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执行功能障碍:在注意力缺陷多动障碍和创伤后应激神经精神障碍中的作用

Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders.

作者信息

Martínez Lía, Prada Edward, Satler Corina, Tavares Maria C H, Tomaz Carlos

机构信息

Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of Brasilia Brasilia, Brazil.

Laboratory of Neurosciences and Behavior, Department of Physiological Sciences, University of BrasiliaBrasilia, Brazil; Faculty of Psychology, Social Sciences Department, Universidad Pontificia Bolivariana Seccional BucaramangaBucaramanga, Colombia.

出版信息

Front Psychol. 2016 Aug 23;7:1230. doi: 10.3389/fpsyg.2016.01230. eCollection 2016.

Abstract

Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future prospects for research and interventions in the area will be outlined, with the intention of contributing scientific reference information that encompasses the knowledge and understanding of executive dysfunction and its relationship with these treated disorders.

摘要

执行功能(EFs)是一个涵盖多种由复杂神经活动控制的认知过程的术语,这些认知过程能产生旨在实现特定目标的不同类型行为,其中之一是抑制控制。人们普遍认为,与执行功能相关的临床和行为改变,如抑制控制,存在于各种神经精神疾病中。本文综述了关于执行功能障碍、额叶 - 皮质下神经回路变化以及与注意力缺陷多动障碍(ADHD)和创伤后应激障碍(PTSD)相关的精神病理过程之间关系的研究文献。对额叶 - 皮质下神经回路的作用及其可能的异常功能以及神经精神症状的高发性进行修订,有助于解释在将效应机制付诸行动时遇到的困难,为个体提供在其环境中有效行动所需的工具。尽管文献中已报道了关于ADHD和PTSD的神经元底物数据,但这些数据是孤立的。因此,本综述强调了ADHD和PTSD在执行功能症状学方面神经底物的重叠,特别是在抑制成分方面。因此,ADHD和PTSD等疾病伴随的执行功能受损相关变化,可由对这些回路功能有直接或间接影响的干扰来解释。首先,将介绍当前神经心理学中执行功能的理论模型,重点关注抑制成分。在第二阶段,将针对每种相关疾病分析该成分,同时考虑临床方面、病因和神经生物学基础。此外,将从认知和情感抑制的角度考虑这两种神经精神疾病之间的共性。最后,将概述该领域研究和干预的意义及未来前景,旨在提供科学参考信息,涵盖对执行功能障碍及其与这些所讨论疾病关系的认识和理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85e/4993788/784cb38b32ba/fpsyg-07-01230-g001.jpg

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