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解析注意力缺陷/多动障碍的病因:当前治疗面临的挑战与未来方向

Unraveling Attention-Deficit/Hyperactivity Disorder Etiology: Current Challenges and Future Directions in Treatment.

作者信息

Poddar Abhishek, Gaddam Sreelatha, Sonnaila Shivakumar, Bavaraju Venkata Suryanarayana Murthy, Agrawal Shilpi

机构信息

Department of Molecular Biology, Massachusetts General Hospital, Boston, MA 02114, USA.

Department of Genetics, Harvard Medical School, Boston, MA 02114, USA.

出版信息

NeuroSci. 2025 May 6;6(2):41. doi: 10.3390/neurosci6020041.

DOI:10.3390/neurosci6020041
PMID:40407614
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12101162/
Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex neurodevelopmental disorder with a multifactorial etiology involving genetic, epigenetic, and environmental factors. This review focuses on the current understanding of these contributing elements, examining how they interact to influence ADHD development. Genetic predispositions, environmental exposures, and epigenetic modifications collectively shape the risk and manifestation of the disorder. Despite advancements in research, significant challenges remain in identifying precise mechanisms and translating them into effective treatments. The variability of symptoms across individuals, influenced by factors such as age, gender, and cultural background, further complicates diagnosis and treatment. Addressing these challenges requires a deeper investigation into the underlying causes of ADHD and the development of tailored interventions. This review aims to highlight both the progress made in understanding ADHD etiology and the current gaps in treatment approaches, calling for more targeted research and personalized therapeutic strategies.

摘要

注意力缺陷多动障碍(ADHD)是一种复杂的神经发育障碍,其病因多因素,涉及遗传、表观遗传和环境因素。本综述聚焦于对这些促成因素的当前理解,审视它们如何相互作用以影响ADHD的发展。遗传易感性、环境暴露和表观遗传修饰共同塑造了该疾病的风险和表现。尽管研究取得了进展,但在确定精确机制并将其转化为有效治疗方法方面仍存在重大挑战。受年龄、性别和文化背景等因素影响,个体症状的变异性进一步使诊断和治疗复杂化。应对这些挑战需要对ADHD的潜在病因进行更深入的研究,并制定针对性的干预措施。本综述旨在突出在理解ADHD病因方面取得的进展以及当前治疗方法中的差距,呼吁开展更具针对性的研究和个性化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/cee2ecf0915e/neurosci-06-00041-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/048e5f316923/neurosci-06-00041-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/623a0edb1d77/neurosci-06-00041-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/0b09fa8e3d5a/neurosci-06-00041-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/cee2ecf0915e/neurosci-06-00041-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/048e5f316923/neurosci-06-00041-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/623a0edb1d77/neurosci-06-00041-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/0b09fa8e3d5a/neurosci-06-00041-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7227/12101162/cee2ecf0915e/neurosci-06-00041-g004.jpg

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本文引用的文献

1
The impacts associated with having ADHD: an umbrella review.与注意力缺陷多动障碍相关的影响:一项综合性综述。
Front Psychiatry. 2024 May 21;15:1343314. doi: 10.3389/fpsyt.2024.1343314. eCollection 2024.
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Genotype-Environment Interaction in ADHD: Genetic Predisposition Determines the Extent to Which Environmental Influences Explain Variability in the Symptom Dimensions Hyperactivity and Inattention.ADHD 中的基因型-环境交互作用:遗传易感性决定了环境影响在多大程度上解释了多动和注意力不集中症状维度的变异性。
Behav Genet. 2024 Mar;54(2):169-180. doi: 10.1007/s10519-023-10168-5. Epub 2024 Jan 25.
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Attention Deficit Hyperactivity Disorder (ADHD) Causes and Diagnosis in Adults: A Review.
成人注意力缺陷多动障碍(ADHD)的病因与诊断:综述
Cureus. 2023 Nov 20;15(11):e49144. doi: 10.7759/cureus.49144. eCollection 2023 Nov.
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Prevalence and Trends in Diagnosed ADHD Among US Children and Adolescents, 2017-2022.2017 - 2022年美国儿童和青少年确诊注意力缺陷多动障碍的患病率及趋势
JAMA Netw Open. 2023 Oct 2;6(10):e2336872. doi: 10.1001/jamanetworkopen.2023.36872.
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A twin study of genetic and environmental contributions to attention-deficit/hyperactivity disorder over time.一项关于随着时间推移基因和环境对注意力缺陷多动障碍影响的双生子研究。
J Child Psychol Psychiatry. 2023 Nov;64(11):1608-1616. doi: 10.1111/jcpp.13854. Epub 2023 Jul 6.
6
The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder.心理社会逆境在注意缺陷多动障碍的病因和病程中的作用。
Rev Colomb Psiquiatr (Engl Ed). 2023 Jan-Mar;52(1):65-72. doi: 10.1016/j.rcpeng.2021.02.007.
7
Author Correction: Genome-wide analyses of ADHD identify 27 risk loci, refine the genetic architecture and implicate several cognitive domains.作者更正:注意力缺陷多动障碍的全基因组分析确定了27个风险位点,完善了遗传结构并涉及多个认知领域。
Nat Genet. 2023 Apr;55(4):730. doi: 10.1038/s41588-023-01350-w.
8
Adult ADHD: Underdiagnosis of a Treatable Condition.成人注意力缺陷多动障碍:一种可治疗病症的诊断不足
J Health Serv Psychol. 2023;49(1):11-19. doi: 10.1007/s42843-023-00077-w. Epub 2023 Jan 28.
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Mitochondrial Dysfunction in Attention Deficit Hyperactivity Disorder.注意缺陷多动障碍中的线粒体功能障碍
Eurasian J Med. 2022 Dec;54(Suppl1):187-195. doi: 10.5152/eurasianjmed.2022.22187.
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Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.注意缺陷多动障碍的治疗:药物、心理疗法、设备、补充和替代方法以及临床试验趋势。
Front Pharmacol. 2022 Nov 17;13:1066988. doi: 10.3389/fphar.2022.1066988. eCollection 2022.