Malone M A, Kershner J R, Swanson J M
Division of Neurology, Hospital For Sick Children, Toronto, Ontario, Canada.
J Child Neurol. 1994 Apr;9(2):181-9. doi: 10.1177/088307389400900216.
To advance our understanding of attention-deficit hyperactivity disorder and medication effects we draw upon the evidence for (1) a neurotransmitter imbalance between norepinephrine and dopamine in attention-deficit hyperactivity disorder and (2) an asymmetric neural control system that links the dopaminergic pathways to left hemispheric processing and links the noradrenergic pathways to right hemispheric processing. It appears that attention-deficit hyperactivity disorder may involve a bihemispheric dysfunction characterized by reduced dopaminergic and excessive noradrenergic functioning. In turn, favorable medication effects may be mediated by a restoration in neurotransmitter balance and by increased control over the allocation of attentional resources between hemispheres.
为了加深我们对注意力缺陷多动障碍及药物疗效的理解,我们依据以下证据:(1)注意力缺陷多动障碍中去甲肾上腺素与多巴胺之间存在神经递质失衡;(2)存在一个不对称的神经控制系统,该系统将多巴胺能通路与左半球加工相联系,将去甲肾上腺素能通路与右半球加工相联系。注意力缺陷多动障碍似乎可能涉及一种双侧半球功能障碍,其特征为多巴胺能功能降低和去甲肾上腺素能功能亢进。相应地,良好的药物疗效可能是通过神经递质平衡的恢复以及半球间注意力资源分配控制的增强来介导的。