Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China.
International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China.
Neuropsychopharmacology. 2024 Jul;49(8):1330-1340. doi: 10.1038/s41386-024-01831-4. Epub 2024 Feb 26.
Children with ADHD show abnormal brain function and structure. Neuroimaging studies found that stimulant medications may improve brain structural abnormalities in children with ADHD. However, prior studies on this topic were conducted with relatively small sample sizes and wide age ranges and showed inconsistent results. In this cross-sectional study, we employed latent class analysis and linear mixed-effects models to estimate the impact of stimulant medications using demographic, clinical measures, and brain structure in a large and diverse sample of children aged 9-11 from the Adolescent Brain and Cognitive Development Study. We studied 273 children with low ADHD symptoms and received stimulant medication (Stim Low-ADHD), 1002 children with high ADHD symptoms and received no medications (No-Med ADHD), and 5378 typically developing controls (TDC). After controlling for the covariates, compared to Stim Low-ADHD and TDC, No-Med ADHD showed lower cortical thickness in the right insula (INS, d = 0.340, P = 0.003) and subcortical volume in the left nucleus accumbens (NAc, d = 0.371, P = 0.003), indicating that high ADHD symptoms were associated with structural abnormalities in these brain regions. In addition, there was no difference in brain structural measures between Stim Low-ADHD and TDC children, suggesting that the stimulant effects improved both ADHD symptoms and ADHD-associated brain structural abnormalities. These findings together suggested that children with ADHD appear to have structural abnormalities in brain regions associated with saliency and reward processing, and treatment with stimulant medications not only improve the ADHD symptoms but also normalized these brain structural abnormalities.
患有 ADHD 的儿童表现出异常的大脑功能和结构。神经影像学研究发现，兴奋剂药物可能改善 ADHD 儿童的大脑结构异常。然而，先前关于这个主题的研究样本量相对较小，年龄范围较广，结果不一致。在这项横断面研究中，我们采用潜在类别分析和线性混合效应模型，使用人口统计学、临床测量和大脑结构数据，在来自青少年大脑与认知发展研究的一个大而多样化的 9-11 岁儿童样本中，估计兴奋剂药物的影响。我们研究了 273 名 ADHD 症状较低且接受兴奋剂药物治疗的儿童（Stim Low-ADHD）、1002 名 ADHD 症状较高且未接受药物治疗的儿童（No-Med ADHD）和 5378 名典型发育对照儿童（TDC）。在控制了协变量后，与 Stim Low-ADHD 和 TDC 相比，No-Med ADHD 右侧岛叶（INS）皮质厚度较低（d=0.340，P=0.003），左侧伏隔核（NAc）体积较小（d=0.371，P=0.003），表明高 ADHD 症状与这些大脑区域的结构异常有关。此外，Stim Low-ADHD 和 TDC 儿童的大脑结构测量值没有差异，表明兴奋剂药物的治疗效果改善了 ADHD 症状和与 ADHD 相关的大脑结构异常。这些发现表明，ADHD 儿童的大脑区域似乎存在与突显和奖励处理相关的结构异常，而兴奋剂药物治疗不仅改善了 ADHD 症状，而且还使这些大脑结构异常正常化。
