Reduced activation and inter-regional functional connectivity of fronto-striatal networks in adults with childhood Attention-Deficit Hyperactivity Disorder (ADHD) and persisting symptoms during tasks of motor inhibition and cognitive switching
Reduced activation and inter-regional functional connectivity of fronto-striatal networks in adults with childhood Attention-Deficit Hyperactivity Disorder (ADHD) and persisting symptoms during tasks of motor inhibition and cognitive switching
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DOI：
10.1016/j.jpsychires.2009.11.016
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发表时间：
2010-07-01
影响因子：
4.8
通讯作者：
Rubia, Katya
中科院分区：
文献类型：
--
作者：
Cubillo, Ana;Halari, Rozmin;Rubia, Katya
儿童注意缺陷多动障碍（ADHD）与抑制控制任务期间的额纹状体功能异常有关。然而，在患有ADHD的成年人中，几乎没有任何功能性磁共振成像（fMRI）研究调查了运动反应抑制的最受损认知功能的神经功能相关性，也没有研究调查了认知灵活性。在这项研究中，我们使用fMRI比较了11名患有持续性注意力不集中/多动行为的未接受药物治疗的成年人之间的脑功能和任务相关的区域间功能连接，从儿童时期被诊断患有ADHD时开始随访，以及14名年龄匹配的健康对照组在停止和认知转换任务中。在患者中进行全脑回归MR分析，以将症状与脑激活相关联。尽管类似的任务性能，成年儿童多动症显示减少激活相比，控制在双侧下前额叶皮层，尾状核和丘脑在这两个任务，以及在左顶叶在开关任务。在患者中，行为症状的严重程度与额纹状体、顶叶和小脑脑区类似区域的更广泛激活呈负相关。在停止任务中，患者显示右下额-额，额-纹状体和额-顶神经网络之间的区域间功能连接减少。研究结果表明，患有儿童ADHD和持续行为症状的成年人在相同的抑制控制任务中表现出与儿童ADHD中观察到的额纹状体和顶叶功能障碍惊人相似的模式。这表明多动症患者的神经功能异常可能会在童年和成年早期持续存在。(C)2009爱思唯尔有限公司保留所有权利。
Attention-Deficit Hyperactivity Disorder (ADHD) in children has been associated with fronto-striatal functional abnormalities during tasks of inhibitory control. In adults with ADHD, however, hardly any functional magnetic resonance imaging (fMRI) studies have investigated the neurofunctional correlates of the most compromised cognitive functions of motor response inhibition and no study has investigated cognitive flexibility. In this study we used fMRI to compare brain function and task-relevant inter-regional functional connectivity between 11 medication-naive adults with persistent inattentive/hyperactive behaviours, followed up from childhood when they had been diagnosed with ADHD, and 14 age-matched healthy controls during a Stop and a cognitive Switch tasks. Whole-brain regression MR analyses were conducted within patients to correlate symptoms with brain activation. Despite comparable task performance, adults with childhood ADHD showed reduced activation compared to controls in bilateral inferior prefrontal cortex, caudate and thalamus during both tasks, as well as in left parietal lobe during the Switch task. Within patients, the severity of the behavioural symptoms was negatively correlated with more extensive activation of similar regions in fronto-striatal, parietal and cerebellar brain areas. In the Stop task, patients showed reduced inter-regional functional connectivity between right inferior fron-to-frontal, fronto-striatal and fron-to-parietal neural networks. The findings demonstrate that adults with childhood ADHD and persisting behavioural symptoms show strikingly similar patterns of fronto-striatal and parietal dysfunction to those observed in childhood ADHD during the same tasks of inhibitory control. This suggests that neuro-functional abnormalities in ADHD patients are likely to continue between childhood and early adulthood. (C) 2009 Elsevier Ltd. All rights reserved.