Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, and the Child and Adolescent Psychiatry Hospital Sant Joan de Déu of Barcelona, Spain.
MRI Research Unit, Hospital del Mar, Barcelona; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain.
J Am Acad Child Adolesc Psychiatry. 2019 Feb;58(2):256-266. doi: 10.1016/j.jaac.2018.09.441. Epub 2018 Nov 26.
Sluggish cognitive tempo (SCT) is a cluster of symptoms associated with poor function in various domains of major life activities that may comprise a novel attention disorder distinct from attention-deficit/hyperactivity disorder (ADHD). Nevertheless, very little is known about the neural substrate of SCT in children. The present study aimed to examine associations between SCT symptoms and brain structure and function in school-aged children.
We performed a cross-sectional MRI study in 178 children 8 to 12 years old from primary schools in Barcelona, Spain. Data were collected between January 2012 and March 2013. Parents completed the Sluggish Cognitive Tempo-Child Behavior Checklist (SCT-CBCL). Participants underwent magnetic resonance imaging to assess regional brain volume, white matter integrity using diffusion tensor imaging, and functional connectivity in major neural networks.
SCT symptoms were associated with altered anatomy of the frontal lobe in the form of increased regional volume. The anomalously large cortical regions were less mature in terms of functional connectivity. Importantly, all the anatomical and functional anomalies identified remained significant after adjusting the analyses for ADHD symptom scores.
Our results suggest that SCT symptoms are associated with distinct features of brain structure and function that differ from the classical neural substrates described in ADHD.
认知迟钝（SCT）是一组与主要生活活动各个领域功能不良相关的症状，可能构成一种与注意力缺陷多动障碍（ADHD）不同的新型注意障碍。然而，关于儿童 SCT 的神经基础知之甚少。本研究旨在探讨 SCT 症状与学龄儿童大脑结构和功能之间的关系。
我们对来自西班牙巴塞罗那小学的 178 名 8 至 12 岁的儿童进行了横断面 MRI 研究。数据收集于 2012 年 1 月至 2013 年 3 月期间。家长完成了认知迟钝儿童行为检查表（SCT-CBCL）。参与者接受了磁共振成像，以评估区域脑体积、使用弥散张量成像评估白质完整性以及主要神经网络的功能连接。
SCT 症状与额叶解剖结构的改变有关，表现为区域体积增加。功能连接方面，异常增大的皮质区域成熟度较低。重要的是，在调整 ADHD 症状评分分析后，所有确定的解剖和功能异常仍然显著。
我们的结果表明，SCT 症状与大脑结构和功能的独特特征有关，这些特征与 ADHD 中描述的经典神经基础不同。
