Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder
Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder
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DOI：
10.1001/jama.288.14.1740
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发表时间：
2002-10-09
影响因子：
120.7
通讯作者：
Rapoport, JL
中科院分区：
文献类型：
--
作者：
Castellanos, FX;Lee, PP;Rapoport, JL
目的比较服用药物和未服用药物的注意缺陷多动障碍男女患者和健康对照组的初始扫描脑体积及其随时间的变化。设计、设置和参与者19912001在马里兰州贝塞斯达国立精神卫生研究所进行的病例对照研究，包括152名患有注意缺陷多动障碍的儿童和青少年(年龄范围5-18岁)和139名年龄和性别匹配的对照组(年龄范围，年龄范围，年龄和性别匹配的对照，年龄范围，年龄，年龄和性别匹配的对照，年龄范围，从当地社区招募，年龄4.5-19年，贡献了544个解剖磁共振图像。采用全自动方法，比较了患者和对照组的全脑、小脑、灰质、白质和尾状核4个主要脑叶的初始体积和预期年龄相关变化。结果在初次扫描时，即使调整了显著的协变量，ADHD患者所有区域的脑体积都明显缩小。这种总体差异反映在较小的脑体积(-3.2%，调整后的F-1，F-280=8.30，P=.004)和显著较小的小脑体积(-3.5%，调整后的F-1，F-280=12.29，P=.001)。与对照组相比，既往未服用药物的ADHD儿童的总脑体积(总体F-2，F-288=6.65；所有配对比较，Bonferroni校正后，-5.8%；P=0.002)和小脑体积(-6.2%，F-2，F-288=8.97，P
Context Various anatomic brain abnormalities have been reported for attention-deficit/hyperactivity disorder (ADHD), with varying methods, small samples, cross-sectional designs, and without accounting for stimulant drug exposure.Objective To compare regional brain volumes at initial scan and their change over time in medicated and previously unmedicated male and female patients with ADHD and healthy controls.Design, Setting, and Participants Case-control study conducted from 19912001 at the National Institute of Mental Health, Bethesda, Md, of 152 children and adolescents with ADHD (age range, 5-18 years) and 139 age- and sex-matched controls (age range, 4.5-19 years) recruited from the local community, who contributed 544 anatomic magnetic resonance images.Main Outcome Measures Using completely automated methods, initial volumes and prospective age-related changes of total cerebrum, cerebellum, gray and white matter for the 4 major lobes, and caudate nucleus of the brain were compared in patients and controls.Results On initial scan, patients with ADHD had significantly smaller brain volumes in all regions, even after adjustment for significant covariates. This global difference was reflected in smaller total cerebral volumes (-3.2%, adjusted F-1,F-280=8.30, P=.004) and in significantly smaller cerebellar volumes (-3.5%, adjusted F-1,F-280=12.29, P=.001). Compared with controls, previously unmedicated children with ADHD demonstrated significantly smaller total cerebral volumes (overall F-2,F-288=6.65; all pairwise comparisons Bonferroni corrected, -5.8%; P=.002) and cerebellar volumes (-6.2%, F-2,F-288=8.97, P