Levy F, Barr C, Sunohara G
Department of Child and Adolescent Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Aust N Z J Psychiatry. 1998 Feb;32(1):97-103. doi: 10.3109/00048679809062715.
The aim of this paper is to review and integrate recent literature on aetiological factors that have been postulated for attention deficit hyperactivity disorder (ADHD).
Recent studies relating to perinatal brain damage, intra-uterine toxic effects, neurochemical, brain imaging and genetic studies are reviewed, and those considered most significant are discussed. Where possible, recent findings are integrated and directions of future research are suggested. Clinical implications are briefly discussed.
Perinatal studies indicate that children with a birth weight under 750 g may be disadvantaged for attentional skills. Magnetic resonance imaging (MRI) and steady state visually evoked potential studies show differences in prefrontal, caudate and parietal areas in ADHD children, suggesting right hemispheric dysfunction. Functional MRI studies hold promise in further elucidating attentional systems in the central nervous system that are involved in ADHD. Genetic studies suggest genes related to dopaminergic systems may be important.
Recent research on ADHD has made considerable advances, particularly in the areas of brain imaging and genetic studies. Genetic studies should provide further aetiological understandings of ADHD, leading to more targeted treatments.
本文旨在回顾和整合近期关于注意力缺陷多动障碍（ADHD）病因学因素的文献。
回顾了与围产期脑损伤、宫内毒性作用、神经化学、脑成像和基因研究相关的近期研究，并讨论了那些被认为最重要的研究。在可能的情况下，整合近期研究结果并提出未来研究方向。简要讨论了临床意义。
围产期研究表明，出生体重低于750克的儿童在注意力技能方面可能处于劣势。磁共振成像（MRI）和稳态视觉诱发电位研究显示，ADHD儿童的前额叶、尾状核和顶叶区域存在差异，提示右脑功能障碍。功能MRI研究有望进一步阐明中枢神经系统中与ADHD相关的注意力系统。基因研究表明，与多巴胺能系统相关的基因可能很重要。
近期关于ADHD的研究取得了相当大的进展，特别是在脑成像和基因研究领域。基因研究应能为ADHD提供进一步的病因学认识，从而实现更具针对性的治疗。
