Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Mol Psychiatry. 2020 Nov;25(11):3020-3033. doi: 10.1038/s41380-018-0202-6. Epub 2018 Aug 14.
Attention-Deficit/Hyperactivity Disorder (ADHD) and conduct disorder (CD) exemplify top-down dysregulation conditions that show a large comorbidity and shared genetics. At the same time, they entail two different types of symptomology involving mainly non-emotional or emotional dysregulation. Few studies have tried to separate the specific biology underlying these two dimensions. It has also been suggested that both types of conditions consist of extreme cases in the general population where the symptoms are widely distributed. Here we test whether brain structure is specifically associated to ADHD or CD symptoms in a general population of adolescents (n = 1093) being part of the IMAGEN project. Both ADHD symptoms and CD symptoms were related to similar and overlapping MRI findings of a smaller structure in prefrontal and anterior cingulate cortex. However, our regions of interest (ROI) approach indicated that gray matter volume (GMV) and surface area (SA) in dorsolateral/dorsomedial prefrontal cortex and caudal anterior cingulate cortex were negatively associated to ADHD symptoms when controlling for CD symptoms while rostral anterior cingulate cortex GMV was negatively associated to CD symptoms when controlling for ADHD symptoms. The structural findings were mirrored in performance of neuropsychological tests dependent on prefrontal and anterior cingulate regions, showing that while performance on the Stop Signal test was specifically related to the ADHD trait, delayed discounting and working memory were related to both ADHD and CD traits. These results point towards a partially domain specific and dimensional capacity in different top-down regulatory systems associated with ADHD and CD symptoms.
注意缺陷多动障碍(ADHD)和品行障碍(CD)是自上而下的调节障碍的典型例子,它们具有很高的共病性和共同的遗传基础。同时,它们涉及两种不同类型的症状,主要涉及非情感或情感调节障碍。很少有研究试图将这两种维度的具体生物学基础分开。有人还提出,这两种情况都包含了在普通人群中症状广泛分布的极端情况。在这里,我们在 IMAGEN 项目的青少年普通人群(n=1093)中测试了大脑结构是否与 ADHD 或 CD 症状有特定的关联。ADHD 症状和 CD 症状都与前额叶和前扣带回皮质较小结构的相似且重叠的 MRI 发现有关。然而,我们的兴趣区域(ROI)方法表明,在控制 CD 症状的情况下,背外侧/背内侧前额叶和后扣带回皮质的灰质体积(GMV)和表面积(SA)与 ADHD 症状呈负相关,而在前扣带回皮质 GMV 与 ADHD 症状呈负相关控制 CD 症状时。结构发现与依赖前额叶和前扣带区域的神经心理学测试的表现相吻合,表明在停止信号测试中的表现与 ADHD 特征特异性相关,而延迟折扣和工作记忆与 ADHD 和 CD 特征都相关。这些结果表明,与 ADHD 和 CD 症状相关的不同自上而下的调节系统具有部分特定于域和维度的能力。