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注意缺陷多动障碍患者大脑结构和功能改变的荟萃分析。

Meta-analysis of structural and functional alterations of brain in patients with attention-deficit/hyperactivity disorder.

作者信息

Yu Miaomiao, Gao Xinyu, Niu Xiaoyu, Zhang Mengzhe, Yang Zhengui, Han Shaoqiang, Cheng Jingliang, Zhang Yong

机构信息

Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.

出版信息

Front Psychiatry. 2023 Jan 6;13:1070142. doi: 10.3389/fpsyt.2022.1070142. eCollection 2022.

Abstract

BACKGROUND

A large and growing body of neuroimaging research has concentrated on patients with attention-deficit/hyperactivity disorder (ADHD), but with inconsistent conclusions. This article was intended to investigate the common and certain neural alterations in the structure and function of the brain in patients with ADHD and further explore the differences in brain alterations between adults and children with ADHD.

METHODS

We conducted an extensive literature search of whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies associated with ADHD. Two separate meta-analyses with the seed-based d mapping software package for functional neural activation and gray matter volume (GMV) were carried out, followed by a joint analysis and a subgroup analysis.

RESULTS

This analysis included 29 VBM studies and 36 fMRI studies. Structurally, VBM analysis showed that the largest GMV diminutions in patients with ADHD were in several frontal-parietal brain regions, the limbic system, and the corpus callosum. Functionally, fMRI analysis discovered significant hypoactivation in several frontal-temporal brain regions, the right postcentral gyrus, the left insula, and the corpus callosum.

CONCLUSION

This study showed that abnormal alterations in the structure and function of the left superior frontal gyrus and the corpus callosum may be the key brain regions involved in the pathogenesis of ADHD in patients and may be employed as an imaging metric for patients with ADHD pending future research. In addition, this meta-analysis discovered neuroanatomical or functional abnormalities in other brain regions in patients with ADHD as well as findings that can be utilized to guide future research.

摘要

背景

大量且不断增加的神经影像学研究聚焦于注意力缺陷多动障碍(ADHD)患者,但结论并不一致。本文旨在探究ADHD患者大脑结构和功能中常见且特定的神经改变,并进一步探讨成人和儿童ADHD患者大脑改变的差异。

方法

我们对与ADHD相关的全脑基于体素的形态测量学(VBM)和功能磁共振成像(fMRI)研究进行了广泛的文献检索。使用基于种子点的d映射软件包对功能性神经激活和灰质体积(GMV)进行了两项独立的荟萃分析,随后进行联合分析和亚组分析。

结果

该分析纳入了29项VBM研究和36项fMRI研究。在结构上,VBM分析显示,ADHD患者中GMV减少最多的是几个额顶叶脑区、边缘系统和胼胝体。在功能上,fMRI分析发现几个额颞叶脑区、右侧中央后回、左侧岛叶和胼胝体存在显著的激活不足。

结论

本研究表明,左侧额上回和胼胝体的结构和功能异常改变可能是ADHD患者发病机制中涉及的关键脑区,并且在未来研究之前可作为ADHD患者的成像指标。此外,这项荟萃分析还发现了ADHD患者其他脑区的神经解剖或功能异常以及可用于指导未来研究的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/9853532/eee0eab1baf8/fpsyt-13-1070142-g0001.jpg

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