注意缺陷多动障碍和重度抑郁症共有的情绪调节障碍中小脑与注意网络的功能失调:一项多模态影像学研究

Functional dysconnectivity of cerebellum and attention networks in emotional dysregulation shared between attention deficit hyperactivity disorder and major depressive disorder: a multimodal imaging study.

作者信息

Wu Shun-Chin J, Hsu Ju-Wei, Huang Kai-Lin, Bai Ya-Mei, Tu Pei-Chi, Chen Mu-Hong

机构信息

Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.

Graduate School of Neural and Behavioral Sciences, University of Tübingen, Tübingen, Germany.

出版信息

CNS Spectr. 2023 Aug;28(4):470-477. doi: 10.1017/S1092852922000876. Epub 2022 Jun 28.

Abstract

BACKGROUND

Emotional dysregulation (ED) is a common characteristic of both attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD), especially in adolescents. However, whether ADHD and MDD may share the specific ED-related neural networks remains unknown.

METHODS

In total, 43 adolescents with clinical ED (22 adolescents with ADHD and 21 with MDD) were recruited; in addition, 29 sex- and age-matched healthy controls (HCs) were included. Resting-state functional connectivity (RSFC) analysis, voxel-based morphometry, and diffusion tensor imaging analysis were performed for each patient. In addition, we determined the significant regions of interest in patients with ED due to ADHD and MDD as compared with HCs and tested their correlations with clinical rating scale scores.

RESULTS

Compared with HCs, patients with ED had greater RSFC in the cerebellum and supramarginal gyrus (SMG), especially between vermis VI and the SMG in the attention networks, and lower RSFC between the right supplementary motor area and right lateral parietal area. Lower gray matter (GM) volume in the SMG was also found. RSFC was significantly correlated with clinical rating scale scores for all patients with ED due to ADHD or MDD. GM change was correlated with ED and MDD rating scale scores.

DISCUSSION

The cerebellum and attention networks might play major roles in ED pathophysiology in adolescents with ADHD and MDD. Increased connectivity of the vermis to the SMG serves as a possible underlying neural network.

摘要

背景

情绪调节障碍(ED)是注意力缺陷多动障碍(ADHD)和重度抑郁症(MDD)的共同特征,在青少年中尤为常见。然而,ADHD和MDD是否共享与ED相关的特定神经网络仍不清楚。

方法

共招募了43名患有临床ED的青少年(22名患有ADHD的青少年和21名患有MDD的青少年);此外,还纳入了29名性别和年龄匹配的健康对照(HCs)。对每位患者进行静息态功能连接(RSFC)分析、基于体素的形态学测量和扩散张量成像分析。此外,我们确定了与HCs相比,因ADHD和MDD导致ED的患者的显著感兴趣区域,并测试了它们与临床评定量表分数的相关性。

结果

与HCs相比,ED患者在小脑和缘上回(SMG)有更强的RSFC,尤其是在注意力网络中蚓部VI和SMG之间,而右侧辅助运动区和右侧顶叶外侧区之间的RSFC较低。还发现SMG中的灰质(GM)体积较小。RSFC与所有因ADHD或MDD导致ED的患者的临床评定量表分数显著相关。GM变化与ED和MDD评定量表分数相关。

讨论

小脑和注意力网络可能在患有ADHD和MDD的青少年的ED病理生理学中起主要作用。蚓部与SMG之间连接性增加是一个可能的潜在神经网络。

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