E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.
Sleep. 2019 Mar 1;42(3). doi: 10.1093/sleep/zsy251.
Sleep disruption is common in attention deficit hyperactivity disorder (ADHD). Likewise, deficits in attention are a hallmark of sleep deprivation in healthy individuals. Whether ADHD and sleep deprivation modulate common, or disparate, neural systems is unknown. No study has yet utilized functional magnetic resonance imaging (fMRI) to investigate sleep loss in ADHD. We address this gap by performing a novel meta-analysis to compare patterns of fMRI activation during sleep deprivation and ADHD.
We performed a coordinate-based activation likelihood estimate (ALE) meta-analysis using the GingerALE software. A systematic review of task-based fMRI studies of sleep deprivation vs. rested and also ADHD vs. healthy controls (HC) yielded 134 articles. fMRI coordinates were extracted for each contrast (i.e. "ADHD vs. HC," "TSD vs. Rested") and normalized to the Talairach-atlas. Separate ALE analyses were performed for ADHD and sleep deprivation. We directly compared these initial estimates to determine shared vs. distinct areas of fMRI neural activation in ADHD and sleep deprivation.
Conjunction analyses revealed overlapping hypoactivations between ADHD and sleep loss in executive function regions, notably the dorsal anterior cingulate cortex. Sleep deprivation, however, was associated with significantly exaggerated hyperactivation in the thalamus.
Our study indicates that ADHD and sleep deprivation share a common neural signature: hypoactivation of executive function neuroanatomy. In contrast, sleep loss, but not ADHD, was associated with thalamic hyperactivations, intimating a potential compensatory response in sleep loss not present in ADHD. By elucidating shared and distinct patterns of functional neuroanatomy, these data provide novel targets for future experimental investigations of sleep loss in ADHD.
注意力缺陷多动障碍（ADHD）患者常出现睡眠障碍。同样，健康个体睡眠剥夺也会导致注意力缺陷。ADHD 和睡眠剥夺是否会影响共同的或不同的神经系统尚不清楚。目前尚无研究利用功能磁共振成像（fMRI）来研究 ADHD 患者的睡眠缺失。我们通过进行一项新的元分析来比较睡眠剥夺和 ADHD 期间 fMRI 激活的模式，从而填补了这一空白。
我们使用 GingerALE 软件进行了基于坐标的激活似然估计（ALE）元分析。对睡眠剥夺与休息、ADHD 与健康对照（HC）的任务型 fMRI 研究进行了系统回顾，共获得了 134 篇文章。从每个对比（即“ADHD 与 HC”、“TSD 与休息”）的 fMRI 坐标中提取，并归一化为 Talairach 图谱。针对 ADHD 和睡眠剥夺分别进行了 ALE 分析。我们直接比较了这些初始估计值，以确定 ADHD 和睡眠剥夺中 fMRI 神经激活的共同和不同区域。
联合分析显示，在执行功能区域（尤其是背侧前扣带皮层），ADHD 和睡眠缺失之间存在重叠的低激活。然而，睡眠剥夺与丘脑的显著过度激活有关。
我们的研究表明，ADHD 和睡眠剥夺具有共同的神经特征：执行功能神经解剖结构的低激活。相比之下，睡眠剥夺而不是 ADHD 与丘脑的过度激活有关，这暗示在睡眠剥夺时存在潜在的代偿反应，而在 ADHD 中则不存在。通过阐明功能神经解剖结构的共同和不同模式，这些数据为未来研究 ADHD 患者睡眠缺失提供了新的目标。
