Hyperactivity and impulsivity in adult attention-deficit/hyperactivity disorder is related to glutamatergic dysfunction in the anterior cingulate cortex
Hyperactivity and impulsivity in adult attention-deficit/hyperactivity disorder is related to glutamatergic dysfunction in the anterior cingulate cortex
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DOI：
10.1080/15622975.2016.1262060
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发表时间：
2018-01-01
影响因子：
3.1
通讯作者：
Ohrmann, Patricia
中科院分区：
文献类型：
--
作者：
Bauer, Jochen;Werner, Anne;Ohrmann, Patricia
目的：注意缺陷多动障碍(ADHD)与额纹状体神经网络包括前扣带回皮质(ACC)和背外侧前额叶皮质(DLPFC)中多巴胺能和去甲肾上腺素能神经传递的失调密切相关。此外，越来越多的证据支持谷氨酸能系统参与ADHD的病理生理学。冲动性是ADHD患者的一个核心症状，它与谷氨酸能神经传递有关，药物治疗ADHD可以降低前额叶皮质的谷氨酸水平。方法：用3T单体素质子磁共振波谱研究了30例ADHD患者和30名健康对照的ACC和DLPFC中的谷氨酸水平。结果：ADHD组ACC中的谷氨酸水平显著高于对照组，而DLPFC中的代谢物没有显著差异。总体而言，ACC中的谷氨酸水平与ADHD症状呈正相关，尤其是多动和冲动症状。结论：ACC中谷氨酸水平的升高与ADHD症状的多动和冲动呈正相关，支持这一假说，即功能障碍的谷氨酸能神经传递至少部分地与ADHD症状有关。因此，谷氨酸能神经传递的调节可能是未来药物干预的一条很有前途的途径。
Objectives: Attention-deficit/hyperactivity disorder (ADHD) is closely linked to the dysregulation of dopaminergic and noradrenergic neurotransmission in the fronto-striatal neural network, including the anterior cingulate cortex (ACC) and the dorsolateral prefrontal cortex (DLPFC). Additionally, increasing evidence supports the involvement of the glutamatergic system in the pathophysiology of ADHD. Impulsivity, a core symptom in patients with ADHD, has been repeatedly associated with glutamatergic neurotransmission, and pharmacological treatment of ADHD has been shown to reduce glutamate levels in the prefrontal cortex.Methods: We investigated glutamate levels in the ACC and the DLPFC in 30 adults with ADHD and 30 healthy controls using single-voxel proton magnetic resonance spectroscopy on a 3T scanner.Results: The ADHD group showed a significant increase in glutamate in the ACC compared to controls, no significant differences in metabolites were observed in the DLPFC. Overall, glutamate levels in the ACC were positively correlated with ADHD symptomatology, especially hyperactivity and impulsivity symptoms.Conclusions: Increased levels of glutamate in the ACC, which were positively correlated with hyperactivity and impulsivity, support the hypothesis that dysfunctional glutamatergic neurotransmission is at least partially responsible for ADHD symptomatology. Modulation of glutamatergic neurotransmission might therefore be a promising avenue for future pharmacological interventions.