Department of Neurology, Toulouse University Hospital, Toulouse, France; Inserm UMR1214, UPS, Toulouse NeuroImaging Center, Université de Toulouse, Toulouse, France.
Department of Neurology, Toulouse University Hospital, Toulouse, France.
Rev Neurol (Paris). 2021 Apr;177(4):341-348. doi: 10.1016/j.neurol.2021.01.006. Epub 2021 Feb 19.
Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and/or impulsivity. While ADHD was initially recognized as a childhood syndrome, scientific evidence accumulated to indicate that a significant proportion of ADHD children continue to experience symptoms of ADHD in adulthood. Moreover, the question of ADHD diagnosis can arise in adult patients who were not diagnosed in childhood. Currently, the diagnosis of ADHD in adulthood is based on the revised criteria described for children. However, their application for adults may be difficult for many reasons including compensation and comorbid disorders. To date, no clinical, neuropsychological, biological or imaging marker is available for the diagnosis of ADHD. Considering that ADHD is based on a neuropsychological model, in this article we will examine the usefulness of neuropsychological testing in the diagnosis in adults. We will first present diagnostic criteria of ADHD and the limits of their application in adults. We will then detail the neuropsychological data available in adult ADHD and the French and international clinical recommendations for neuropsychological assessment. Finally, we will explore the predictive value of neuropsychological scores in the diagnosis of ADHD and discuss key methodological points and perspectives for clinical research.
注意缺陷多动障碍（ADHD）是一种神经发育障碍，其特征是注意力不集中、多动和/或冲动。虽然 ADHD 最初被认为是一种儿童综合征，但科学证据的积累表明，相当一部分 ADHD 儿童在成年后仍继续存在 ADHD 症状。此外，在童年时未被诊断出 ADHD 的成年患者中，也可能会出现 ADHD 的诊断问题。目前，成人 ADHD 的诊断基于为儿童描述的修订标准。然而，由于许多原因，包括补偿和合并症，这些标准在成人中的应用可能存在困难。迄今为止，尚无用于 ADHD 诊断的临床、神经心理学、生物学或影像学标志物。鉴于 ADHD 基于神经心理学模型，在本文中，我们将探讨神经心理学测试在成人诊断中的作用。我们将首先介绍 ADHD 的诊断标准及其在成人中的应用限制。然后，我们将详细介绍成人 ADHD 中的神经心理学数据以及法国和国际临床对神经心理学评估的建议。最后，我们将探讨神经心理学评分在 ADHD 诊断中的预测价值，并讨论临床研究的关键方法学要点和前景。
