Hai Tasmia, Duffy Hanna, Lemay Jean-Francois, Swansburg Rose, Climie Emma A, MacMaster Frank P
Werklund School of Education, University of Calgary, Calgary, Alberta.
Department of Pediatrics, University of Calgary, Calgary, Alberta.
J Can Acad Child Adolesc Psychiatry. 2020 Mar;29(1):15-25. Epub 2020 Mar 1.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder with no known biomarkers. The objectives of this study were 1) to investigate spectroscopic biomarkers in the right prefrontal cortex (R-PFC) and left striatum; 2) to evaluate Executive Function (EF) performance; and, 3) to examine the clinical relevance of glutamate in EF tasks.
A total of 21 children with ADHD ( = 10.41 years, = 1.41) and 15 controls without ADHD ( = 9.90 years, = 1.54 years) were enrolled. Short echo proton magnetic resonance spectroscopy (1H-MRS; TE = 30ms) was used to study the changes in the R-PFC and left striatum. Both groups completed an EF assessment battery, including working memory, inhibition, cognitive flexibility and verbal fluency tasks.
In the R-PFC, independent t-tests found decreased concentration of glutamate ( = 0.009), NAA ( = 0.029) and choline ( = 0.016) in ADHD participants compared to controls. No significant differences were seen in the left striatum. Multivariate analysis of variance did not indicate overall EF challenges in the ADHD sample ( < .05). Positive correlations with glutamate concentration and EF performance in the control group were observed, however, no such correlations were reported in the ADHD group.
The results indicated a subgroup of children with ADHD who presented with hypo-glutamatergic signalling in the R-PFC. Additionally, findings suggested a decoupling effect of glutamate in EF related tasks in children with ADHD compared to controls. Thus, glutamate concentration may be a possible ADHD biomarker and novel treatments target.
注意力缺陷多动障碍(ADHD)是一种常见的神经发育障碍,目前尚无已知的生物标志物。本研究的目的是:1)研究右侧前额叶皮质(R - PFC)和左侧纹状体中的光谱生物标志物;2)评估执行功能(EF)表现;3)检验谷氨酸在EF任务中的临床相关性。
共纳入21名患有ADHD的儿童(平均年龄 = 10.41岁,标准差 = 1.41)和15名无ADHD的对照儿童(平均年龄 = 9.90岁,标准差 = 1.54岁)。采用短回波质子磁共振波谱(1H - MRS;TE = 30ms)研究R - PFC和左侧纹状体的变化。两组均完成了一套EF评估测试,包括工作记忆、抑制、认知灵活性和语言流畅性任务。
在R - PFC中,独立样本t检验发现,与对照组相比,ADHD参与者的谷氨酸(p = 0.009)、N - 乙酰天门冬氨酸(NAA,p = 0.029)和胆碱(p = 0.016)浓度降低。左侧纹状体未见显著差异。多因素方差分析未表明ADHD样本存在整体EF挑战(p < 0.05)。然而,在对照组中观察到谷氨酸浓度与EF表现呈正相关,而在ADHD组中未发现此类相关性。
结果表明,有一部分ADHD儿童在R - PFC中存在低谷氨酸能信号。此外,研究结果表明,与对照组相比,ADHD儿童在EF相关任务中谷氨酸存在解耦效应。因此,谷氨酸浓度可能是一种潜在的ADHD生物标志物和新的治疗靶点。