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注意缺陷多动障碍儿童及青少年大脑皮质和皮质下结构的不对称性

Asymmetry in Cortical and Subcortical Structures of the Brain in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

作者信息

Chen Sijian, Guan Lin, Tang Jie, He Fan, Zheng Yi

机构信息

Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China.

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2021 Feb 12;17:493-502. doi: 10.2147/NDT.S292444. eCollection 2021.

Abstract

BACKGROUND

Human cognitive and emotional functions are asymmetrical between the left and right hemispheres. In neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) patients, the absence of aberrant asymmetry might serve as a neuroanatomical marker of ADHD. However, few studies have estimated abnormalities in cortical and subcortical asymmetry in children and adolescents of different ADHD subtypes.

METHODS

Data were from the results collected by the Peking University site in the "ADHD-200 sample" dataset, which comprised 31 eligible ADHD (20 inattentive ADHD (ADHD-I), 11 combined ADHD (ADHD-C)) and 31 matched typically developing (TD) individuals. The Asymmetry Indexes (AIs) in cortical thickness, cortical gray-matter volume and subcortical nucleus (SN) volume were calculated based on an automated surface-based approach. The differences in cortical thickness, cortical gray-matter volume, and SN volume AIs were evaluated among groups. We also analyzed the correlation between AIs and the severity of ADHD symptoms.

RESULTS

Compared with the TD group, SN asymmetry in ADHD group did not reveal significant differences. Altered cortical asymmetry of different subtypes in ADHD groups was located in the orbitofrontal and anterior cingulate circuits, including the medial orbitofrontal, paracentral, pars triangularis, caudal anterior cingulate, isthmus cingulate, and superior frontal regions. In the comparisons, cortical gray-matter volume AIs were significantly different in the caudal anterior cingulate, isthmus cingulate, and superior frontal regions between ADHD-I and ADHD-C groups. There were significant correlations between the severity of ADHD symptoms and asymmetric measurements in medial orbitofrontal, paracentral and isthmus cingulate regions.

CONCLUSION

These findings provide further evidence for the altered cortical morphological asymmetry in children and adolescents with ADHD, and these differences are associated (at least in part) with the severity of ADHD symptoms. Brain asymmetry could be an appropriate precursor of morphological alterations in neurodevelopmental disorders.

摘要

背景

人类认知和情感功能在左右半球之间是不对称的。在注意力缺陷多动障碍(ADHD)患者的神经影像学研究中,不存在异常不对称可能作为ADHD的神经解剖学标志物。然而,很少有研究评估不同ADHD亚型的儿童和青少年皮质及皮质下不对称的异常情况。

方法

数据来自北京大学站点在“ADHD - 200样本”数据集中收集的结果,该数据集包括31名符合条件的ADHD患者(20名注意力不集中型ADHD(ADHD - I),11名混合型ADHD(ADHD - C))和31名匹配的发育正常(TD)个体。基于自动表面法计算皮质厚度、皮质灰质体积和皮质下核(SN)体积的不对称指数(AIs)。评估各组之间皮质厚度、皮质灰质体积和SN体积AIs的差异。我们还分析了AIs与ADHD症状严重程度之间的相关性。

结果

与TD组相比,ADHD组的SN不对称未显示出显著差异。ADHD组不同亚型的皮质不对称改变位于眶额和前扣带回回路,包括内侧眶额、中央旁、三角部、尾侧前扣带回、扣带回峡部和额上区。在比较中,ADHD - I组和ADHD - C组之间,尾侧前扣带回、扣带回峡部和额上区的皮质灰质体积AIs存在显著差异。ADHD症状的严重程度与内侧眶额、中央旁和扣带回峡部区域的不对称测量之间存在显著相关性。

结论

这些发现为ADHD儿童和青少年皮质形态不对称改变提供了进一步证据,且这些差异(至少部分)与ADHD症状的严重程度相关。脑不对称可能是神经发育障碍形态学改变的合适先兆。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb1/7886251/81793001dcc4/NDT-17-493-g0001.jpg

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