Liu Qi, Chen Lizhou, Li Fei, Chen Ying, Guo Lanting, Gong Qiyong, Huang Xiaoqi
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2016 Jun;33(3):526-32.
Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neuro-developmental disorders occurring in childhood,characterized by symptoms of age-inappropriate inattention,hyperactivity/impulsivity,and the prevalence is higher in boys.Although gray matter volume deficits have been frequently reported for ADHD children via structural magnetic resonance imaging,few of them had specifically focused on male patients.The present study aimed to explore the alterations of gray matter volumes in medicated-naive boys with ADHD via a relatively new voxel-based morphometry technique.According to the criteria of DSM-IV-TR,43medicated-naive ADHD boys and 44age-matched healthy boys were recruited.The magnetic resonance image(MRI)scan was performed via a 3T MRI system with three-dimensional(3D)spoiled gradient recalled echo(SPGR)sequence.Voxel-based morphometry with diffeomorphic anatomical registration through exponentiated lie algebra in SPM8 was used to preprocess the3DT1-weighted images.To identify gray matter volume differences between the ADHD and the controls,voxelbased analysis of whole brain gray matter volumes between two groups were done via two sample t-test in SPM8 with age as covariate,threshold at P<0.001.Finally,compared to the controls,significantly reduced gray matter volumes were identified in the right orbitofrontal cortex(peak coordinates[-2,52,-25],t=4.01),and bilateral hippocampus(Left:peak coordinates[14,0,-18],t=3.61;Right:peak coordinates[-14,15,-28],t=3.64)of ADHD boys.Our results demonstrated obvious reduction of whole brain gray matter volumes in right orbitofrontal cortex and bilateral hippocampus in boys with ADHD.This suggests that the abnormalities of prefrontal-hippocampus circuit may be the underlying cause of the cognitive dysfunction and abnormal behavioral inhibition in medicatednaive boys with ADHD.
注意缺陷多动障碍（ADHD）是儿童期最常见的神经发育障碍之一，其特征为存在与年龄不符的注意力不集中、多动/冲动症状，且男孩患病率更高。尽管通过结构磁共振成像经常报道ADHD儿童存在灰质体积减少，但很少有研究专门聚焦于男性患者。本研究旨在通过一种相对较新的基于体素的形态学测量技术，探索未用药的ADHD男孩的灰质体积变化。根据《精神疾病诊断与统计手册第四版修订版》（DSM-IV-TR）标准，招募了43名未用药的ADHD男孩和44名年龄匹配的健康男孩。通过3T磁共振成像系统，采用三维（3D）扰相梯度回波（SPGR）序列进行磁共振图像（MRI）扫描。使用SPM8中通过指数李代数进行微分同胚解剖配准的基于体素的形态学测量方法对3D T1加权图像进行预处理。为了确定ADHD组与对照组之间的灰质体积差异，在SPM8中以年龄作为协变量，通过两样本t检验对两组全脑灰质体积进行基于体素的分析，阈值设定为P<0.001。最后，与对照组相比，在ADHD男孩的右侧眶额皮质（峰值坐标[-2,52,-25]，t=4.01）以及双侧海马体（左侧：峰值坐标[14,0,-18]，t=3.61；右侧：峰值坐标[-14,15,-28]，t=3.64）中发现灰质体积显著减少。我们的结果表明，ADHD男孩右侧眶额皮质和双侧海马体的全脑灰质体积明显减少。这表明前额叶 - 海马体回路异常可能是未用药的ADHD男孩认知功能障碍和行为抑制异常的潜在原因。
