ADHD 成人奖赏过程中的眶额皮层功能障碍：一项 fMRI 研究。
Orbitofrontal dysfunction during the reward process in adults with ADHD: An fMRI study.
机构信息
Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Psychology, National Cheng Kung University, Tainan, Taiwan.
出版信息
Clin Neurophysiol. 2019 May;130(5):627-633. doi: 10.1016/j.clinph.2019.01.022. Epub 2019 Feb 19.
OBJECTIVE
The present study aimed to detect differences in the reward response between adults with attention deficit hyperactivity disorder (ADHD) and healthy controls (HCs) using functional magnetic resonance imaging (fMRI).
METHODS
The Iowa gambling task (IGT) was designed to explore participants' reward-related decision-making in relation to selections during risky behaviors. Twenty adults with ADHD and 20 HCs were enrolled. fMRI with a modified IGT was performed.
RESULTS
The adults with ADHD showed a poorer performance in terms of avoidance during risky behaviors. The fMRI results indicated that the adults with ADHD had significantly lower orbitofrontal cortex (OFC) activation. A positive correlation between performance in the IGT and brain activation in the OFC was detected.
CONCLUSIONS
The results suggested that the adults with ADHD exhibited abnormal OFC responses during decision-making.
SIGNIFICANCE
To the best of our knowledge, this is the first study to use fMRI to collect brain activation data while performing the IGT in adults with ADHD. Our findings suggest that deficits in reward processing in ADHD are still present during adulthood.
目的
本研究旨在使用功能磁共振成像（fMRI）检测注意力缺陷多动障碍（ADHD）成年患者与健康对照（HC）之间的奖励反应差异。
方法
设计了爱荷华赌博任务（IGT），以探索参与者在冒险行为期间与选择相关的奖励相关决策。纳入 20 名 ADHD 成年患者和 20 名 HCs，并进行 fMRI 检查。
结果
ADHD 成年患者在冒险行为期间表现出较差的回避能力。fMRI 结果表明，ADHD 成年患者眶额皮质（OFC）的激活明显降低。在 IGT 中的表现与 OFC 中的脑激活之间存在正相关关系。
结论
结果表明，ADHD 成年患者在决策过程中表现出异常的 OFC 反应。
意义
据我们所知，这是第一项使用 fMRI 采集 ADHD 成年患者执行 IGT 时脑激活数据的研究。我们的发现表明，ADHD 患者在成年期仍存在奖励处理缺陷。
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