Neurodevelopmental abnormalities in ADHD.
Neurodevelopmental abnormalities in ADHD.
复制标题
DOI：
10.1007/7854_2011_138
复制
发表时间：
2012
影响因子：
--
通讯作者：
Vaidya, Chandan J
中科院分区：
文献类型：
--
作者：
Vaidya, Chandan J
结构和功能成像研究的主题与注意缺陷多动障碍（ADHD）的目的是收集信息的神经发育异常的障碍。结构成像研究，特别是那些纵向设计的研究，表明ADHD患者的大脑成熟延迟了几年。然而，单独的成熟延迟模型是不完整的：交替课程与表型因素相关的差异，如症状缓解/持续和暴露于兴奋剂治疗。功能成像研究的结果指出了多个异常位点，这些异常不仅限于对执行和动机功能很重要的额纹状体回路，还包括顶叶、颞叶和运动皮质以及小脑。然而，关于成熟延迟或替代轨迹的明确结论不能从这项工作中得出，因为激活模式受到特定任务因素的影响，这些因素可能会导致不同的性能水平和发展策略。此外，没有研究已经实施了横截面或纵向设计，没有激活差异的发展起源不能推断。因此，目前的任务诱发功能成像提供的信息动态或状态依赖的差异，而不是固定的或特质相关的差异。在未来，无任务功能成像有望揭示神经发育信息，这是最低限度地影响性能/战略差异。此外，需要使用纵向设计的研究，以确定大脑成熟的表型异质性来源，并表征大脑功能和基础结构特性之间的关系，以提供ADHD神经发育异常的全面观点。
Structural and functional imaging studies in subjects with attention deficit hyperactivity disorder (ADHD) are reviewed with the goal of gleaning information about neurodevelopmental abnormalities characterizing the disorder. Structural imaging studies, particularly those with longitudinal designs, suggest that brain maturation is delayed by a few years in ADHD. However, a maturational delay model alone is incomplete: alternate courses are suggested by differences associated with phenotypic factors, such as symptom remission/persistence and exposure to stimulant treatment. Findings from functional imaging studies point to multiple loci of abnormalities that are not limited to frontal–striatal circuitry, which is important for executive and motivational function, but also include parietal, temporal and motor cortices, and the cerebellum. However, a definitive conclusion about maturational delays or alternate trajectories cannot be drawn from this work as activation patterns are influenced by task-specific factors that may induce variable performance levels and strategies across development. In addition, no studies have implemented cross-sectional or longitudinal designs, without which the developmental origin of differences in activation cannot be inferred. Thus, current task-evoked functional imaging provides information about dynamic or state-dependent differences rather than fixed or trait-related differences. In the future, task-free functional imaging holds promise for revealing neurodevelopmental information that is minimally influenced by performance/strategic differences. Further, studies using longitudinal designs that identify sources of phenotypic heterogeneity in brain maturation and characterize the relationship between brain function and underlying structural properties are needed to provide a comprehensive view of neurodevelopmental abnormalities in ADHD.