Deviant white matter structure in adults with attention-deficit/hyperactivity disorder points to aberrant myelination and affects neuropsychological performance.
Deviant white matter structure in adults with attention-deficit/hyperactivity disorder points to aberrant myelination and affects neuropsychological performance.
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DOI：
10.1016/j.pnpbp.2015.04.008
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发表时间：
2015-12-03
影响因子：
5.6
通讯作者：
Franke B
中科院分区：
文献类型：
--
作者：
Onnink AM;Zwiers MP;Hoogman M;Mostert JC;Dammers J;Kan CC;Vasquez AA;Schene AH;Buitelaar J;Franke B
儿童期注意力缺陷多动障碍（ADHD）的特征是几个脑区的灰质和白色物质异常。关于成人ADHD患者的白色物质微结构及其与临床症状和认知表现的关系，我们知之甚少。在107名成人ADHD患者和109名性别，年龄和智商匹配的对照组中，我们使用弥散张量成像（DTI）和基于轨迹的空间统计（TBSS）来研究全骨骼各向异性分数（FA）和平均，轴向和径向扩散率（MD，AD，RD）的变化。此外，我们研究了FA和MD值与症状严重程度和认知性能的任务测量工作记忆，注意力，抑制和延迟折扣的关系。与对照组相比，ADHD患者的胼胝体、双侧放射冠和丘脑放射的FA减少。较高的MD和RD被发现在重叠的，甚至更广泛的地区，在两个半球，也包括内外囊，矢状层，穹窿，和上级外侧束。FA和MD值与症状严重程度无关。然而，在区分患者和对照组的一些白色物质簇中，更差的抑制性能与FA降低相关，更冲动的决策与MD增加相关。这项研究表明，持续性ADHD成人和健康个体之间的白色物质完整性存在广泛差异。RD的变化表明髓鞘形成异常是持续性ADHD的一个病理生理因素。成人ADHD的微结构差异可能导致抑制力差和冲动性更大，但似乎与疾病的严重程度无关。
Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, saggital stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity.