Atypical Prefrontal Connectivity in Attention-Deficit/Hyperactivity Disorder: Pathway to Disease or Pathological End Point?
Atypical Prefrontal Connectivity in Attention-Deficit/Hyperactivity Disorder: Pathway to Disease or Pathological End Point?
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DOI：
10.1016/j.biopsych.2011.03.022
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发表时间：
2011-06-15
影响因子：
10.6
通讯作者：
Casey, B. J.
中科院分区：
文献类型：
--
作者：
Liston, Conor;Cohen, Matthew Malter;Casey, B. J.
功能性神经影像学研究发现，注意力缺陷多动障碍（ADHD）患者的额纹状体和中皮质边缘网络存在多个功能障碍节点。然而，相对较少的研究探讨了这些网络中节点之间的结构和功能连接如何与ADHD的行为症状相关。此外，尚不清楚连接异常是否是症状的主要原因或继发于常见的病因机制。我们回顾了最新的弥散张量成像和功能磁共振成像研究的连接在ADHD额纹状体连接异常和注意力不集中和冲动的行为症状之间的关联的特点。此外，我们研究结构和功能的连接措施与ADHD的环境和遗传途径。弥散张量成像研究表明，ADHD与白色物质微结构的显著不规则性相关，特别是在额纹状体和选择皮质皮质束。静息状态功能磁共振成像研究表明，在内省、无任务过程中活跃的默认模式结构网络内的连接性发生了改变，该网络与额纹状体注意力系统之间的相互作用中断。额纹状体和mesocorticolimbic网络内的功能连接的缺陷可能会引起，部分，ADHD症状。相反，结构连接缺陷和ADHD症状可能是偶然出现的一个共同的病因机制，涉及改变调制的突触增强和修剪多巴胺和其他因素在发展过程中。总的来说，这些研究表明，ADHD的核心症状可能来自发育中大脑皮质可塑性的调节失调，导致皮质皮质连接模式的改变，这种改变可能持续到成年期。
Functional neuroimaging studies have identified multiple nodes of dysfunction in frontostriatal and mesocorticolimbic networks in attention-deficit/hyperactivity disorder (ADHD). Yet relatively few studies have examined how structural and functional connectivity between nodes in these networks might relate to the behavioral symptoms of ADHD. Moreover, it is unknown whether abnormalities in connectivity are a primary cause of symptoms or arise secondary to common etiologic mechanisms. We review the most recent diffusion tensor imaging and functional magnetic resonance imaging studies of connectivity in ADHD to characterize associations between frontostriatal connectivity abnormalities and the behavioral symptoms of inattention and impulsivity in ADHD. Furthermore, we examine how structural and functional connectivity measures relate to environmental and genetic pathways to ADHD. Diffusion tensor imaging studies indicate that ADHD is associated with significant irregularities in white matter microstructure, especially in frontostriatal and select corticocortical tracts. Resting state functional magnetic resonance imaging studies implicate altered connectivity within a default mode network of structures active during introspective, task-free processes and disrupted interactions between this network and frontostriatal attentional systems. Deficits in functional connectivity within frontostriatal and mesocorticolimbic networks might give rise, in part, to ADHD symptoms. Conversely, structural connectivity deficits and ADHD symptoms might arise incidentally from a common etiologic mechanism, involving altered modulation of synaptic potentiation and pruning by dopamine and other factors during development. Collectively, these studies suggest that the core symptoms of ADHD might derive from dysregulated modulation of cortical plasticity in the developing brain, resulting in altered patterns of corticocortical connectivity that might persist into adulthood.