Zhu Yike, Liu Siqi, Zhang Fan, Ren Yongying, Zhang Tingyu, Sun Jing, Wang Xin, Wang Lin, Yang Jian
Center of Children's Healthcare, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Department of Neurology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Front Neurosci. 2023 Mar 2;17:1119289. doi: 10.3389/fnins.2023.1119289. eCollection 2023.
Executive dysfunction in children with attention deficit hyperactivity disorder (ADHD) is thought to be closely related to the prefrontal cortex (PFC). However, there is controversy over the activation of the PFC in children with ADHD. Differences could be related to the subtype. Meanwhile, no study to date has used functional near-infrared spectroscopy (fNIRS) to explore the differences between subtypes. Thus, this study aimed to explore the activation of the PFC in children with different subtypes of ADHD during executive function task.
Participants in this study include typically developing (TD) children ( = 28), ADHD-predominantly inattentive (ADHD-PI) ( = 39) and ADHD-combined (ADHD-C) ( = 24). To examine the executive function of ADHD, the Go/No-go task is chosen to assess the response inhibition function. The activation of PFC in all participants during the Go/No-go task was recorded by fNIRS. Meanwhile, behavioral data were also recorded.
Both TD and ADHD children activated the right PFC [middle frontal gyrus (MFG) and inferior frontal gyrus (IFG)] during response inhibition. However, the range and degree of activation differed among these groups. Compared with TD children, those with ADHD-PI had a smaller extent of activation in the right PFC, and those with ADHD-C only had a tendency to enhance activation. In addition, children with ADHD-PI and ADHD-C had impaired activation of the temporal gyrus. Besides, compared with ADHD-C and TD, those with ADHD-PI also had impaired activation of the right precentral gyrus (PG), and the supplementary motor area (SMA). Compared with ADHD-PI, ADHD-C showed decreased activation of the right MFG. The activation of Ch34 (BA44, rPFC) in children with ADHD-PI and ADHD-C was negatively correlated with their clinical symptoms.
The activation of the PFC in children with different subtypes of ADHD has both commonalities and differences. The degree of activation of the right PFC Ch34 in children with ADHD is negatively correlated with clinical symptoms. fNIRS could be served as a candidate hemodynamic biomarker for the diagnosis of ADHD.
注意力缺陷多动障碍（ADHD）患儿的执行功能障碍被认为与前额叶皮质（PFC）密切相关。然而，ADHD患儿PFC的激活情况存在争议。差异可能与亚型有关。同时，迄今为止尚无研究使用功能近红外光谱（fNIRS）来探究不同亚型之间的差异。因此，本研究旨在探讨不同亚型ADHD患儿在执行功能任务期间PFC的激活情况。
本研究的参与者包括发育正常（TD）儿童（n = 28）、以注意力不集中为主的ADHD（ADHD-PI）（n = 39）和混合型ADHD（ADHD-C）（n = 24）。为了检测ADHD的执行功能，选择了Go/No-go任务来评估反应抑制功能。在Go/No-go任务期间，通过fNIRS记录所有参与者PFC的激活情况。同时，也记录行为数据。
TD儿童和ADHD患儿在反应抑制期间均激活了右侧PFC[额中回（MFG）和额下回（IFG）]。然而，这些组之间的激活范围和程度有所不同。与TD儿童相比，ADHD-PI患儿右侧PFC的激活范围较小，而ADHD-C患儿仅有激活增强的趋势。此外，ADHD-PI和ADHD-C患儿的颞回激活受损。此外，与ADHD-C和TD儿童相比，ADHD-PI患儿右侧中央前回（PG）和辅助运动区（SMA）的激活也受损。与ADHD-PI相比，ADHD-C患儿右侧MFG的激活减少。ADHD-PI和ADHD-C患儿Ch34（BA44，rPFC）的激活与其临床症状呈负相关。
不同亚型ADHD患儿PFC的激活既有共性也有差异。ADHD患儿右侧PFC Ch34的激活程度与临床症状呈负相关。fNIRS可作为ADHD诊断的候选血液动力学生物标志物。
