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社论:精神运动迟缓的神经相关因素:一种独特临床实体的生物学证据?

Editorial: Neural Correlates of Sluggish Cognitive Tempo: Biological Evidence of a Distinct Clinical Entity?

机构信息

New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY.

New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY.

出版信息

J Am Acad Child Adolesc Psychiatry. 2019 Feb;58(2):164-166. doi: 10.1016/j.jaac.2018.08.015. Epub 2018 Dec 4.


DOI:10.1016/j.jaac.2018.08.015
PMID:30738543
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6453133/
Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder encompassing a wide array of clinical presentations, levels of impairment, etiologies, and neurobiological correlates. Despite this well-known heterogeneity, most research into the pathophysiology of ADHD has relied on comparisons between typically developing youth and those with the disorder (or perhaps further stratifying by DSM-defined ADHD subtypes). Although informative, this approach assumes a level of pathophysiologic homogeneity that belies the large and growing body of literature underscoring diverse neurobiological and neuropsychological profiles subsumed under the umbrella of this complex syndrome. For example, deficits in executive functions are characteristic of ADHD, yet meta-analysis suggests that these deficits are neither necessary nor sufficient to define all cases and that substantial overlaps in levels of executive functioning exist between children with ADHD and their typically developing peers. Likewise, neuroimaging research points to distinct neural circuits underlying different clinical presentations of ADHD, suggesting that, within the diagnosis of ADHD, the neural circuits that are most salient to the disorder can differ from one child to the next. Refining our understanding of ADHD subtypes not only on the basis of symptoms, but also by incorporating neurobiology, physiology, and neurocognitive profiles, could help propel the field toward greater specificity in diagnosis and treatment.

摘要

注意缺陷多动障碍(ADHD)是一种异质性疾病,包括广泛的临床表现、损害程度、病因和神经生物学相关性。尽管存在这种众所周知的异质性,但 ADHD 病理生理学的大多数研究都依赖于与正常发育的青年人和患有该疾病的人进行比较(或者可能根据 DSM 定义的 ADHD 亚型进一步分层)。尽管这种方法很有启发性,但它假设了一种病理生理学的同质性,而这种同质性与越来越多的文献所强调的涵盖在这个复杂综合征下的不同神经生物学和神经心理学特征背道而驰。例如,执行功能缺陷是 ADHD 的特征,但荟萃分析表明,这些缺陷既不是所有病例的必要条件,也不是充分条件,而且 ADHD 儿童和他们的正常发育同龄人之间的执行功能水平存在显著重叠。同样,神经影像学研究指出了 ADHD 不同临床表现背后的不同神经回路,表明在 ADHD 的诊断中,与该疾病最相关的神经回路可以因孩子而异。不仅基于症状,而且还结合神经生物学、生理学和神经认知特征来细化对 ADHD 亚型的理解,可以帮助该领域在诊断和治疗方面实现更高的特异性。

相似文献

[1]
Editorial: Neural Correlates of Sluggish Cognitive Tempo: Biological Evidence of a Distinct Clinical Entity?

J Am Acad Child Adolesc Psychiatry. 2018-12-4

[2]
[Is emotional dysregulation a component of attention-deficit/hyperactivity disorder (ADHD)?].

Encephale. 2015-4

[3]
Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults.

J Abnorm Psychol. 2011-5-23

[4]
Cortical morphology as a shared neurobiological substrate of attention-deficit/hyperactivity symptoms and executive functioning: a population-based pediatric neuroimaging study.

J Psychiatry Neurosci. 2017-3

[5]
The cognitive-energetic model: an empirical approach to attention-deficit hyperactivity disorder.

Neurosci Biobehav Rev. 2000-1

[6]
Functional Neuroimaging Evidence for Distinct Neurobiological Pathways in Attention-Deficit/Hyperactivity Disorder.

Biol Psychiatry Cogn Neurosci Neuroimaging. 2017-9-23

[7]
Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity.

J Clin Child Adolesc Psychol. 2012-10-24

[8]
[Sluggish cognitive tempo: symptoms of predominantly inattentive attention deficit hyperactivity disorder or a new clinical entity?].

Rev Neurol. 2006-2-13

[9]
Timing deficits in attention-deficit/hyperactivity disorder (ADHD): evidence from neurocognitive and neuroimaging studies.

Neuropsychologia. 2012-9-28

[10]
Executive dysfunction in attention-deficit/hyperactivity disorder: cognitive and neuroimaging findings.

Psychiatr Clin North Am. 2004-3

引用本文的文献

[1]
The prevalence of SCT in China, its comorbidity with ADHD and its association with life events and parental-rearing behaviors.

Sci Rep. 2023-10-7

[2]
Is an irritable ADHD profile traceable using personality dimensions? Replicability, stability, and predictive value over time of data-driven profiles.

Eur Child Adolesc Psychiatry. 2021-4

本文引用的文献

[1]
Brain Structure and Function in School-Aged Children With Sluggish Cognitive Tempo Symptoms.

J Am Acad Child Adolesc Psychiatry. 2018-11-26

[2]
Sluggish Cognitive Tempo, Processing Speed, and Internalizing Symptoms: the Moderating Effect of Age.

J Abnorm Child Psychol. 2018-1

[3]
Moving towards causality in attention-deficit hyperactivity disorder: overview of neural and genetic mechanisms.

Lancet Psychiatry. 2016-6

[4]
The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review.

J Am Acad Child Adolesc Psychiatry. 2016-3

[5]
Sluggish Cognitive Tempo: A (Misnamed) Second Attention Disorder?

J Am Acad Child Adolesc Psychiatry. 2016-3

[6]
Differentiating SCT and inattentive symptoms in ADHD using fMRI measures of cognitive control.

Neuroimage Clin. 2015-5-21

[7]
The Child Concentration Inventory (CCI): Initial validation of a child self-report measure of sluggish cognitive tempo.

Psychol Assess. 2015-9

[8]
Distinct frontal lobe morphology in girls and boys with ADHD.

Neuroimage Clin. 2014-12-10

[9]
Disrupted network architecture of the resting brain in attention-deficit/hyperactivity disorder.

Hum Brain Mapp. 2014-9

[10]
Connecting the dots: a review of resting connectivity MRI studies in attention-deficit/hyperactivity disorder.

Neuropsychol Rev. 2014-2-5

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