Department of Psychology, Georgetown University, Washington, DC, USA.
Children's Research Institute, Children's National Health System, Washington, DC, USA.
Curr Top Behav Neurosci. 2022;57:159-177. doi: 10.1007/7854_2022_334.
High rates of co-occurring Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) suggest common causal pathways, which await elucidation. What is well-established, however, is the negative impact of comorbid ADHD and ASD on outcomes for everyday living, particularly in social interaction and communication and on broader psychopathology. Neurocognitive approaches suggest correlates of comorbidity are rooted in functional connectivity networks associated with executive control. There is support for familial origins, with molecular-genetic studies suggesting a causal role of pleiotropic genes. Further investigation is needed to elucidate fully how genetic risk for ADHD and ASD affects neurodevelopment and to identify structural and functional neural correlates and their behavioral sequelae. Identification of intermediate phenotypes is necessary to advance understanding, which requires studies that include the full spectrum of ASD and ADHD symptom severity, use longitudinal designs and multivariate methods to probe broad constructs, such as executive and social function, and consider other sources of heterogeneity, such as age, sex, and other psychopathology. Randomized efficacy trials targeting comorbid symptomatology are needed to mitigate negative developmental outcomes.
注意力缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）的高共病率表明存在共同的因果途径，但其仍有待阐明。然而，已明确的是，ADHD 和 ASD 的共病对日常生活的结果有负面影响，特别是在社交互动和沟通以及更广泛的精神病理学方面。神经认知方法表明，共病的相关性源于与执行控制相关的功能连接网络。家族起源也得到了支持，分子遗传学研究表明，多效基因起因果作用。需要进一步研究才能充分阐明 ADHD 和 ASD 的遗传风险如何影响神经发育，并确定结构和功能神经相关性及其行为后果。识别中间表型对于推进理解是必要的，这需要包括 ASD 和 ADHD 症状严重程度的全谱研究，使用纵向设计和多变量方法来探究广泛的结构，如执行和社会功能，并考虑其他异质性来源，如年龄、性别和其他精神病理学。需要针对共病症状进行随机疗效试验，以减轻发育不良的后果。
