Pan Nanfang, Ma Tianyu, Liu Yixi, Zhang Shufang, Hu Samantha, Shekara Aniruddha, Cao Hengyi, Gong Qiyong, Chen Ying
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA.
Psychol Med. 2025 Jan 14;54(16):1-15. doi: 10.1017/S003329172400285X.
Psychostimulants and nonstimulants have partially overlapping pharmacological targets on attention-deficit/hyperactivity disorder (ADHD), but whether their neuroimaging underpinnings differ is elusive. We aimed to identify overlapping and medication-specific brain functional mechanisms of psychostimulants and nonstimulants on ADHD.
After a systematic literature search and database construction, the imputed maps of separate and pooled neuropharmacological mechanisms were meta-analyzed by Seed-based Mapping toolbox, followed by large-scale network analysis to uncover potential coactivation patterns and meta-regression analysis to examine the modulatory effects of age and sex.
Twenty-eight whole-brain task-based functional MRI studies (396 cases in the medication group and 459 cases in the control group) were included. Possible normalization effects of stimulant and nonstimulant administration converged on increased activation patterns of the left supplementary motor area ( = 1.21, < 0.0001, central executive network). Stimulants, relative to nonstimulants, increased brain activations in the left amygdala ( = 1.30, = 0.0006), middle cingulate gyrus ( = 1.22, = 0.0008), and superior frontal gyrus ( = 1.27, = 0.0006), which are within the ventral attention network. Neurodevelopmental trajectories emerged in activation patterns of the right supplementary motor area and left amygdala, with the left amygdala also presenting a sex-related difference.
Convergence in the left supplementary motor area may delineate novel therapeutic targets for effective interventions, and distinct neural substrates could account for different therapeutic responses to stimulants and nonstimulants.
精神兴奋剂和非兴奋剂在注意力缺陷多动障碍（ADHD）上具有部分重叠的药理学靶点，但它们的神经影像学基础是否不同尚不清楚。我们旨在确定精神兴奋剂和非兴奋剂对ADHD的重叠及药物特异性脑功能机制。
在进行系统的文献检索和数据库构建后，通过基于种子的映射工具箱对单独和汇总的神经药理学机制的推算图谱进行荟萃分析，随后进行大规模网络分析以揭示潜在的共激活模式，并进行荟萃回归分析以检查年龄和性别的调节作用。
纳入了28项基于全脑任务的功能磁共振成像研究（药物治疗组396例，对照组459例）。兴奋剂和非兴奋剂给药可能的归一化效应集中在左辅助运动区激活模式增加（ = 1.21， < 0.0001，中央执行网络）。与非兴奋剂相比，兴奋剂增加了左杏仁核（ = 1.30， = 0.0006）、中扣带回（ = 1.22， = 0.0008）和额上回（ = 1.27， = 0.0006）的脑激活，这些区域位于腹侧注意网络内。右辅助运动区和左杏仁核的激活模式出现了神经发育轨迹，左杏仁核也存在性别相关差异。
左辅助运动区的趋同可能描绘出有效干预的新治疗靶点，不同的神经底物可能解释对兴奋剂和非兴奋剂的不同治疗反应。
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