Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, United States.
Department of Psychology, Queens College, City University of New York, NY, United States.
Eur Neuropsychopharmacol. 2020 Apr;33:117-125. doi: 10.1016/j.euroneuro.2020.01.014. Epub 2020 Feb 17.
Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder that emerges in childhood and persists into adulthood in a sizeable portion of afflicted individuals. The persistence of ADHD symptoms elevates the risk of adverse outcomes that result in substantial individual and societal burden. The objective of this study was to delineate neuroanatomical substrates associated with the diversity of adult outcomes of childhood ADHD, which may have considerable value for development of novel interventions that target mechanisms associated with recovery. Structural MRI and diffusion tensor imaging data from 32 young adults who were diagnosed with ADHD combined-type during childhood and 35 group-matched controls were analyzed. Adults with childhood ADHD were divided into 16 remitters and 16 persisters based on DSM-IV criteria. Compared to the controls, ADHD probands showed significantly reduced gray matter (GM) volume in right putamen and white matter (WM) volume in left parieto-insular fiber tracts. Within the ADHD probands, the remitters, as compared to persisters, showed significantly greater volume of right hippocampo-frontal and right parieto-insular WM fiber tracts, and those connecting caudate with the frontal, parietal, occipital, temporal, and insular cortices. Among ADHD probands, increased fractional anisotropy value of left caudate-parietal tract was significantly correlated with reduced hyperactive/impulsive symptoms. These findings suggest that optimal structural development in the WM tracts that connect caudate with cortical areas, especially in the caudate-parietal path, may play an important role in symptom remission in young adults with childhood ADHD.
注意缺陷多动障碍（ADHD）是一种高发的神经发育障碍，在儿童时期出现，并在相当一部分患者中持续到成年。ADHD 症状的持续存在会增加不良后果的风险，从而给个人和社会带来巨大负担。本研究旨在描绘与儿童 ADHD 成年后多样化结局相关的神经解剖学基础，这对于开发针对与恢复相关机制的新型干预措施可能具有重要价值。对 32 名在儿童时期被诊断为 ADHD 混合型的年轻成年人和 35 名年龄匹配的对照组的结构 MRI 和扩散张量成像数据进行了分析。根据 DSM-IV 标准，将患有儿童 ADHD 的成年人分为 16 名缓解者和 16 名持续者。与对照组相比，ADHD 患者的右侧壳核灰质（GM）体积和左侧顶岛纤维束白质（WM）体积显著减少。在 ADHD 患者中，与持续者相比，缓解者的右侧海马-额 WM 纤维束和连接尾状核与额、顶、枕、颞和岛叶皮质的右侧顶岛 WM 纤维束的体积明显增大。在 ADHD 患者中，左侧尾状核-顶叶束的各向异性分数值增加与多动/冲动症状减少显著相关。这些发现表明，连接尾状核与皮质区域的 WM 束，特别是尾状核-顶叶束的最佳结构发育，可能在儿童 ADHD 成年缓解者的症状缓解中发挥重要作用。
