Saraçaydın Gülhan, van Rooij Daan, Kleine-Deters Renee, Messchendorp Marieke, Naaijen Jilly, Penzol María José, Rosa Mireia, Aggensteiner Pascal-M, Baumeister Sarah, Holz Nathalie, Banaschewski Tobias, Saam Melanie, Schulze Ulrike M E, Sethi Arjun, Craig Michael, Castro-Fornieles Josefina, Arango Celso, Walitza Susanne, Werhahn Julia, Brandeis Daniel, Franke Barbara, Ruisch I Hyun, Buitelaar Jan K, Dietrich Andrea, Hoekstra Pieter J
Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Eur Child Adolesc Psychiatry. 2025 Jan 18. doi: 10.1007/s00787-025-02638-4.
While impaired response inhibition has been reported in attention-deficit/hyperactivity disorder (ADHD), findings in disruptive behavior disorders (DBDs) have been inconsistent, probably due to unaccounted effects of co-occurring ADHD in DBD. This study investigated the associations of behavioral and neural correlates of response inhibition with DBD and ADHD symptom severity, covarying for each other in a dimensional approach. Functional magnetic resonance imaging data were available for 35 children and adolescents with DBDs (8-18 years old, 19 males), and 31 age-matched unaffected controls (18 males) while performing a performance-adjusted stop-signal task. No significant association was found between behavioral performance and symptom severities. However, contrasting successful inhibition with failed inhibition revealed that DBD and ADHD symptom severity was associated with greater activation in the right inferior frontal regions and reduced activation in the bilateral striatal regions, respectively. During successful inhibition versus go-trials, ADHD symptom severity was associated with the left lateral occipital cortex activation. The contrast of failed inhibition versus go-trials revealed reduced activation in the right frontal and left parietal regions associated with DBD symptom severity while ADHD symptom severity was associated with bilateral precunei, dorsolateral prefrontal and left posterior parietal regions. Except for the right inferior frontal regions during successful versus failed inhibition, all clusters were also found to be inversely associated with the other dimension of interest (i.e., DBD or ADHD symptoms). Opposite direction of the associations between DBD and ADHD symptom severity, and fronto-parietal and fronto-striatal activation suggest unique contributions of DBD and ADHD to the neural correlates of response inhibition.
虽然注意力缺陷多动障碍（ADHD）患者存在反应抑制受损的情况，但破坏性行为障碍（DBD）的研究结果并不一致，这可能是由于DBD中共病的ADHD产生了未被考虑的影响。本研究采用维度分析方法，探讨了反应抑制的行为和神经相关性与DBD及ADHD症状严重程度之间的关联，并对彼此进行了协变量调整。35名患有DBD的儿童和青少年（8至18岁，19名男性）以及31名年龄匹配的未受影响对照组（18名男性）在执行性能调整后的停止信号任务时，获得了功能磁共振成像数据。行为表现与症状严重程度之间未发现显著关联。然而，将成功抑制与失败抑制进行对比发现，DBD和ADHD症状严重程度分别与右下额叶区域的激活增加和双侧纹状体区域的激活减少有关。在成功抑制与执行试验对比时，ADHD症状严重程度与左侧枕叶皮质激活有关。失败抑制与执行试验的对比显示，与DBD症状严重程度相关的右额叶和左顶叶区域激活减少，而ADHD症状严重程度与双侧楔前叶、背外侧前额叶和左后顶叶区域有关。除了成功抑制与失败抑制时的右下额叶区域外，所有聚类也被发现与另一个感兴趣的维度（即DBD或ADHD症状）呈负相关。DBD和ADHD症状严重程度与额顶叶和额纹状体激活之间关联方向相反，这表明DBD和ADHD对反应抑制的神经相关性有独特贡献。
