Bumb Jan Malte, Mier Daniela, Noelte Ingo, Schredl Michael, Kirsch Peter, Hennig Oliver, Liebrich Luisa, Fenske Sabrina, Alm Barbara, Sauer Carina, Leweke Franz Markus, Sobanski Esther
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Eur Neuropsychopharmacol. 2016 Jul;26(7):1119-26. doi: 10.1016/j.euroneuro.2016.03.016. Epub 2016 Apr 14.
The pineal gland, as part of the human epithalamus, is the main production site of peripheral melatonin, which promotes the modulation of sleep patterns, circadian rhythms and circadian preferences (morningness vs. eveningness). The present study analyses the pineal gland volume (PGV) and its association with circadian preferences and symptom severity in adult ADHD patients compared to healthy controls. PGV was determined manually using high-resolution 3T MRI (T1-magnetization prepared rapid gradient echo) in medication free adult ADHD patients (N=74) compared to healthy controls (N=86). Moreover, the Morningness-Eveningness Questionnaire (MEQ), the ADHD Diagnostic Checklist and the Wender-Utah Rating Scale were conducted. PGV differed between both groups (patients: 59.9±33.8mm(3); healthy controls: 71.4±27.2mm(3), P=0.04). In ADHD patients, more eveningness types were revealed (patients: 29%; healthy controls: 17%; P=0.05) and sum scores of the MEQ were lower (patients: 45.8±11.5; healthy controls 67.2±10.1; P<0.001). Multiple regression analyses indicated a positive correlation of PGV and MEQ scores in ADHD (β=0.856, P=0.003) but not in healthy controls (β=0.054, P=0.688). Patients' MEQ scores (β=-0.473, P=0.003) were negatively correlated to ADHD symptoms. The present results suggest a linkage between the PGV and circadian preference in adults with ADHD and an association of the circadian preference to symptom severity. This may facilitate the development of new chronobiological treatment approaches for the add-on treatment in ADHD.
松果体作为人类丘脑上部的一部分，是外周褪黑素的主要产生部位，褪黑素有助于调节睡眠模式、昼夜节律和昼夜偏好（早型与晚型）。本研究分析了成年注意力缺陷多动障碍（ADHD）患者与健康对照者相比的松果体体积（PGV）及其与昼夜偏好和症状严重程度的关系。在未服用药物的成年ADHD患者（N = 74）与健康对照者（N = 86）中，使用高分辨率3T磁共振成像（T1磁化准备快速梯度回波序列）手动测定PGV。此外，还进行了晨型-夜型问卷（MEQ）、ADHD诊断清单和温德-犹他评定量表评估。两组之间PGV存在差异（患者：59.9±33.8mm³；健康对照者：71.4±27.2mm³，P = 0.04）。在ADHD患者中，晚型的比例更高（患者：29%；健康对照者：17%；P = 0.05），MEQ的总分更低（患者：45.8±11.5；健康对照者：67.2±10.1；P < 0.001）。多元回归分析表明，ADHD患者中PGV与MEQ评分呈正相关（β = 0.856，P = 0.003），而在健康对照者中无相关性（β = 0.054，P = 0.688）。患者的MEQ评分（β = -0.473，P = 0.003）与ADHD症状呈负相关。目前的结果表明，成年ADHD患者的PGV与昼夜偏好之间存在联系，且昼夜偏好与症状严重程度相关。这可能有助于开发新的时间生物学治疗方法用于ADHD的辅助治疗。
