Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.
NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
CNS Neurosci Ther. 2024 Aug;30(8):e14900. doi: 10.1111/cns.14900.
AIMS: Altered brain functional connectivity has been proposed as the neurobiological underpinnings of attention-deficit/hyperactivity disorder (ADHD), and the default mode interference hypothesis is one of the most popular neuropsychological models. Here, we explored whether this hypothesis is supported in adults with ADHD and the association with high-risk genetic variants and treatment outcomes. METHODS: Voxel-based whole-brain connectome analysis was conducted on resting-state functional MRI data from 84 adults with ADHD and 89 healthy controls to identify functional connectivity substrates corresponding to ADHD-related alterations. The candidate genetic variants and 12-week cognitive behavioral therapy data were leveraged from the same population to assess these associations. RESULTS: We detected breakdowns of functional connectivity in the precuneus and left middle temporal gyrus in adults with ADHD, with exact contributions from decreased connectivity within the default mode, dorsal and ventral attention networks, as well as increased connectivity among them with the middle temporal gyrus serving as a crucial 'bridge'. Additionally, significant associations between the altered functional connectivity and genetic variants in both MAOA and MAOB were detected. Treatment restored brain function, with the amelioration of connectivity of the middle temporal gyrus, accompanied by improvements in ADHD core symptoms. CONCLUSIONS: These findings support the interference of default mode on attention in adults with ADHD and its association with genetic risk variants and clinical management, providing insights into the underlying pathogenesis of ADHD and potential biomarkers for treatment evaluation.
目的:大脑功能连接的改变被认为是注意力缺陷/多动障碍(ADHD)的神经生物学基础,而默认模式干扰假说(Default Mode Interference Hypothesis)是最流行的神经心理学模型之一。在这里,我们探讨了这一假说是否适用于 ADHD 成人,以及与高风险遗传变异和治疗结果的关系。
方法:对 84 名 ADHD 成人和 89 名健康对照者的静息态功能磁共振成像数据进行基于体素的全脑连接组学分析,以确定与 ADHD 相关改变相对应的功能连接基础。从同一人群中利用候选遗传变异和 12 周认知行为治疗数据来评估这些关联。
结果:我们在 ADHD 成人中检测到楔前叶和左中颞叶功能连接的破坏,具体表现为默认模式、背侧和腹侧注意网络内的连接减少,以及它们之间的连接增加,而中颞叶则作为一个关键的“桥梁”。此外,还检测到改变的功能连接与 MAOA 和 MAOB 中的遗传变异之间存在显著关联。治疗恢复了大脑功能,中颞叶的连接得到改善,同时 ADHD 的核心症状也得到了改善。
结论:这些发现支持 ADHD 成人中默认模式对注意力的干扰及其与遗传风险变异和临床管理的关系,为 ADHD 的发病机制提供了新的见解,并为治疗评估提供了潜在的生物标志物。
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