Miranda Priya, Cox Christopher D, Alexander Michael, Danev Slav, Lakey Jonathan R T
Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA.
Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Med Devices (Auckl). 2020 May 22;13:115-137. doi: 10.2147/MDER.S241205. eCollection 2020.
Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the "characterizing ADHD" and on the quest for objective "pathognomonic/endophenotypic diagnostic markers of ADHD". The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.
注意缺陷多动障碍（ADHD）是一种需要长期管理的慢性遗传性发育迟缓精神障碍，其特征为注意力不集中、多动、过度活跃和冲动。主观临床评估在其诊断中仍然至关重要。本文讨论了“ADHD的特征描述”以及寻求ADHD客观“病理特征/内表型诊断标志物”的两个关键方面。第一个方面简要围绕ADHD病理特征/内表型诊断标志物的识别相关问题展开。讨论的问题包括ADHD定义的变化、缓解/持续以及与其共病的跨界精神障碍的重叠症状和共同遗传性。讨论的第二个方面是基于神经生物学和脑电图的ADHD研究。考虑到ADHD症状的神经生物学和时间方面，像Medeia公司的NeuralScan这样的脑电图仪似乎是一种合适的工具。当与合适的行为/认知/运动/心理任务/范式相结合时，脑电图的适用性会进一步增强，从而产生基于脑电图的标志物，如事件相关电位（如P3波幅和潜伏期的ERP）、反应时间变异性（RTV）、θ：β比值（TBR）和感觉运动节律（SMR）。目前，这些标志物可能有助于ADHD的神经生物学特征描述，并有助于识别或为识别基于脑电图的病理特征和/或内表型标志物奠定基础，从而实现其诊断、治疗和管理。
