Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
CNS Spectr. 2021 Jun;26(3):299-306. doi: 10.1017/S1092852920001133. Epub 2020 Apr 20.
It is well-known that attention deficit hyperactivity disorder (ADHD) is associated with changes in the dopaminergic system. However, the relationship between central dopaminergic tone and the blood oxygen level-dependent (BOLD) signal during receipt of rewards and penalties in the corticostriatal pathway in adults with ADHD is unclear.
Single-photon emission computed tomography with [99mTC]TRODAT-1 was used to assess striatal dopamine transporter (DAT) availability. Event-related functional magnetic resonance imaging was conducted on subjects performing the Iowa Gambling Test.
DAT availability was found to be associated with the BOLD response, which was a covariate of monetary loss, in the medial prefrontal cortex (r = 0.55, P = .03), right ventral striatum (r = 0.69, P = .003), and right orbital frontal cortex (r = 0.53, P = .03) in adults with ADHD. However, a similar correlation was not found in the controls.
The results confirmed that dopaminergic tone may play a different role in the penalty-elicited response of adults with ADHD. It is plausible that a lower neuro-threshold accompanied by insensitivity to punishment could be exacerbated by the hypodopaminergic tone in ADHD.
众所周知，注意缺陷多动障碍（ADHD）与多巴胺能系统的变化有关。然而，ADHD 患者中，皮质纹状体通路在接受奖惩时，中枢多巴胺能张力与血氧水平依赖（BOLD）信号之间的关系尚不清楚。
使用[99mTC]TRODAT-1 单光子发射计算机断层扫描评估纹状体多巴胺转运体（DAT）的可用性。对接受爱荷华赌博测试的受试者进行事件相关功能磁共振成像。
研究发现，ADHD 患者的纹状体多巴胺转运体（DAT）可用性与中前额叶皮层（r = 0.55，P =.03）、右侧腹侧纹状体（r = 0.69，P =.003）和右侧眶额皮层（r = 0.53，P =.03）的 BOLD 反应与金钱损失有关，是货币损失的协变量。然而，对照组中没有发现类似的相关性。
研究结果证实，多巴胺能张力可能在 ADHD 患者的惩罚反应中发挥不同的作用。ADHD 患者的多巴胺能张力降低，对惩罚不敏感，可能会因神经阈值降低而加剧。
