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将数十年的神经科学研究转化为 ADHD 的诊断和治疗生物标志物。

Translating Decades of Neuroscience Research into Diagnostic and Treatment Biomarkers for ADHD.

机构信息

Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

National Institute of Mental Health, Bethesda, MD, USA.

出版信息

Adv Neurobiol. 2024;40:579-616. doi: 10.1007/978-3-031-69491-2_20.

Abstract

In this chapter, we review scientific findings that form the basis for neuroimaging and neurophysiological biomarkers for ADHD diagnosis and treatment. We then highlight the different challenges in translating mechanistic findings into biomarkers for ADHD diagnosis and treatment. Population heterogeneity is a primary barrier for identifying biomarkers of ADHD diagnosis, which requires shifts toward dimensional approaches that identify clinically useful subgroups or prospective biomarkers that can identify trajectories of illness, function, or treatment response. Methodological limitations, including emphasis on group level analyses of treatment effects in small sample sizes, are the primary barriers to biomarker discovery in ADHD treatment. Modifications to clinical trials, including shifting towards testing biomarkers of a priori prediction of functionally related brain targets, treatment response, and side effects, are suggested. Finally, future directions for biomarker work are discussed.

摘要

在本章中,我们回顾了构成 ADHD 诊断和治疗的神经影像学和神经生理学生物标志物的科学发现。然后,我们强调了将机制研究结果转化为 ADHD 诊断和治疗生物标志物的不同挑战。人群异质性是识别 ADHD 诊断生物标志物的主要障碍,这需要转向多维方法,以识别具有临床应用价值的亚组或前瞻性生物标志物,以识别疾病、功能或治疗反应的轨迹。方法学限制,包括在小样本量上强调对治疗效果的组水平分析,是 ADHD 治疗中生物标志物发现的主要障碍。建议对临床试验进行修改,包括转向测试与功能相关的大脑靶点、治疗反应和副作用的预先预测的生物标志物。最后,讨论了生物标志物工作的未来方向。

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