注意缺陷多动障碍中的皮质发育能让我们了解到哪些涉及早期发育机制的知识?

What can Cortical Development in Attention-Deficit/Hyperactivity Disorder Teach us About the Early Developmental Mechanisms Involved?

机构信息

NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.

出版信息

Cereb Cortex. 2017 Sep 1;27(9):4624-4634. doi: 10.1093/cercor/bhx182.

Abstract

Studies of Attention-Deficit/Hyperactivity Disorder (ADHD) have shown developmental changes in the cortical mantle. Different dimensions of cortical morphology, such as surface area and thickness, relate to different neurodevelopmental mechanisms. As such, studying multiple dimensions may inform us about the developmental origins of ADHD. Furthermore, results from existing longitudinal samples await replication. Therefore, we conducted a longitudinal study of multiple cortical dimensions in a sizable, independent ADHD sample. We analyzed 297 anatomical MRI scans from two matched groups of 94 subjects with ADHD and 94 controls, aged 6-28 years. We estimated the developmental trajectories of cortical volume, surface, thickness and gyrification for 68 regions using mixed-effects regression analysis. Subjects with ADHD had smaller overall cortical volume, predominantly driven by decreases in frontal lobe volume that were associated with reduced surface area and gyrification. Nearly all decreases were stable across development. Only a few decreases survived stringent Bonferroni correction for multiple comparisons, with the smallest detectable Cohen's d |0.43|. There were no between-group differences in cortical thickness, or in subcortical volumes. Our results suggest that ADHD is associated with developmentally persistent reductions in frontal cortical volume, surface area, and gyrification. This may implicate early neurodevelopmental mechanisms regulating cortical expansion and convolution in ADHD.

摘要

研究表明,注意缺陷多动障碍(ADHD)患者大脑皮质有发育变化。皮质形态的不同维度,如表面积和厚度,与不同的神经发育机制有关。因此,研究多个维度可能有助于我们了解 ADHD 的发育起源。此外,现有的纵向样本结果有待复制。因此,我们在一个相当大的、独立的 ADHD 样本中进行了多个皮质维度的纵向研究。我们分析了 297 名 ADHD 患者和 94 名对照组受试者的 297 个解剖学 MRI 扫描,年龄在 6-28 岁之间。我们使用混合效应回归分析估计了 68 个区域的皮质体积、表面积、厚度和脑回发育轨迹。ADHD 患者的整体皮质体积较小,主要是由于额叶体积减少所致,而额叶体积的减少与表面积和脑回减少有关。几乎所有的减少都是在整个发育过程中稳定的。只有少数减少在严格的多重比较 Bonferroni 校正后仍然存在,可检测到的最小 Cohen's d 值为 |0.43|。组间皮质厚度或皮质下体积无差异。我们的研究结果表明,ADHD 与额皮质体积、表面积和脑回发育的持续减少有关。这可能意味着早期神经发育机制在 ADHD 中调节皮质扩张和脑回形成。

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