Nickel Kathrin, Tebartz van Elst Ludger, Manko Jacek, Unterrainer Josef, Rauh Reinhold, Klein Christoph, Endres Dominique, Kaller Christoph P, Mader Irina, Riedel Andreas, Biscaldi Monica, Maier Simon
Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
Front Psychiatry. 2018 Oct 23;9:521. doi: 10.3389/fpsyt.2018.00521. eCollection 2018.
Autism spectrum (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with a high rate of comorbidity. To date, diagnosis is based on clinical presentation and distinct reliable biomarkers have been identified neither for ASD nor ADHD. Most previous neuroimaging studies investigated ASD and ADHD separately. To address the question of structural brain differences between ASD and ADHD, we performed FreeSurfer analysis in a sample of children with ADHD ( = 30), with high-functioning ASD ( = 14), with comorbid high-functioning ASD and ADHD ( = 15), and of typically developed controls (TD; = 36). With FreeSurfer, an automated brain imaging processing and analyzing suite, we reconstructed the cerebral cortex and calculated gray matter volumes as well as cortical surface parameters in terms of cortical thickness and mean curvature. A significant main effect of the factor ADHD was detected for the left inferior frontal gyrus (Pars orbitalis) volume, with the ADHD group exhibiting smaller Pars orbitalis volumes. Dimensional measures of autism (SRS total raw score) and ADHD (DISYPS-II FBB-ADHD score) had no significant influence on the left Pars orbitalis volume. Both, ASD and ADHD tended to have an effect on cortical thickness or mean curvature, which did not survive correction for multiple comparisons. Our results underline that ADHD rather than ASD is associated with volume loss in the left inferior frontal gyrus (Pars orbitalis). This area might play a relevant role in modulating symptoms of inattention and/or impulsivity in ADHD. The effect of comorbid ADHD in ASD samples and vice versa, on cortical thickness and mean curvature, requires further investigation in larger samples.
自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)是共病率很高的神经发育障碍。迄今为止,诊断基于临床表现,尚未确定ASD和ADHD的独特可靠生物标志物。以前的大多数神经影像学研究分别调查了ASD和ADHD。为了解决ASD和ADHD之间脑结构差异的问题,我们对患有ADHD的儿童样本(n = 30)、高功能ASD儿童样本(n = 14)、患有高功能ASD和ADHD共病的儿童样本(n = 15)以及正常发育对照组(TD;n = 36)进行了FreeSurfer分析。使用FreeSurfer(一种自动化脑成像处理和分析套件),我们重建了大脑皮层,并计算了灰质体积以及皮层厚度和平均曲率方面的皮层表面参数。对于左侧额下回(眶部)体积,检测到ADHD因素有显著的主效应,ADHD组的眶部体积较小。自闭症维度测量(社会反应量表总原始分数)和ADHD维度测量(儿童青少年多维度量表-II多动冲动-ADHD分数)对左侧眶部体积没有显著影响。ASD和ADHD都倾向于对皮层厚度或平均曲率产生影响,但在多重比较校正后这种影响不显著。我们的结果强调,与左侧额下回(眶部)体积减少相关的是ADHD而非ASD。该区域可能在调节ADHD的注意力不集中和/或冲动症状方面发挥相关作用。ASD样本中共病ADHD以及反之ADHD样本中共病ASD对皮层厚度和平均曲率的影响,需要在更大样本中进一步研究。