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药物治疗与未用药的注意缺陷多动障碍成年患者在 fMRI 运动抑制和认知转换任务中的大脑激活模式。

Brain activation patterns in medicated versus medication-naïve adults with attention-deficit hyperactivity disorder during fMRI tasks of motor inhibition and cognitive switching.

机构信息

Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.

Department of Radiology and Medical Informatics, University of Geneva, 1202, Geneva, Switzerland.

出版信息

BMC Med Imaging. 2021 Mar 19;21(1):53. doi: 10.1186/s12880-021-00579-3.

Abstract

BACKGROUND

Adult-attention-deficit-hyperactive-disorder (ADHD) is often unrecognized condition. FMRI examination along with neuropsychological testing might strengthen the diagnosis. We hypothesized that ADHD-adults with and without medication would show different fMRI pattern compared to healthy controls while testing tasks of motor inhibition and cognitive switching.

METHODS

45 subjects in three age-matched groups: (1) controls, (2) ADHD-adults under medication (ADHD+) and (3) medication-naïve adults with ADHD (ADHD-) underwent fMRI and neuropsychological testing. Group analysis and population-based statistics were performed.

RESULTS

DTVP-A, intellectual ability as well as attention capability, visual-perceptual and visual-motor abilities showed no significant differences between the groups. However, fMRI revealed statistically significant differences between the ADHD+, ADHD- and control groups on tasks of motor inhibition and cognitive switching on adults in bilateral fronto-striatal brain regions, inferior fronto-frontal, fronto-cingulate and fronto-parietal networks as well as in the parietal lobe (p < 0.05).

CONCLUSIONS

fMRI offers the potential to differentiate between the ADHD+, ADHD- and control groups. FMRI possibly opens a new window for monitoring the therapeutic effect of ADHD medication.

TRIAL REGISTRATION

NCT02578342, registered at August 2015 to clinical trial registry ( https://ichgcp.net/clinical-trials-registry/NCT02578342 ).

摘要

背景

成人注意力缺陷多动障碍(ADHD)常被漏诊。功能磁共振成像(fMRI)检查结合神经心理学测试可能有助于提高诊断准确性。我们假设,与健康对照组相比,服用药物和未服用药物的 ADHD 成人在进行运动抑制和认知转换任务测试时,其 fMRI 模式会有所不同。

方法

将 45 名年龄匹配的受试者分为三组:(1)对照组;(2)服用药物的 ADHD 成人(ADHD+);(3)未服用药物的 ADHD 成人(ADHD-),对他们进行 fMRI 和神经心理学测试。对组间分析和基于人群的统计学进行了分析。

结果

DTVP-A、智力能力和注意力能力、视觉感知和视觉运动能力在组间无显著差异。然而,在运动抑制和认知转换任务中,ADHD+、ADHD-和对照组成人的双侧额-纹状体脑区、额-额下、额-扣带回和额-顶叶网络以及顶叶存在统计学上的显著差异(p<0.05)。

结论

fMRI 具有区分 ADHD+、ADHD-和对照组的潜力。fMRI 可能为监测 ADHD 药物治疗效果提供了一个新窗口。

试验注册

NCT02578342,于 2015 年 8 月在临床试验注册中心注册(https://ichgcp.net/clinical-trials-registry/NCT02578342)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4433/7977301/3c6c65809a1e/12880_2021_579_Fig1_HTML.jpg

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