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使用静息态功能近红外光谱技术对中国儿童中未用药的合并与未合并共病的注意力缺陷多动障碍患者的脑功能进行比较

Comparison of Brain Function Between Medication-Naïve ADHD with and without Comorbidity in Chinese Children Using Resting-State fNIRS.

作者信息

Liao Wenjing, Li Haimei, Liu Qinwei, Cao Longfei, Leng Lingli, Yu Jie, Liu Ningning, Qian Qiujin, Bai Guannan

机构信息

Department of Psychology, Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, P.R. China.

Peking University Sixth Hospital, Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders, Beijing, P.R. China.

出版信息

Alpha Psychiatry. 2024 Aug 1;25(4):485-492. doi: 10.5152/alphapsychiatry.2024.241674. eCollection 2024 Aug.

Abstract

BACKGROUND

This study used functional near-infrared spectroscopy (fNIRS) to investigate brain activation patterns in children with attention deficit hyperactivity disorder (ADHD) with and without additional comorbidities to identify disease-related biomarkers by the neuroimaging that will facilitate to make a diagnosis decision.

METHODS

In this study, 165 medication-naive children aged 7 to 15 years were recruited and categorized into four groups: ADHD, ADHD with learning disabilities (ADHD&LD), ADHD with oppositional defiant disorder (ADHD&ODD), and healthy controls. A multichannel fNIRS system was used to monitor hemodynamic changes at rest state in the prefrontal and temporal lobes of the brain. The amplitude of a low-frequency fluctuation (ALFF) matrix was calculated by summation and averaging of the square root of the signal power spectrum. One-way analysis of variance was used to identify statistical differences between channels.

RESULTS

All ADHD children presented significantly higher ALFF values in different brain regions when compared with the healthy controls. Patients with ADHD&LD exhibited higher ALFF values in the medial prefrontal cortex (  = .01,  = .01), temporal cortex (  = .04,  = .002,  = .001), and the left ventrolateral prefrontal cortex (  = .0009,  = .001), whereas ADHD&ODD children were not significantly different to those diagnosed with ADHD.

CONCLUSIONS

ADHD with learning disabilities (LD) possessed a different pathogenesis from ADHD, manifested as lower functional brain activity in the medial prefrontal cortex, temporal cortex, and the left ventrolateral prefrontal cortex, while ADHD&ODD did not present significant changes compared with ADHD. ODD-related symptoms may be part of ADHD symptoms rather than being an independent disorder.

摘要

背景

本研究使用功能近红外光谱技术(fNIRS)来探究患有和未患有其他合并症的注意力缺陷多动障碍(ADHD)儿童的脑激活模式,通过神经影像学识别与疾病相关的生物标志物,这将有助于做出诊断决策。

方法

在本研究中,招募了165名7至15岁未服用过药物的儿童,并将其分为四组:ADHD组、合并学习障碍的ADHD组(ADHD&LD)、合并对立违抗障碍的ADHD组(ADHD&ODD)和健康对照组。使用多通道fNIRS系统监测大脑前额叶和颞叶静息状态下的血流动力学变化。通过对信号功率谱平方根进行求和与平均来计算低频波动幅度(ALFF)矩阵。采用单因素方差分析来确定各通道之间的统计学差异。

结果

与健康对照组相比,所有ADHD儿童在不同脑区的ALFF值均显著更高。ADHD&LD患者在内侧前额叶皮质(P = 0.01,P = 0.01)、颞叶皮质(P = 0.04,P = 0.002,P = 0.001)和左侧腹外侧前额叶皮质(P = 0.0009,P = 0.001)表现出更高的ALFF值,而ADHD&ODD儿童与被诊断为ADHD的儿童相比无显著差异。

结论

合并学习障碍(LD)的ADHD与ADHD具有不同的发病机制,表现为内侧前额叶皮质、颞叶皮质和左侧腹外侧前额叶皮质的脑功能活动较低,而ADHD&ODD与ADHD相比未呈现显著变化。与ODD相关的症状可能是ADHD症状的一部分,而非独立疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55e4/11443291/fecb2ad92a8b/ap-25-4-485_f001.jpg

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