Mizuno Yoshifumi, Yamashita Masatoshi, Shou Qiulu, Hamatani Sayo, Cai Weidong
Research Centre for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
Research Centre for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.
Brain Dev. 2025 Apr;47(2):104340. doi: 10.1016/j.braindev.2025.104340. Epub 2025 Mar 4.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and/or impulsivity that significantly affects academic, occupational, and social functioning. This review summarizes key findings of structural and functional magnetic resonance imaging (MRI) studies investigating the neural underpinnings of ADHD, focusing on T1-weighted structural MRI, diffusion tensor imaging (DTI), task-based functional MRI (task fMRI), and resting-state functional MRI (rs-fMRI). T1-weighted structural MRI studies have revealed reduced gray matter volume in regions implicated in executive function, particularly the frontal cortex, basal ganglia, and cerebellum, along with evidence of delayed cortical maturation. DTI findings highlighted abnormalities in white matter integrity, particularly in the fronto-striatal-cerebellar circuits and connections between the corpus callosum and cingulum. Task fMRI studies have demonstrated reduced activation of brain networks involved in cognitive control, timing, and reward processing, including fronto-striatal and fronto-parietal networks. Furthermore, rs-fMRI research has shown altered connectivity patterns within and between key brain networks, including the default mode, fronto-parietal, and salience networks. Despite these insights, inconsistencies across studies underscore the need for larger and more standardized research efforts. Future research should employ multimodal imaging techniques and advanced analytical methods such as machine learning to better subtype ADHD and customize interventions. Moreover, establishing harmonized imaging protocols across institutions, as exemplified by innovative strategies, such as the traveling-subject method, is crucial for mitigating intersite variability. Through collaborative efforts, neuroimaging studies in ADHD are anticipated to enhance our understanding of the disorder's heterogeneity while informing the development of precise clinical diagnoses and personalized therapeutic interventions.
注意缺陷多动障碍（ADHD）是一种常见的神经发育障碍，其特征为持续的注意力不集中、多动和/或冲动，这些症状会显著影响学业、职业和社交功能。本综述总结了结构和功能磁共振成像（MRI）研究的主要发现，这些研究旨在探究ADHD的神经基础，重点关注T1加权结构MRI、扩散张量成像（DTI）、基于任务的功能MRI（任务fMRI）和静息态功能MRI（rs-fMRI）。T1加权结构MRI研究显示，与执行功能相关的区域，特别是额叶皮质、基底神经节和小脑的灰质体积减少，同时有皮质成熟延迟的证据。DTI研究结果突出了白质完整性的异常，特别是在额-纹状体-小脑回路以及胼胝体和扣带之间的连接中。任务fMRI研究表明，参与认知控制、时间感知和奖励处理的脑网络激活减少，包括额-纹状体和额-顶叶网络。此外，rs-fMRI研究显示关键脑网络内部和之间的连接模式发生了改变，包括默认模式、额-顶叶和突显网络。尽管有这些见解，但研究之间的不一致强调了需要进行更大规模和更标准化的研究工作。未来的研究应采用多模态成像技术和先进的分析方法，如机器学习，以更好地对ADHD进行亚型分类并定制干预措施。此外，建立跨机构的统一成像方案，如采用旅行受试者方法等创新策略，对于减少站点间的变异性至关重要。通过合作努力，预计ADHD的神经影像学研究将增进我们对该疾病异质性的理解，同时为精确的临床诊断和个性化治疗干预的发展提供信息。
