Rethinking a right hemisphere deficit in ADHD.

Rethinking a right hemisphere deficit in ADHD.
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DOI:
10.1177/1087054708323005
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发表时间:
2009-07
影响因子:
3
通讯作者:
Smalley SL
Smalley SL
中科院分区:
医学2区
文献类型:
--
作者:
Hale TS;Loo SK;Zaidel E;Hanada G;Macion J;Smalley SL

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病变研究的早期观察表明 ADHD 存在右半球 (RH) 功能障碍。然而,严格的右翼赤字并没有得到很好的支持。另一种观点认为,大脑功能的 R>L 不对称性增加以及半球间相互作用异常。如果属实,ADHD 中的 RH 病理学应该反映半球间网络化和过度激活的功能。我们评估了这些断言。测量了偏侧脑功能的四个要素:LH 专门化、RH 专门化、LH 与半球间处理(LH/IH)和 RH 与半球间处理(RH/IH)。接下来,我们在 79 名 ADHD 儿童中测试了它们与认知能力、精神合并症和兄弟姐妹相关性的关联。 RH/IH 处理与其他结果测量具有独特的相关性。单独的 RH 或 LH 功能不存在关联。半球间网络化的 RH 处理对于 ADHD 至关重要。此外,LH 专门处理和认知能力(尤其是言语认知任务)之间缺乏关联,支持增加 RH 对任务处理的调节。
Early observations from lesion studies suggested right hemisphere (RH) dysfunction in ADHD. However, a strictly right-lateralized deficit has not been well supported. An alternatively view suggests increased R>L asymmetry of brain function and abnormal interhemispehric interaction. If true, RH pathology in ADHD should reflect interhemispherically networked and over-activated functioning. We evaluated these assertions. Four elements of lateralized brain function were measured: LH specialized, RH specialized, LH with interhemispheric processing (LH/IH), and RH with interhemispheric processing (RH/IH). Next, we tested their association with cognitive ability, psychiatric comorbidity, and sibling correlations in 79 children with ADHD. RH/IH processing was uniquely associated with other outcome measures. There were no associations for independent RH or LH function alone. Interhemispherically networked RH processing is critical in ADHD. Additionally, lack of association between LH specialized processing and cognitive ability (especially for verbal cognitive tasks) supports increased RH mediation of task processing.
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