Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Biol Sex Differ. 2019 Oct 29;10(1):50. doi: 10.1186/s13293-019-0264-4.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Relevant sex differences in symptomatology are discussed. This study compared brain neurometabolism in the anterior cingulate cortex (ACC) and left cerebellar hemisphere in age- and IQ-matched adult male (mADHD) and female (fADHD) ADHD patients.
We studied 48 (ACC) and 42 (cerebellum) male/female pairs of stimulant-free patients with adult ADHD. Single voxel magnetic resonance spectroscopy (MRS) was used to investigate creatine (Cre), total choline (t-Cho), glutamate + glutamine (Glx), N-acetylaspartate, and myo-inositol. The mADHD and fADHD groups were compared using robust linear regression. The level of significance was corrected for multiple tests using the Benjamini-Hochberg approach.
For the ACC, the signals of Cre (p = 0.008) and t-Cho (p = 0.004) showed significant effects of the age covariate as well as an interaction of sex and age (Cre: p = 0.033; t-Cho: p = 0.040). For the Glx signal, an interaction of sex and age could also be observed (p = 0.033). For cerebellar neurometabolites, the signals of t-Cho (p = 0.049) and Glx (p = 0.049) showed significant effects of the factor sex.
This is the largest study yet to analyze sex differences in brain neurochemistry in adult patients with ADHD. Different age-dependent t-Cho signals in the ACC might be associated with delayed myelinization in mADHD. Further MRS studies in adult ADHD, accounting for possible sex effects, are warranted to validate the present findings.
注意力缺陷多动障碍（ADHD）是一种常见的神经发育障碍。本文讨论了症状相关的性别差异。本研究比较了年龄和智商匹配的成年男性（mADHD）和女性（fADHD）ADHD 患者前扣带回皮质（ACC）和左侧小脑半球的脑神经代谢。
我们研究了 48 名（ACC）和 42 名（小脑）无兴奋剂的成年 ADHD 男性/女性患者对。使用单质子磁共振波谱（MRS）研究肌酸（Cre）、总胆碱（t-Cho）、谷氨酸+谷氨酰胺（Glx）、N-乙酰天门冬氨酸和肌醇。使用稳健线性回归比较 mADHD 和 fADHD 组。使用 Benjamini-Hochberg 方法校正多重检验的显著性水平。
对于 ACC，Cre（p=0.008）和 t-Cho（p=0.004）信号显示年龄协变量有显著影响，并且性别和年龄存在交互作用（Cre：p=0.033；t-Cho：p=0.040）。对于 Glx 信号，也可以观察到性别和年龄的相互作用（p=0.033）。对于小脑神经代谢物，t-Cho（p=0.049）和 Glx（p=0.049）信号显示性别因素有显著影响。
这是迄今为止分析成年 ADHD 患者大脑神经化学性别差异的最大研究。ACC 中不同的依赖年龄的 t-Cho 信号可能与 mADHD 中的髓鞘形成延迟有关。需要进一步进行成人 ADHD 的 MRS 研究，以考虑可能的性别影响，验证本研究的发现。
