Shu Yan-Ping, Zhang Qin, Li Da, Liu Jiao-Ying, Wang Xiao-Ming, He Qiang, Hou Yong-Zhe
Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang 550004, Guizhou Province, China.
Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang 550004, Guizhou Province, China.
World J Psychiatry. 2025 Apr 19;15(4):102215. doi: 10.5498/wjp.v15.i4.102215.
Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in adolescents characterized by inattention, hyperactivity, and impulsivity, which impact cognitive, behavioral, and emotional functioning. Resting-state functional magnetic resonance imaging (rs-fMRI) provides critical insights into the functional architecture of the brain in ADHD. Despite extensive research, specific brain regions consistently affected in ADHD patients during these formative years have not been comprehensively delineated.
To identify consistent vulnerable brain regions in adolescent ADHD patients using rs-fMRI and activation likelihood estimation (ALE) meta-analysis.
We conducted a comprehensive literature search up to August 31, 2024, to identify studies investigating functional brain alterations in adolescents with ADHD. We utilized regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), dynamic ALFF (dALFF) and fractional ALFF (fALFF) analyses. We compared the regions of aberrant spontaneous neural activity in adolescents with ADHD with those in healthy controls (HCs) using ALE.
Fifteen studies (468 adolescent ADHD patients and 466 HCs) were included. Combining the ReHo and ALFF/fALFF/dALFF data, the results revealed increased activity in the right lingual gyrus [LING, Brodmann Area (BA) 18], left LING (BA 18), and right cuneus (CUN, BA 23) in adolescent ADHD patients compared with HCs (voxel size: 592-32 mm³, < 0.05). Decreased activity was observed in the left medial frontal gyrus (MFG, BA 9) and left precuneus (PCUN, BA 31) in adolescent ADHD patients compared with HCs (voxel size: 960-456 mm³, < 0.05). Jackknife sensitivity analyses demonstrated robust reproducibility in 11 of the 13 tests for the right LING, left LING, and right CUN and in 11 of the 14 tests for the left MFG and left PCUN.
We identified specific brain regions with both increased and decreased activity in adolescent ADHD patients, enhancing our understanding of the neural alterations that occur during this pivotal stage of development.
注意力缺陷多动障碍（ADHD）是青少年中一种常见的神经发育障碍，其特征为注意力不集中、多动和冲动，会影响认知、行为和情感功能。静息态功能磁共振成像（rs-fMRI）为了解ADHD患者大脑的功能结构提供了关键见解。尽管进行了广泛研究，但在这些发育关键期ADHD患者中始终受到影响的特定脑区尚未得到全面界定。
使用rs-fMRI和激活可能性估计（ALE）元分析确定青少年ADHD患者中一致的易损脑区。
我们进行了全面的文献检索，截至2024年8月31日，以确定研究ADHD青少年大脑功能改变的研究。我们采用了局部一致性（ReHo）、低频振幅（ALFF）、动态ALFF（dALFF）和分数ALFF（fALFF）分析。我们使用ALE将ADHD青少年异常自发神经活动区域与健康对照（HC）的区域进行比较。
纳入了15项研究（468例ADHD青少年患者和466例HC）。结合ReHo和ALFF/fALFF/dALFF数据，结果显示与HC相比，ADHD青少年患者右侧舌回[LING，布罗德曼区（BA）18]、左侧LING（BA 18）和右侧楔叶（CUN，BA 23）的活动增加（体素大小：592 - 32立方毫米，P < 0.05）。与HC相比，ADHD青少年患者左侧额内侧回（MFG，BA 9）和左侧楔前叶（PCUN，BA 31）的活动减少（体素大小：960 - 456立方毫米，P < 0.05）。留一法敏感性分析表明，右侧LING、左侧LING和右侧CUN的13项测试中有11项以及左侧MFG和左侧PCUN的14项测试中有11项具有稳健的可重复性。
我们确定了ADHD青少年患者中活动增加和减少的特定脑区，增进了我们对这一发育关键阶段发生的神经改变的理解。
