男性成人注意缺陷多动障碍患者静息态脑功能连接特点

Characteristics of resting-state functional connectivity in male adults with attention-deficit/ hyperactivity disorder

目的探讨男性成人注意缺陷多动障碍(ADHD)患者静息态脑网络功能连接特点及与临床症状严重程度的关系。方法选取符合DSM-Ⅳ-TR诊断的男性成人ADHD患者47例(ADHD组),以及性别、年龄和智商匹配的健康对照47名(对照组),使用ADHD症状评定量表评定症状严重程度,采用GE Discovery MR-750 3.0T扫描仪采集MRI静息态数据。采用两独立样本t检验分析ADHD组与对照组静息态全脑功能连接强度的差异。结果ADHD组与对照组相比,右侧颞中回(t=-3.42)、右侧颞下回(t=-3.32)、右侧枕中回(t=-3.11)、右侧枕下回(t=-4.44)的全脑功能连接降低(多重比较校正后均P<0.05),ADHD组右侧枕下回与全脑功能连接强度与症状严重程度(r=-0.403,P<0.05)和注意缺陷得分(r=-0.507,P<0.05)呈负相关关系。结论男性成人ADHD患者在静息态时脑功能连接强度存在异常,枕叶功能异常可能与成人ADHD症状严重程度有关,颞叶和枕叶可能与成人ADHD病理机制存在关联。

Objective To explore the characteristics of resting-state functional connectivity in male adults with attention deficit hyperactivity disorder (ADHD) and the relationship with clinical symptoms.Method Forty-seven male adult ADHD patients diagnosed by DSM-Ⅳ-TR and 47 healthy controls matched with sex, age and IQ were enrolled by clinical interviews. All subjects underwent structural MRI scan and resting-state functional MRI scan. All subjects were rated the ADHD symptom severity with the ADHD symptom rating scale. A two independent-samples t-test was used to analyze the differences of the resting-state functional connectivity strength (FCS) between the male adult ADHD group and the healthy control group.Results Compared with healthy controls, adult ADHD patients had shown the reduced FCS in the right middle temporal gyrus(t=-3.42), inferior temporal gyrus (t=-3.32), right middle occipital gyrus (t=-3.11) and inferior occipital gyrus (t=-4.44,P<0.05 after multiple correction). The FCS of right inferior occipital gyrus in ADHD group had a tendency to negatively correlated with the severity of symptoms (r=-0.403, P<0.05). A trend of negative correlation between the FCS in the right inferior occipital gyrus in ADHD group and the attention deficit score was found (r=-0.507, P<0.05).Conclusion Abnormalities in resting-state brain function connectivity are prominent in male adult ADHD patients. Occipitallobe dysfunction may be more related to the severity of the ADHD symptoms. Temporal lobe and occipital lobe seem to be crucial to the pathogenesis of adult male ADHD.