Brain Imaging of the Cortex in ADHD: A Coordinated Analysis of Large-Scale Clinical and Population-Based Samples
Brain Imaging of the Cortex in ADHD: A Coordinated Analysis of Large-Scale Clinical and Population-Based Samples
复制标题
DOI：
10.1176/appi.ajp.2019.18091033
复制
发表时间：
2019-07-01
影响因子：
17.7
通讯作者：
Franke, Barbara
中科院分区：
文献类型：
--
作者：
Hoogman, Martine;Muetzel, Ryan;Franke, Barbara
目的：神经影像学研究显示，注意力缺陷多动障碍（ADHD）儿童和成人的不同脑区结构改变，尽管非复制是常见的。作者试图通过大规模研究来确定与ADHD相关的皮质特征。方法：在ENIGMA-ADHD（一个由36个中心组成的联盟）中，对ADHD病例组（N = 2，246）和对照组（N = 1，934）的儿童、青少年和成人的皮质厚度和表面积（基于Desikan-Killiany图谱）进行比较。为了评估家族对皮质测量的影响，比较了NeuroIMAGE研究中的病例受试者、未受影响的兄弟姐妹和对照受试者（N = 506）。儿童行为检查表的注意力量表与皮质测量的关联在儿科人群样本（R代，N = 2，707）中确定。结果：在ENIGMA-ADHD样本中，ADHD儿童的表面积值较低，主要在额叶，扣带回和颞叶区域;最大的显着影响是总表面积（Cohen的d = -0.21）。梭状回和颞极皮质厚度在ADHD儿童中也较低。青少年组和成人组的表面积和厚度均无差异。在几个区域的表面积中观察到家族效应。在一组重叠的区域，表面积，但不是厚度，与注意力问题的Generation-R sample.Conclusions：皮质表面积的细微差异是广泛的儿童，但不是青少年和成人多动症，确认参与额叶皮层和突出区域值得进一步关注。值得注意的是，这些改变表现得像家庭中的内在表型，并与人群中的ADHD症状有关，从而扩大了ADHD在人群中表现为连续性状的证据。未来的纵向研究应该澄清个人的寿命轨迹，导致无意义的结果，在青少年和成人群体，尽管存在ADHD的诊断。
Objective: Neuroimaging studies show structural alterations of various brain regions in children and adults with attention deficit hyperactivity disorder (ADHD), although nonreplications are frequent. The authors sought to identify cortical characteristics related to ADHD using large-scale studies.Methods: Cortical thickness and surface area (based on the Desikan-Killiany atlas) were compared between case subjects with ADHD (N = 2,246) and control subjects (N = 1,934) for children, adolescents, and adults separately in ENIGMA-ADHD, a consortium of 36 centers. To assess familial effects on cortical measures, case subjects, unaffected siblings, and control subjects in the NeuroIMAGE study (N = 506) were compared. Associations of the attention scale from the Child Behavior Checklist with cortical measures were determined in a pediatric population sample (Generation-R, N = 2,707).Results: In the ENIGMA-ADHD sample, lower surface area values were found in children with ADHD, mainly in frontal, cingulate, and temporal regions; the largest significant effect was for total surface area (Cohen's d = -0.21). Fusiform gyrus and temporal pole cortical thickness was also lower in children with ADHD. Neither surface area nor thickness differences were found in the adolescent or adult groups. Familial effects were seen for surface area in several regions. In an overlapping set of regions, surface area, but not thickness, was associated with attention problems in the Generation-R sample.Conclusions: Subtle differences in cortical surface area are widespread in children but not adolescents and adults with ADHD, confirming involvement of the frontal cortex and highlighting regions deserving further attention. Notably, the alterations behave like endophenotypes in families and are linked to ADHD symptoms in the population, extending evidence that ADHD behaves as a continuous trait in the population. Future longitudinal studies should clarify individual lifespan trajectories that lead to nonsignificant findings in adolescent and adult groups despite the presence of an ADHD diagnosis.