Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task
Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task
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DOI：
10.1111/j.1399-5618.2005.00257.x
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发表时间：
2005-12-01
影响因子：
5.4
通讯作者：
Strakowski, SM
中科院分区：
文献类型：
--
作者：
Adler, CM;DelBello, MP;Strakowski, SM
目的：双相情感障碍越来越被认为是儿童和青少年精神疾病的重要来源。年轻双相患者的症状与成人不同，并且经常出现共病性疾病，特别是注意缺陷多动障碍（ADHD）。然而，这两种疾病之间的神经生理学关系尚不清楚。在这项研究中，我们利用功能性磁共振成像（fMRI）来比较有和没有多动症的双相青少年在执行简单注意力任务时的激活模式。方法：共招募11名双相青少年伴发ADHD和15名无伴发ADHD的双相青少年。结果：两组表现在正确率（p = 0.36）和可辨别性（p = 0.11）方面无显著差异。ADHD合并症与腹外侧前额叶皮层（Brodmann 10）和前扣带激活较少，后顶叶皮层和中颞回激活较多有关。共病性ADHD与表现和逐体素激活之间的相关模式存在实质性差异。参加功能磁共振成像扫描。在块设计范式中，与控制任务交替进行的个位数连续性能任务。采用逐体素分析进行组间比较。随访时对表现和激活进行了相关性分析。结果：各组表现在正确率（p = 0.36）和可辨别性（p = 0.11）方面无显著差异。ADHD合并症与腹外侧前额叶皮层（Brodmann 10）和前扣带激活较少，后顶叶皮层和中颞回激活较多有关。共病性ADHD与表现和逐体素激活之间的相关模式存在实质性差异。结论：我们的研究结果表明，双相情感障碍青少年的共病性ADHD与在执行简单注意力任务时激活替代通路有关。差异模式表明，与未患ADHD的双相青少年相比，合并ADHD的双相青少年前额叶区域的激活减少，并优先招募部分后顶叶和颞叶皮层。
Objective: Bipolar disorder is increasingly recognized as a significant source of psychiatric morbidity in children and adolescents. Younger bipolar patients symptomatically differ from adults, and frequently present with comorbid disorders, particularly attention-deficit hyperactivity disorder (ADHD). The neurophysiological relationship between these two disorders, however, remains unclear. In this study we utilized functional magnetic resonance imaging (fMRI) to compare activation patterns during performance of a simple attention task between bipolar adolescents with and without ADHD.Methods: Eleven bipolar adolescents with comorbid ADHD and 15 bipolar adolescents without comorbidity were recruited tResults: Group performance did not significantly differ in percentage correct (p = 0.36) or discriminability (p = 0.11). ADHD comorbidity was associated with less activation in the ventrolateral prefrontal cortex (Brodmann 10) and anterior cingulate, and greater activation in posterior parietal cortex and middle temporal gyrus. Comorbid ADHD was associated with substantial differences in patterns of correlation between performance and voxel- by- voxel activation.o participate in fMRI scans. A single-digit continuous performance task alternated with a control task in a block-design paradigm. between-group comparisons were made using voxel-by-voxel analysis. Follow-up correlations were made between performance and activation.Results: Group performance did not significantly differ in percentage correct (p = 0.36) or discriminability (p = 0.11). ADHD comorbidity was associated with less activation in the ventrolateral prefrontal cortex (Brodmann 10) and anterior cingulate, and greater activation in posterior parietal cortex and middle temporal gyrus. Comorbid ADHD was associated with substantial differences in patterns of correlation between performance and voxel-by-voxel activation.Conclusions: Our findings suggest that comorbid ADHD in bipolar adolescents is associated with activation of alternative pathways during performance of a simple attention task. The pattern of differences suggests that bipolar adolescents with comorbid ADHD demonstrate decreased activation of prefrontal regions, compared with bipolar adolescents without ADHD, and preferentially recruit portions of posterior parietal and temporal cortex.