Buitelaar Jan, Bölte Sven, Brandeis Daniel, Caye Arthur, Christmann Nina, Cortese Samuele, Coghill David, Faraone Stephen V, Franke Barbara, Gleitz Markus, Greven Corina U, Kooij Sandra, Leffa Douglas Teixeira, Rommelse Nanda, Newcorn Jeffrey H, Polanczyk Guilherme V, Rohde Luis Augusto, Simonoff Emily, Stein Mark, Vitiello Benedetto, Yazgan Yanki, Roesler Michael, Doepfner Manfred, Banaschewski Tobias
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands.
Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands.
Front Behav Neurosci. 2022 Jul 6;16:900981. doi: 10.3389/fnbeh.2022.900981. eCollection 2022.
Attention-Deficit Hyperactivity Disorder (ADHD) is a complex and heterogeneous neurodevelopmental condition for which curative treatments are lacking. Whilst pharmacological treatments are generally effective and safe, there is considerable inter-individual variability among patients regarding treatment response, required dose, and tolerability. Many of the non-pharmacological treatments, which are preferred to drug-treatment by some patients, either lack efficacy for core symptoms or are associated with small effect sizes. No evidence-based decision tools are currently available to allocate pharmacological or psychosocial treatments based on the patient's clinical, environmental, cognitive, genetic, or biological characteristics. We systematically reviewed potential biomarkers that may help in diagnosing ADHD and/or stratifying ADHD into more homogeneous subgroups and/or predict clinical course, treatment response, and long-term outcome across the lifespan. Most work involved exploratory studies with cognitive, actigraphic and EEG diagnostic markers to predict ADHD, along with relatively few studies exploring markers to subtype ADHD and predict response to treatment. There is a critical need for multisite prospective carefully designed experimentally controlled or observational studies to identify biomarkers that index inter-individual variability and/or predict treatment response.
注意力缺陷多动障碍（ADHD）是一种复杂的异质性神经发育疾病，目前缺乏治愈性治疗方法。虽然药物治疗总体上有效且安全，但患者之间在治疗反应、所需剂量和耐受性方面存在相当大的个体差异。许多非药物治疗方法，一些患者更喜欢使用非药物治疗而非药物治疗，但这些方法要么对核心症状缺乏疗效，要么效果甚微。目前尚无基于证据的决策工具可根据患者的临床、环境、认知、遗传或生物学特征来分配药物治疗或心理社会治疗。我们系统地综述了潜在的生物标志物，这些生物标志物可能有助于诊断ADHD和/或将ADHD分层为更同质的亚组，以及/或者预测整个生命周期的临床病程、治疗反应和长期预后。大多数研究是探索性研究，使用认知、活动记录仪和脑电图诊断标志物来预测ADHD，而探索ADHD亚型标志物和预测治疗反应的研究相对较少。迫切需要开展多中心前瞻性、精心设计的实验对照或观察性研究，以确定能够反映个体差异和/或预测治疗反应的生物标志物。
