Executive attention control and emotional responding in attention-deficit/hyperactivity disorder--A functional MRI study.
Executive attention control and emotional responding in attention-deficit/hyperactivity disorder--A functional MRI study.
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DOI：
10.1016/j.nicl.2015.10.005
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Blair RJ
中科院分区：
文献类型：
--
作者：
Hwang S;White SF;Nolan ZT;Craig Williams W;Sinclair S;Blair RJ
注意力缺陷多动障碍（ADHD）患者存在执行性注意控制和情绪调节障碍。本研究探讨了ADHD患者的情绪调节作为执行注意力募集的一个功能。35名健康儿童/青少年（平均年龄= 13.91）和26名ADHD儿童/青少年（平均年龄= 14.53）参加了这项fMRI研究。他们完成了情感Stroop范式，在不同的认知负荷下观看积极，中性和消极的图像。对BOLD响应数据进行3因素ANOVA（按条件按情绪诊断）。在此之后，将2个3向ANOVA（按条件按情绪诊断）应用于从背内侧额叶皮层和杏仁核种子产生的情境依赖性心理生理相互作用（gPPI）分析（分别从条件和情绪的BOLD响应ANOVA主效应识别）。一个诊断条件的相互作用，在背内侧额叶皮质的招聘减少，作为一个功能的任务需求增加的ADHD儿童/青少年相对于健康的儿童/青少年。在ADHD儿童/青少年中，背内侧额叶皮质招募的减少水平与Conner父母报告量表测量的症状严重程度（总的和多动）显着相关。此外，对来自背内侧额叶皮层种子的gPPI数据的分析揭示了外侧额叶皮层内显著的诊断-条件相互作用;在相对于视图试验的一致和不一致任务试验期间，ADHD患者的背内侧额叶皮层和外侧额叶皮层之间的连接性相对于对照青年降低。在BOLD反应方差分析中，杏仁核内没有组的相互作用或组的主要效应（尽管ADHD儿童/青少年在任务试验期间对颞叶皮层区域内的积极图像的反应增加;通过诊断条件与情绪的相互作用确定）。然而，对杏仁核种子的gPPI数据的分析显示，在ADHD儿童/青少年中，在存在情绪刺激的情况下，杏仁核和豆状核之间的连接性降低（通过情绪相互作用诊断）。目前的研究表明，在ADHD儿童/青少年中，与执行功能有关的区域的招募中断，这些区域内的连接受损。也有迹象表明，ADHD患者的情绪刺激表现增强。然而，由于研究结果是针对积极刺激的，因此ADHD情绪调节普遍失败的建议不受支持。ADHD表现为背内侧额叶皮层活动减少，认知需求增加。背内侧额叶皮质活动减少与ADHD症状严重程度相关。ADHD患者的背内侧额叶皮层-外侧额叶皮层的连通性受损。ADHD表现为对积极情绪刺激的情绪反应区活动增加。
There are suggestions that patients with attention-deficit/hyperactivity disorder (ADHD) show impairment in executive attention control and emotion regulation. This study investigated emotion regulation as a function of the recruitment of executive attention in patients with ADHD. Thirty-five healthy children/adolescents (mean age = 13.91) and twenty-six children/adolescents with ADHD (mean age = 14.53) participated in this fMRI study. They completed the affective Stroop paradigm viewing positive, neutral and negative images under varying cognitive loads. A 3-way ANOVA (diagnosis-by-condition-by-emotion) was conducted on the BOLD response data. Following this, 2 3-way ANOVAs (diagnosis-by-condition-by-emotion) were applied to context-dependent psychophysiological interaction (gPPI) analyses generated from a dorsomedial frontal cortex and an amygdala seed (identified from the BOLD response ANOVA main effects of condition and emotion respectively). A diagnosis-by-condition interaction within dorsomedial frontal cortex revealed reduced recruitment of dorsomedial frontal cortex as a function of increased task demands in the children/adolescents with ADHD relative to healthy children/adolescents. The level of reduction in recruitment of dorsomedial frontal cortex was significantly correlated with symptom severity (total and hyperactivity) measured by Conner's Parent Report Scale in the children/adolescents with ADHD. In addition, analysis of gPPI data from a dorsomedial frontal cortex seed revealed significant diagnosis-by-condition interactions within lateral frontal cortex; connectivity between dorsomedial frontal cortex and lateral frontal cortex was reduced in the patients with ADHD relative to comparison youth during congruent and incongruent task trials relative to view trials. There were no interactions of group, or main effect of group, within the amygdala in the BOLD response ANOVA (though children/adolescents with ADHD showed increased responses to positive images within temporal cortical regions during task trials; identified by the diagnosis-by-condition-by-emotion interaction). However, analysis of gPPI data from an amygdala seed revealed decreased connectivity between amygdala and lentiform nucleus in the presence of emotional stimuli in children/adolescents with ADHD (diagnosis-by-emotion interaction). The current study demonstrated disrupted recruitment of regions implicated in executive function and impaired connectivity within those regions in children/adolescents with ADHD. There were also indications of heightened representation of emotional stimuli in patients with ADHD. However, as the findings were specific for positive stimuli, the suggestion of a general failure in emotion regulation in ADHD was not supported. ADHD showed decreased dorsomedial frontal cortex activity with increased cognitive demand. Decreased dorsomedial frontal cortex activity was correlated with symptom severity of ADHD. Connectivity of dorsomedial frontal cortex–lateral frontal cortex was compromised in ADHD. ADHD showed increased activities in emotional responding areas to positive emotional stimuli.