Attention Deficit Hyperactivity Disorder and N-methyl-D-aspartate (NMDA) Dysregulation
Attention Deficit Hyperactivity Disorder and N-methyl-D-aspartate (NMDA) Dysregulation
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DOI：
10.2174/1381612819666140110115227
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发表时间：
2014-01-01
影响因子：
3.1
通讯作者：
Tsai, Guochuan E.
中科院分区：
文献类型：
--
作者：
Chang, Jane Pei-Chen;Lane, Hsien-Yuan;Tsai, Guochuan E.
注意力缺陷多动障碍（ADHD）是一种常见的儿童期疾病。ADHD青少年在学校和同伴关系中往往遇到更多的困难，而ADHD成年人则有更多的职业和人际关系困难。然而，使用中枢神经系统（CNS）兴奋剂治疗，10- 20%的患者仍然对治疗反应差。在ADHD的假说中，N-甲基-D-天冬氨酸（NMDA）型谷氨酸受体功能障碍最近已通过积累遗传和动物研究提出。本文从神经发育、注意回路和冲动抑制等方面系统综述了支持NMDA功能障碍是ADHD潜在发病机制的证据。该综述还涉及通过调节NMDA/甘氨酸位点来治疗ADHD的新方法的发展。这些所谓的NMDA增强剂可能为ADHD患者提供新的治疗选择。
Attention deficit hyperactivity disorder (ADHD) is a long recognized and common childhood disorder. ADHD adolescents tend to encounter more difficulties in school and peer relationships, whereas ADHD adults have more occupational and interpersonal difficulties. However, with the treatment of central nervous system (CNS) stimulants, 10-20 % of the patients still remain poor responders to treatment. Among hypotheses for ADHD, dysfunction of N-methyl-D-aspartate (NMDA)-type glutamate receptors has recently been suggested by accumulating genetic and animal studies. This article systemically reviews evidence supporting NMDA dysfunction as a potential ADHD pathogenesis from perspectives of neurodevelopment, attentional circuitry, and impulse inhibition. The review also addresses the development of novel treatments for ADHD via modulation of glutamatergic system, particularly the NMDA/glycine site. These so-called NMDA enhancers may provide a new treatment option for patients with ADHD.