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注意缺陷多动障碍患儿及成人静息态功能连接的共享与差异。

Shared and distinct resting functional connectivity in children and adults with attention-deficit/hyperactivity disorder.

机构信息

Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China.

National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), 100191, Beijing, China.

出版信息

Transl Psychiatry. 2020 Feb 12;10(1):65. doi: 10.1038/s41398-020-0740-y.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, with a shift of symptoms including less hyperactivity/impulsivity and more co-morbidity of affective disorders in ADHD. Many studies have questioned the stability in diagnosing of ADHD from childhood to adulthood, and the shared and distinct aberrant functional connectivities (FCs) between ADHD and ADHD remain unidentified. We aim to explore shared and distinct FC patterns in ADHD and ADHD, and further investigated the cross-cohort predictability using the identified FCs. After investigating the ADHD-discriminative FCs from healthy controls (HCs) in both child (34 ADHD, 28 HCs) and adult (112 ADHD,77 HCs) cohorts, we identified both shared and distinct aberrant FC patterns between cohorts and their association with clinical symptoms. Moreover, the cross-cohort predictability using the identified FCs were tested. The ADHD-HC classification accuracies were 84.4% and 81.0% for children and male adults, respectively. The ADHD-discriminative FCs shared in children and adults lie in the intra-network within default mode network (DMN) and the inter-network between DMN and ventral attention network, positively correlated with total scores of ADHD symptoms. Particularly, inter-network FC between somatomotor network and dorsal attention network was uniquely impaired in ADHD, positively correlated with hyperactivity index; whereas the aberrant inter-network FC between DMN and limbic network exhibited more adult-specific ADHD dysfunction. And their cross-cohort predictions were 70.4% and 75.6% between each other. This work provided imaging evidence for symptomatic changes and pathophysiological continuity in ADHD from childhood to adulthood, suggesting that FCs may serve as potential biomarkers for ADHD diagnosis.

摘要

注意缺陷多动障碍(ADHD)常持续至成年期,症状转变包括多动/冲动减少,以及合并更多情感障碍。许多研究质疑 ADHD 从儿童期到成年期的诊断稳定性,以及 ADHD 与 ADHD 之间共享和独特的异常功能连接(FC)仍未确定。我们旨在探索 ADHD 和 ADHD 之间的共享和独特 FC 模式,并进一步使用鉴定的 FC 研究跨队列的可预测性。在从儿童(34 名 ADHD,28 名 HC)和成年(112 名 ADHD,77 名 HC)队列的健康对照(HC)中调查 ADHD 区分性 FC 后,我们确定了队列之间的共享和独特异常 FC 模式及其与临床症状的关联。此外,还测试了使用鉴定的 FC 的跨队列可预测性。使用鉴定的 FC 的 ADHD-HC 分类准确率在儿童和男性成年中分别为 84.4%和 81.0%。儿童和成人共有的 ADHD 区分性 FC 位于默认模式网络(DMN)内网络和 DMN 与腹侧注意网络之间的网络内,与 ADHD 症状的总分呈正相关。特别是,躯体运动网络和背侧注意网络之间的网络间 FC 异常在 ADHD 中受到损害,与多动指数呈正相关;而 DMN 和边缘网络之间异常的网络间 FC 在 ADHD 中具有更多的成人特异性功能障碍。它们在彼此之间的跨队列预测率分别为 70.4%和 75.6%。这项工作为 ADHD 从儿童期到成年期的症状变化和病理生理学连续性提供了影像学证据,表明 FC 可能作为 ADHD 诊断的潜在生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b834/7026417/3902827a937a/41398_2020_740_Fig1_HTML.jpg

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