Huang Jue, Ulke Christine, Strauss Maria
Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103, Leipzig, Germany.
BMC Neurosci. 2019 Aug 20;20(1):43. doi: 10.1186/s12868-019-0526-4.
The aim of the present study was to evaluate the stability of brain arousal in adult attention-deficit/hyperactivity disorder (ADHD) outpatients with and without depressive symptomatology, and its association with depressive symptom severity and absolute electroencephalogram (EEG) power in different frequency bands.
We included 31 outpatient adults (45.16% females), who were diagnosed according to DSM-IV and received no medication. Their arousal stability score (index of the steepness of arousal decline during a 15-min EEG under resting conditions), the absolute EEG power and self-reports, including depressive and ADHD-related symptoms, were analyzed. Participants were split into an unstable and stable arousal group based on the median (= 6) of the arousal stability score.
ADHD patients in the stable group reported more severe depressive symptoms (p = 0.018) and showed reduced absolute EEG power in the delta (0.002 ≤ p ≤ 0.025) and theta (0.011 ≤ p ≤ 0.034) bands compared to those in the unstable group. There was no correlation between the arousal stability score and self-report-scales concerning ADHD-related symptoms (0.214 ≤ p ≤ 0.989), but a positive association with self-reported depressive severity (p = 0.018) and negative association with powers in the EEG delta and theta bands (0.001 ≤ p ≤ 0.033).
In view of high comorbidity of depression and ADHD in adult patients, these findings support the assumption that brain arousal regulation could be considered as a helpful marker for the clinical differentiation between ADHD and depression.
本研究旨在评估伴有和不伴有抑郁症状的成年注意力缺陷多动障碍（ADHD）门诊患者大脑觉醒的稳定性，及其与抑郁症状严重程度和不同频段脑电图（EEG）绝对功率的关联。
我们纳入了31名门诊成年患者（45.16%为女性），他们根据《精神疾病诊断与统计手册》第四版（DSM-IV）被诊断为ADHD且未接受药物治疗。分析了他们的觉醒稳定性评分（静息状态下15分钟脑电图期间觉醒下降陡度指数）、EEG绝对功率和自我报告，包括抑郁和ADHD相关症状。根据觉醒稳定性评分的中位数（=6）将参与者分为觉醒不稳定组和稳定组。
与不稳定组相比，稳定组的ADHD患者报告的抑郁症状更严重（p=0.018），并且在δ（0.002≤p≤0.025）和θ（0.011≤p≤0.034）频段的EEG绝对功率降低。觉醒稳定性评分与ADHD相关症状的自我报告量表之间无相关性（0.214≤p≤0.989），但与自我报告的抑郁严重程度呈正相关（p=0.018），与EEGδ和θ频段的功率呈负相关（0.001≤p≤0.033）。
鉴于成年患者中抑郁症和ADHD的高共病率，这些发现支持以下假设，即大脑觉醒调节可被视为ADHD和抑郁症临床鉴别诊断的有用标志物。
