Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
J Neurodev Disord. 2022 May 6;14(1):30. doi: 10.1186/s11689-022-09440-2.
Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood neurodevelopmental disorder. It shares some genetic risk with Autism Spectrum Disorder (ASD), and the conditions often occur together. Both are potentially associated with abnormal glutamate and GABA neurotransmission, which can be modelled by measuring the synaptic activity in the retina with an electroretinogram (ERG). Reduction of retinal responses in ASD has been reported, but little is known about retinal activity in ADHD. In this study, we compared the light-adapted ERGs of individuals with ADHD, ASD and controls to investigate whether retinal responses differ between these neurodevelopmental conditions.
Full field light-adapted ERGs were recorded from 15 ADHD, 57 ASD (without ADHD) and 59 control participants, aged from 5.4 to 27.3 years old. A Troland protocol was used with a random series of nine flash strengths from -0.367 to 1.204 log photopic cd.s.m. The time-to-peak and amplitude of the a- and b-waves and the parameters of the Photopic Negative Response (PhNR) were compared amongst the three groups of participants, using generalised estimating equations.
Statistically significant elevations of the ERG b-wave amplitudes, PhNR responses and faster timings of the b-wave time-to-peak were found in those with ADHD compared with both the control and ASD groups. The greatest elevation in the b-wave amplitudes associated with ADHD were observed at 1.204 log phot cd.s.m flash strength (p < .0001), at which the b-wave amplitude in ASD was significantly lower than that in the controls. Using this measure, ADHD could be distinguished from ASD with an area under the curve of 0.88.
The ERG b-wave amplitude appears to be a distinctive differential feature for both ADHD and ASD, which produced a reversed pattern of b-wave responses. These findings imply imbalances between glutamate and GABA neurotransmission which primarily regulate the b-wave formation. Abnormalities in the b-wave amplitude could provisionally serve as a biomarker for both neurodevelopmental conditions.
注意力缺陷多动障碍（ADHD）是最常见的儿童神经发育障碍。它与自闭症谱系障碍（ASD）有一些共同的遗传风险，并且这两种疾病经常同时发生。这两种疾病都可能与异常的谷氨酸和 GABA 神经递质传递有关，可以通过测量视网膜电图（ERG）中的突触活动来建模。已经报道了 ASD 中视网膜反应的减少，但关于 ADHD 中的视网膜活动知之甚少。在这项研究中，我们比较了 ADHD、ASD 和对照组个体的光适应 ERG，以研究这些神经发育状况之间的视网膜反应是否存在差异。
从 15 名 ADHD、57 名 ASD（无 ADHD）和 59 名对照组参与者记录全视野光适应 ERG，年龄从 5.4 岁到 27.3 岁。使用 Troland 方案，从 -0.367 到 1.204 log 光视 cd.s.m. 的随机系列九个闪光强度进行测试。使用广义估计方程比较三组参与者的 a-和 b-波的时程至峰值和振幅以及光幻响应（PhNR）的参数。
与对照组和 ASD 组相比，ADHD 患者的 ERG b-波振幅、PhNR 反应和 b-波时程至峰值的时间更快，存在统计学上的显著升高。与 ADHD 相关的 b-波振幅升高最大的是在 1.204 log 光视 cd.s.m 闪光强度（p <.0001），此时 ASD 的 b-波振幅明显低于对照组。使用该指标，ADHD 可以与 ASD 区分开来，曲线下面积为 0.88。
ERG b-波振幅似乎是 ADHD 和 ASD 的一个独特的鉴别特征，产生了 b-波反应的反转模式。这些发现意味着调节 b-波形成的谷氨酸和 GABA 神经递质传递之间的不平衡。b-波振幅的异常可以暂时作为这两种神经发育状况的生物标志物。
