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

我们采用基于体素的形态计量学(VBM)研究了对立违抗障碍(ODD)合并注意缺陷多动障碍(ADHD)患者的脑体积异常。对象：对2002年4月至2005年3月在新宿大学医院就诊的[小于或等于]15岁患者中，符合DSM-IV ADHD或ODD标准的患者进行评估。研究对象为12人(男11人，女1人)。分组包括：(1)ADHD组，包括单纯ADHD患者(n=6)；(2)共病组，包括ADHD和ODD患者(n=6)；(3)正常对照组(NC；n=14)。所有受试者和NC都是右撇子。父母的社会经济状况和围产期并发症在受试者和对照组之间无显著差异。方法使用Simons公司生产的1.5T扫描仪获取MRI数据。用SPM99软件r…进行图像分析在MatLab 6.1中运行更多功能。以全脑体积为协方差的ANCOVA方法进行统计分析。同时，对所有受试者的母亲和正常对照组进行ADHD评定量表、奇异量表、对立违抗行为问卷、艾伯格儿童行为问卷的填写。结果(A)组间比较：(1)ADHD组右侧梭形回、额叶皮质、尾状回体积较正常对照组明显缩小。(2)与正常对照组比较，共病组右侧梭形回、额叶皮质、蚯蚓、颞上沟的体积明显缩小。(3)注意缺陷多动障碍组各脑区体积与合并症组无显著差异。(2)相关分析：(1)随着ADHD评定量表评分的增加，右侧后扣带回体积显著减小。(2)所有受试者右侧颞上沟体积均增加，奇数评分均增加。结论共病组右侧梭形回、额叶皮质和颞上沟体积缩小，推测与社会认知有关。提示社会再认障碍严重影响了ODD与ADHD的共同作用过程。较少

<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