区，并评估每个区域的表面积（SA）和皮质厚度（CT）。分析重点在于总体诊断差异以及男孩和女孩中诊断效果的检查。
结果
患有ADHD的女孩而非男孩，其前额叶皮质（PFC）的总表面积总体减少。定位显示，女孩双侧背外侧PFC、左侧下外侧PFC、右侧内侧PFC、右侧眶额皮质和左侧前扣带回的表面积广泛减少；而男孩仅右侧前扣带回和左侧内侧PFC的表面积减少。相比之下，患有ADHD的男孩而非女孩，其运动前区皮质（PMC）的总表面积总体减少。进一步定位显示，男孩双侧外侧PMC区域的运动前区表面积减少；女孩双侧辅助运动复合体的表面积减少。与诊断组差异一致，患有ADHD的女孩和男孩中，PMC和PFC的表面积均与症状严重程度呈负相关。
结论
这些结果阐明了额叶功能分区皮质形态的性别差异，并为ADHD儿童的表面积与症状严重程度之间的关联提供了更多证据。
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