Abnormal Affective Responsiveness in Attention-Deficit/Hyperactivity Disorder: Subtype Differences
Abnormal Affective Responsiveness in Attention-Deficit/Hyperactivity Disorder: Subtype Differences
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DOI：
10.1016/j.biopsych.2008.10.038
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发表时间：
2009-04-01
影响因子：
10.6
通讯作者：
Pauli, Paul
中科院分区：
文献类型：
--
作者：
Conzelmann, Annette;Mucha, Ronald F.;Pauli, Paul
背景资料：运动-动机功能障碍可能导致注意力缺陷/多动障碍（ADHD），特别是多动和冲动症状。本研究探讨了情感调制的惊吓反射在一个大样本的ADHD患者。方法：对197例未服药的成人ADHD患者（混合型127例，注意力不集中型50例，多动冲动型20例）和128例健康对照者进行检查。情绪调节惊吓反应以及效价和唤醒率进行了评估，愉快的，中性的，和不愉快的图片stimulation.Results：对照组表现出惊吓反应衰减和增强愉快和不愉快的图片，分别。在ADHD-HI中，惊吓反应不被愉快的刺激减弱，也不被不愉快的刺激增强。在ADHD-C，惊吓反应没有衰减愉快的图片，和ADHD-I响应类似的控制对象，但惊吓反应衰减到较小程度的愉快刺激。ADHD-HI组评定所有的图片更积极，和男性ADHD-HI评定不愉快的刺激，因为少arousing.Conclusions：这是第一项研究，以评估ADHD的影响调制惊吓反应。它证实了这些患者的情绪功能障碍;所有亚型都表现出对愉快刺激的情绪反应或多或少的减弱。多动-冲动型也以对不愉快刺激的迟钝反应为标志，结果表明，对情绪线索或奖励的反应模式可能有助于区分ADHD亚型。迟钝的情绪反应在伴有多动和冲动症状的ADHD患者中尤其明显（ADHD-C，ADHD-HI）。
Background: Emotional-motivational dysfunctions likely contribute to attention-deficit/hyperactivity disorder (ADHD), especially to hyperactive and impulsive symptoms. This study examined the affective modulation of the startle reflex in a large sample of ADHD patients. The aim was to compare subtypes of ADHD.Methods: One hundred ninety-seven unmedicated adult ADHD patients (127 combined type [ADHD-C]; 50 inattentive type (ADHD-I]; 20 hyperactive-impulsive type [ADHD-HI]) and 128 healthy control subjects were examined. The affect-modulated startle response as well as valence and arousal ratings were assessed for pleasant, neutral, and unpleasant picture stimuli.Results: Control subjects exhibited startle response attenuation and potentiation by pleasant and unpleasant pictures, respectively. In ADHD-HI, startle response was not attenuated by pleasant and not potentiated by unpleasant stimuli. In ADHD-C, startle response was not attenuated by pleasant pictures, and ADHD-I responded similar to control subjects but startle response was attenuated to a lesser degree by pleasant stimuli. The ADHD-HI group rated all pictures as more positive, and male ADHD-HI rated unpleasant stimuli as less arousing.Conclusions: This is the first study to assess the affect-modulated startle response in ADHD. It confirms emotional dysfunctions in these patients; all subtypes showed more or less diminished emotional reactions to pleasant stimuli. The hyperactive-impulsive type was also marked by blunted reactions to unpleasant stimuli, Results suggest that response patterns to emotional cues or reward may help to differentiate ADHD subtypes. Blunted emotional reactivity is especially pronounced in ADHD patients with symptoms of hyperactivity and impulsivity (ADHD-C, ADHD-HI).