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注意缺陷多动障碍儿童血浆中胶质细胞源性神经营养因子水平升高。

Increased levels of plasma glial-derived neurotrophic factor in children with attention deficit hyperactivity disorder.

作者信息

Shim Se-Hoon, Hwangbo Young, Yoon Hee-Jung, Kwon Young-Joon, Lee Hwa-Young, Hwang Jung-A, Kim Yong-Ku

机构信息

a Se-Hoon Shim, Division of Child & Adolescent Psychiatry, Department of Psychiatry , Soonchunhyang University Cheonan Hospital , Cheonan City , Bongmyoung Dong 23-20 Choongnam Province 330-721, South Korea.

b Young Hwangbo, Department of Preventive medicine , Soonchunhyang University Cheonan Hospital , Cheonan City , Bongmyoung Dong Choongnam Province 330-721, South Korea.

出版信息

Nord J Psychiatry. 2015;69(7):546-51. doi: 10.3109/08039488.2015.1014834. Epub 2015 Mar 9.

Abstract

BACKGROUND

Recent evidence suggests that neurotrophic growth factor systems, including brain-derived neurotrophic factor, might be involved in the pathophysiology of attention deficit hyperactivity disorder (ADHD). Glial cell line-derived neurotrophic factor (GDNF) is from the transforming growth factor-β family and is abundantly expressed in the central nervous system, where it plays a role in the development and function of hippocampal cells. To date, no association studies have been done between ADHD and GDNF. Thus, here we investigate the hypothesis that there are differences in plasma GDNF levels between children with ADHD and healthy controls.

METHODS

Plasma GDNF levels were measured in 86 drug-naïve children with ADHD and 128 healthy children. The severity of ADHD symptoms was determined by scores on the Korean ADHD Rating Scale (K-ARS) in patients and healthy controls.

RESULTS

The median plasma GDNF levels in ADHD patients was 74.0 (IQR: 23.4-280.1) pg/ml versus 24.6 (IQR: 14.5-87.3) pg/ml in healthy controls; thus the median plasma GDNF levels in ADHD patients were significantly higher than in healthy controls (Mann-Whitney U-test, P < 0.01). Plasma GDNF levels were correlated positively with K-ARS subscale scores (inattention, hyperactivity-impulsivity and total), determined by Spearman's correlation test in ADHD patients and healthy controls (r = 0.371, P < 0.01; r = 0.331, P < 0.01; and r = 0.379, P < 0.01, respectively).

CONCLUSIONS

These findings suggest increased plasma GDNF levels in untreated ADHD patients. In addition, plasma GDNF levels had a significant positive correlation with inattention, hyperactivity-impulsivity and K-ARS total scores in ADHD patients and healthy controls. Further studies are required to determine the source and role of circulating GDNF in ADHD.

摘要

背景

近期证据表明,包括脑源性神经营养因子在内的神经营养生长因子系统可能参与注意缺陷多动障碍(ADHD)的病理生理学过程。胶质细胞系源性神经营养因子(GDNF)属于转化生长因子-β家族,在中枢神经系统中大量表达,在海马细胞的发育和功能中发挥作用。迄今为止,尚未开展ADHD与GDNF之间的关联研究。因此,我们在此研究一个假设,即ADHD患儿与健康对照者的血浆GDNF水平存在差异。

方法

测定86例未用药的ADHD患儿和128例健康儿童的血浆GDNF水平。通过韩国ADHD评定量表(K-ARS)对患者和健康对照者的评分来确定ADHD症状的严重程度。

结果

ADHD患者血浆GDNF水平中位数为74.0(四分位间距:23.4 - 280.1)pg/ml,而健康对照者为24.6(四分位间距:14.5 - 87.3)pg/ml;因此,ADHD患者血浆GDNF水平中位数显著高于健康对照者(曼-惠特尼U检验,P < 0.01)。通过Spearman相关性检验确定,在ADHD患者和健康对照者中,血浆GDNF水平与K-ARS子量表评分(注意力不集中、多动冲动及总分)呈正相关(分别为r = 0.371,P < 0.01;r = 0.331,P < 0.01;r = 0.379,P < 0.01)。

结论

这些发现表明未治疗的ADHD患者血浆GDNF水平升高。此外,在ADHD患者和健康对照者中,血浆GDNF水平与注意力不集中、多动冲动及K-ARS总分呈显著正相关。需要进一步研究以确定循环GDNF在ADHD中的来源和作用。

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