Research about the limbic system volume in the Oppositional Defiant Disorder comorbid with Attention Deficit Hyperactivity

本研究采用基于体素的形态测量法（VBM）研究了对立违抗性障碍（ODD）合并注意缺陷多动障碍（ADHD）患者的脑容量异常。[对象]对2002年4月至2005年3月在信州大学医院就诊的15岁以下患者中符合DSM-IV中ADHD或ODD标准的患者进行评估。受试者人数为12人（男11人，女1人）。建立分组：(1)ADHD组，由单独诊断为ADHD的患者组成（n=6）；(2)共病组，由ADHD合并ODD的患者组成（n=6）；(3)正常对照组（NC, n=14）。所有受试者和NC均为右撇子。父母的社会经济状况和围产期并发症在被试和NC之间无显著差异。<方法>采用1.5T扫描仪（Simons）获得MRI数据。利用SPM99软件在MATLAB 6.1环境下进行图像分析。采用ANCOVA方法进行统计分析，使全脑容量为协方差。同时，所有被试母亲和NC进行ADHD评定量表、odd量表、对立违抗行为量表和Eyberg儿童行为量表的填写。<Results>(a)组间比较；(1) ADHD组右侧梭状回、眶额叶皮质、尾状核体积较NC组明显减小。(2)与NC相比，共病组右侧梭状回、眶额皮质、蚓部、颞上沟体积明显减少。(3) ADHD组与共病组各区域的体积均无显著差异。(b)相关性分析；(1)所有被试的右侧后扣带体积均随着ADHD评定量表得分的增加而显著减小。(2)右颞上沟体积随odd量表评分的增加而增加。[结论]合并症组右侧梭状回、眶额叶皮层和颞上沟体积减小，推测与社会认知有关。提示社会认知障碍严重影响了ODD合并ADHD的过程。少

<Introduction>We investigated the abnormality of brain volume on the oppositional defiant disorder (ODD) comorbid with the attention deficit hyperactivity disorder (ADHD) by the voxel-based morphometry (VBM). <Objects>Of the 【less than or equal】15 years old patients who visited the Shinshu University Hospital, between April 2002 and March 2005, those who fulfilled the criteria for ADHD or ODD according to DSM-IV were evaluated. The number of subjects was 12 (11 boys and 1 girl). Groupings were established : (1)the ADHD group, comprised patients with a diagnosis of ADHD alone (n=6), (2)the comorbid group, comprised of those with ADHD and ODD (n=6), and (3)the normal control (NC ; n=14). All the subjects and NC were right-handed. The socio-economic states of parents and the perinatal period complications didn't show significant differences between the subjects and NC. <Method>The MRI data were obtained by using 1.5T scanner (Simons). Image analysis was performed by using SPM99 software r … More unning in MATLAB 6.1. The statistical analysis was performed by the ANCOVA method that made the whole brain volume to be a covariance. Simultaneously, the mothers of all subjects and NC carried out filling up to the ADHD rating scale, ODD-scale, Oppositional defiant behavior inventory, and Eyberg child behavior inventory. <Results>(a)Group comparison ; (1)The ADHD group showed the significant volume decrease of the right fusiform gyrus, orbit frontal cortex, and caudate compared with NC. (2)The comorbid group showed the significant volume decrease of the right fusiform gyrus, orbit frontal cortex, vermis, superior temporal sulcus compared with NC. (3)There were no significant differences between volumes of any regions in the ADHD group and those in the comorbid group. (b)Correlation analysis ; (1)The volume of the right posterior cingulate significantly decreased, as the ADHD rating scale score increased in all the subjects. (2)The volume of the right superior temporal sulcus so did, as the ODD-scale score increased in all the subjects. <Conclusion>The right fusiform gyrus, orbit frontal cortex, and superior temporal sulcus, which showed volume decreases in the comorbid group, guessed to be concerned in the social recognition. It was suggested that the disturbance of social recognition seriously influenced processes that ODD comorbided with ADHD. Less