成人注意缺陷多动障碍生物标志物的初步研究——关注血清铁和黑质经颅超声。

Preliminary Study of ADHD Biomarkers in Adults with Focus on Serum Iron and Transcranial Sonography of the Substantia Nigra.

机构信息

Department of Psychiatry, Kyung Hee University College of Medicine, Seoul 20447, Korea.

Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang 10475, Korea.

出版信息

Int J Environ Res Public Health. 2021 May 3;18(9):4875. doi: 10.3390/ijerph18094875.

Abstract

As previous studies have reported abnormalities in the iron indices of peripheral blood and hyperechogenicity of the substantia nigra (SN) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD), we aimed to examine the same in adults with ADHD using transcranial Doppler sonography (TCS). In addition, we compared the iron indices and TCS findings before and after methylphenidate (MPH) treatment. A total of 39 participants aged ≥19 years (13 patients and 26 healthy controls) were recruited from Kyung Hee University Hospital between October 2018 and September 2019. All subjects were clinically evaluated based on the ADHD diagnostic criteria in the DSM-5, the Adult ADHD Self-Report Scale, and the Diagnostic Interview for ADHD in Adults (DIVA-5). Further, the iron indices including serum iron, ferritin, and mean platelet volume were determined. Additionally, TCS focused on the midbrain and echogenicity of the SN was conducted. Follow-up for all items was conducted for five ADHD patients after MPH treatment. Patients with ADHD had significantly lower education levels (number of years) than controls. There were no statistically significant differences in serum iron indices or the echogenic area between ADHD and control groups. Further, there were no significant changes in iron indices or TCS findings after MPH medication. Unlike previous studies, this study showed no differences between patients with ADHD and controls. Therefore, it is important to determine if these null findings were due to different target populations (children vs. adults) or other factors, including ADHD subtypes.

摘要

如先前的研究报道,注意缺陷多动障碍(ADHD)患儿和青少年外周血铁指标异常和黑质(SN)回声增强,我们旨在使用经颅多普勒超声(TCS)检查成人 ADHD 是否存在同样的情况。此外,我们比较了 ADHD 患者在使用哌甲酯(MPH)治疗前后的铁指标和 TCS 结果。2018 年 10 月至 2019 年 9 月,我们从庆熙大学医院招募了 39 名年龄≥19 岁的参与者(13 名患者和 26 名健康对照者)。所有受试者均根据 DSM-5 的 ADHD 诊断标准、成人 ADHD 自评量表和成人 ADHD 诊断访谈(DIVA-5)进行临床评估。此外,还确定了包括血清铁、铁蛋白和平均血小板体积在内的铁指标。另外,TCS 关注中脑和 SN 的回声强度。对 MPH 治疗后 5 名 ADHD 患者的所有项目进行随访。与对照组相比,ADHD 患者的受教育程度(年数)明显较低。ADHD 组和对照组之间血清铁指标或 SN 回声面积无统计学差异。进一步,MPH 用药后铁指标或 TCS 结果无明显变化。与先前的研究不同,本研究未显示 ADHD 患者与对照组之间存在差异。因此,确定这些阴性结果是由于不同的目标人群(儿童与成人)还是其他因素,包括 ADHD 亚型导致的,这一点很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01e7/8125298/5a4d07d18e2a/ijerph-18-04875-g001.jpg

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