Fronto-striatal underactivation during interference inhibition and attention allocation in grown up children with attention deficit/hyperactivity disorder and persistent symptoms
Fronto-striatal underactivation during interference inhibition and attention allocation in grown up children with attention deficit/hyperactivity disorder and persistent symptoms
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DOI：
10.1016/j.pscychresns.2010.12.014
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发表时间：
2011-07-30
影响因子：
2.3
通讯作者：
Rubia, Katya
中科院分区：
文献类型：
--
作者：
Cubillo, Ana;Halari, Rozmin;Rubia, Katya
未接受药物治疗的儿童的注意力缺陷多动障碍（ADHD）与抑制控制和注意力分配过程中下/内侧前额叶、纹状体和顶颞叶皮质的激活减少有关。然而，成人 ADHD 的功能磁共振成像 (fMRI) 研究并不一致，并且因用药史和儿童 ADHD 回顾性诊断的需要而令人困惑。我们使用功能磁共振成像（fMRI）与西蒙任务（测量干扰抑制、控制和共同测量注意力分配）相结合，比较了 11 名从未接受过药物治疗且持续注意力不集中/多动行为的成年人（从儿童 ADHD 开始随访）和 15 名年龄匹配的对照者的大脑功能。尽管任务表现相当，但与对照组相比，患者在干扰抑制期间左眼眶/内侧额叶皮层和纹状体以及注意力分配期间左外侧下/背外侧前额叶皮层的激活程度有所降低。患者的全脑回归分析显示，症状严重程度与额纹状体、颞顶叶和小脑的大脑激活呈负相关。研究结果表明，在 ADHD 儿童的干扰抑制和注意力分配过程中观察到的典型额纹状体功能障碍，在从童年 ADHD 长大后症状持续的成年人中也观察到。此外，他们还表明，鉴于该样本未经药物治疗，成人多动症的功能缺陷与长期兴奋剂药物无关。 (C) 2011 Elsevier Ireland Ltd. 保留所有权利。
Attention deficit hyperactivity disorder (ADHD) in medication-naive children has been associated with reduced activation in inferior/medial prefrontal, striatal and parieto-temporal cortices during inhibitory control and attention allocation. Functional magnetic resonance imaging (fMRI) studies in adult ADHD, however, have been inconsistent and confounded by medication-history and the need for a retrospective diagnosis of childhood ADHD. We used fMRI combined with a Simon task that measured interference inhibition and controlled for and co-measured attention allocation to compare brain function in 11 medication-naive adults with persistent inattentive/hyperactive behaviours, followed up from childhood ADHD, and 15 age-matched controls. Despite comparable task performance, patients showed reduced activation compared to controls in left orbital/medial frontal cortex and striatum during interference inhibition and in left lateral inferior/dorsolateral prefrontal cortex during attention allocation. Whole-brain regression analyses within patients showed a negative correlation between symptom severity and fronto-striatal, temporo-parietal and cerebellar brain activation. The findings demonstrate that the typical fronto-striatal dysfunction observed in children with ADHD during interference inhibition and attention allocation is also observed in adults grown up from childhood ADHD with persistent symptoms. Furthermore, they show that functional deficits in adult ADHD are not related to chronic stimulant medication given that this sample was medication-naive. (C) 2011 Elsevier Ireland Ltd. All rights reserved.