Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
Int J Dev Neurosci. 2022 Dec;82(8):681-715. doi: 10.1002/jdn.10228. Epub 2022 Sep 28.
The purpose of this study was to systematically review the neural similarities and differences in brain structure and function, measured by magnetic resonance imaging (MRI), in children with neurodevelopmental disorders that commonly co-occur to understand if and how they have shared neuronal characteristics.
Using systematic review methodology, the following databases were comprehensively searched: MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, and ProQuest from the earliest record up to December 2021. Inclusion criteria were (1) peer-reviewed studies, case reports, or theses; (2) children under 18 years of age with at least one of the following neurodevelopmental disorders: autism spectrum disorder (ASD), attention hyperactivity deficit disorder (ADHD), developmental coordination disorder (DCD), and their co-occurrence; and (3) studies based on MRI modalities (i.e., structural MRI, diffusion tensor imaging [DTI], and resting-state fMRI). Thirty-one studies that met the inclusion criteria were included for quality assessment by two independent reviewers using the Appraisal tool for Cross-Sectional Studies (AXIS).
Studies compared brain structure and function of children with DCD and ADHD (n = 6), DCD and ASD (n = 1), ASD and ADHD (n = 17), and various combinations of these co-occurring conditions (n = 7). Structural neuroimaging (n = 15) was the most commonly reported modality, followed by resting-state (n = 8), DTI (n = 5), and multimodalities (n = 3).
Evidence indicated that the neural correlates of the co-occurring conditions were more widespread and distinct compared to a single diagnosis. The majority of findings (77%) suggested that each neurodevelopmental disorder had more distinct neural correlates than shared neural features, suggesting that each disorder is distinct despite commonly co-occurring with each other. As the number of papers examining the co-occurrence of ASD, DCD, and/or ADHD was limited and most findings were not corrected for multiple comparisons, these results must be interpreted with caution.
本研究旨在通过磁共振成像（MRI）系统地综述神经发育障碍儿童的脑结构和功能的神经相似性和差异性，以了解它们是否以及如何具有共同的神经特征。
使用系统综述方法，全面检索了以下数据库：MEDLINE、EMBASE、CINAHL、CENTRAL、PsycINFO 和 ProQuest，检索时间截至 2021 年 12 月。纳入标准为：（1）同行评议的研究、病例报告或论文；（2）年龄在 18 岁以下，至少患有以下一种神经发育障碍：自闭症谱系障碍（ASD）、注意力缺陷多动障碍（ADHD）、发育协调障碍（DCD）及其共病；（3）基于 MRI 模式的研究（即结构 MRI、弥散张量成像[DTI]和静息态 fMRI）。两名独立评审员使用横断面研究评估工具（AXIS）对符合纳入标准的 31 项研究进行了质量评估。
研究比较了 DCD 和 ADHD（n=6）、DCD 和 ASD（n=1）、ASD 和 ADHD（n=17）以及这些共病的各种组合（n=7）儿童的大脑结构和功能。结构神经影像学（n=15）是最常报告的模式，其次是静息态（n=8）、DTI（n=5）和多模态（n=3）。
证据表明，共病的神经相关性比单一诊断更为广泛和独特。大多数发现（77%）表明，每种神经发育障碍都有更独特的神经相关性，而不是共同的神经特征，这表明尽管彼此之间常共病，但每种障碍都是独特的。由于检查 ASD、DCD 和/或 ADHD 共病的论文数量有限，且大多数发现均未进行多重比较校正，因此必须谨慎解释这些结果。
