Dougherty Chase C, Evans David W, Myers Scott M, Moore Gregory J, Michael Andrew M
Autism and Developmental Medicine Institute, Geisinger Health System, 120 Hamm Drive, Lewisburg, PA, 17837, USA.
Department of Psychology, Bucknell University, 701 Moore Avenue, Lewisburg, PA, 17837, USA.
Neuropsychol Rev. 2016 Mar;26(1):25-43. doi: 10.1007/s11065-015-9300-2. Epub 2015 Oct 19.
ASD and ADHD are regarded as distinct disorders in the current DSM-5. However, recent research and the RDoC initiative are recognizing considerable overlap in the clinical presentation of ASD, ADHD, and other neurodevelopmental disorders. In spite of numerous neuroimaging findings in ASD and ADHD, the extent to which either of the above views are supported remains equivocal. Here we compare structural MRI and DTI literature in ASD and ADHD. Our main findings reveal both distinct and shared neural features. Distinct expressions were in total brain volume (ASD: increased volume, ADHD: decreased volume), amygdala (ASD: overgrowth, ADHD: normal), and internal capsule (ASD: unclear, ADHD: reduced FA in DTI). Considerable overlap was noted in the corpus callosum and cerebellum (lower volume in structural MRI and decreased FA in DTI), and superior longitudinal fasciculus (reduced FA in DTI). In addition, we identify brain regions which have not been studied in depth and require more research. We discuss relationships between brain features and symptomatology. We conclude by addressing limitations of current neuroimaging research and offer approaches that account for clinical heterogeneity to better distinguish brain-behavior relationships.
在当前的《精神疾病诊断与统计手册》第五版（DSM-5）中，孤独症谱系障碍（ASD）和注意力缺陷多动障碍（ADHD）被视为不同的疾病。然而，最近的研究以及研究领域标准（RDoC）计划认识到，ASD、ADHD和其他神经发育障碍在临床表现上有相当大的重叠。尽管在ASD和ADHD方面有大量的神经影像学研究结果，但上述两种观点在多大程度上得到支持仍不明确。在此，我们比较了ASD和ADHD的结构磁共振成像（MRI）和扩散张量成像（DTI）文献。我们的主要发现揭示了不同的和共有的神经特征。不同的表现存在于全脑体积（ASD：体积增加，ADHD：体积减小）、杏仁核（ASD：过度生长，ADHD：正常）和内囊（ASD：不明确，ADHD：DTI中各向异性分数降低）。在胼胝体和小脑（结构MRI中体积较小，DTI中各向异性分数降低）以及上纵束（DTI中各向异性分数降低）中发现了相当大的重叠。此外，我们确定了尚未深入研究且需要更多研究的脑区。我们讨论了脑特征与症状学之间的关系。我们通过阐述当前神经影像学研究的局限性来得出结论，并提供考虑临床异质性的方法，以更好地区分脑-行为关系。
