Neuroanatomy of Adult ADHD: An MRI Morphometric Study

成人多动症的神经解剖学：MRI 形态测量研究

• 批准号: 6711099
• 负责人: LARRY J SEIDMAN
• 金额: $ 42.59万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-03-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6711099
• 关键词: adult human (21+); attention; attention deficit disorder; behavioral /social science research tag; brain imaging /visualization /scanning; brain morphology; cerebellum; child (0-11); clinical research; comorbidity; corpus callosums; developmental neurobiology; family genetics; functional magnetic resonance imaging; gender difference; human subject; learning disorders; lenticular nucleus; longitudinal human study; magnetic resonance imaging; morphometry; neuroanatomy; neuropsychology; nucleus accumbens; prefrontal lobe /cortex; short term memory; thalamus

During the last 10-15 years, it has been gradually recognized that Attention Deficit Hyperactivity Disorder (ADHD) persists into late adolescence and adult life in a substantial number of cases. While there are pockets of information which provide clues to neurobiologic abnormalities in ADHD at different age periods (structural brain abnormalities in boys, small samples demonstrating functional brain abnormalities in adults), there is very little systematic neurobiological information on ADHD throughout life. In particular, there is a paucity of neurobiological research in adults with the syndrome. The identification and integration of neuropsychological, neuroanatomical, and functional brain abnormalities in ADHD is crucial for identifying neurobiological mechanisms and improving treatment. Such information is necessary to help clarify the neurodevelopmental evolution of the disorder, treatment response, and the meaning of the disorder to patients, families and clinicians. In light of evidence of clinical continuity between pediatric and adult ADHD, we expect similarities in brain dysfunction across the life cycle. We hypothesize that a key brain abnormality in ADHD involves frontal-striatal circuitry reflected in neurocognitive deficits in attention and executive functions (especially working memory and inhibition). A primary goal of this study is to identify brain and neuropsychological abnormalities in ADHD across life, focusing on inhibition, working memory and vigilance, and the brain structures responsible for these functions. We propose to use state-of-the- art morphometric and functional measures (Counting Stroop, "Two- back" and CPT) of magnetic resonance images (MRI) to evaluate adults with ADHD and their ADHD children. These tools will allow a comprehensive and highly detailed analysis of the brain circuitry putatively abnormal in ADHD: dorsolateral and orbital prefrontal cortex, caudate and pallidum, nucleus accumbens, thalamus, anterior cingulate, cerebellum, and corpus callosum. Because ADHD is very heterogeneous, with substantial psychiatric and cognitive comorbidity (i.e., learning disabilities), it is crucial to study a large enough sample to gain a comprehensive understanding of the disorder (n=140 ADHD adults, n=120 adult controls; 75 ADHD offspring, 75 control offspring). The proposed study will enable us to evaluate the effects of comorbidity, family history, gender, and genetic factors on brain abnormalities in ADHD. Finally, the feasibility and cost effectiveness of the proposed study is quite high because it builds on a large, systematic, ongoing study (MH 57934) which will provide all clinical data on ADHD, and on ongoing relationships between investigators.

在过去的10 - 15年中，人们已经逐渐认识到，注意力缺陷多动障碍（ADHD）在大量病例中一直持续到青春期和成人生活中。 尽管有许多信息可以为不同年龄时期的ADHD神经生物学异常提供线索（男孩的结构性脑异常，但显示成人功能性脑异常的小样本），但一生中的ADHD几乎没有系统的神经生物学信息。 特别是，在患有综合征的成年人中，神经生物学研究很少。 ADHD中神经心理学，神经解剖学和功能性脑异常的鉴定和整合对于鉴定神经生物学机制和改善治疗至关重要。 此类信息对于有助于阐明该疾病的神经发育演化，治疗反应以及对患者，家庭和临床医生的含义的含义。 鉴于小儿和成人多动症之间临床连续性的证据，我们期望在整个生命周期中脑功能障碍的相似性。 我们假设ADHD中的关键大脑异常涉及注意力和执行功能的神经认知缺陷（尤其是工作记忆和抑制作用）中的额叶纹状体电路。 这项研究的主要目的是确定整个生命中多动症的大脑和神经心理学异常，重点是抑制，工作记忆和警惕以及负责这些功能的大脑结构。 我们建议使用磁共振图像（MRI）（MRI）使用最先进的形态和功能测量（计数stroop，“两回”和CPT），以评估ADHD及其ADHD儿童的成年人。 这些工具将允许对ADHD的脑电路进行全面且高度详细的分析：背外侧和轨道前额叶皮层，尾状和胶囊，伏隔核，丘脑，丘脑，前扣带，小脑和cors虫。由于ADHD非常异构，具有实质性的精神病和认知合并症（即学习障碍），因此至关重要的是，研究足够大的样本以获得对疾病的全面理解（n = 140 ADHD成人，n = 120个成人对照组； 75 ADHD ADHD FORKSPRING，75 ADHD CONTRAL SPRING，75 CONTRAL，75 ADHD CONTRALS）。 拟议的研究将使我们能够评估合并症，家族史，性别和遗传因素对ADHD中脑异常的影响。 最后，拟议的研究的可行性和成本效益很高，因为它基于一项大型，系统的，正在进行的研究（MH 57934），该研究将提供有关ADHD的所有临床数据，以及研究人员之间正在进行的关系。