Cerebellar network alterations in adult attention-deficit/hyperactivity disorder.

IF 4.1 2区 医学 Q2 NEUROSCIENCES
Journal of Psychiatry & Neuroscience Pub Date : 2024-07-03 Print Date: 2024-07-01 DOI:10.1503/jpn.230146
Salla Parkkinen, Joaquim Radua, Derek S Andrews, Declan Murphy, Flavio Dell'Acqua, Valeria Parlatini
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引用次数: 0

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that often persists into adulthood. Underlying alterations in brain connectivity have been identified but some relevant connections, such as the middle, superior, and inferior cerebellar peduncles (MCP, SCP, and ICP, respectively), have remained largely unexplored; thus, we sought to investigate whether the cerebellar peduncles contribute to ADHD pathophysiology among adults.

Methods: We applied diffusion-weighted spherical deconvolution tractography to dissect the cerebellar peduncles of male adults with ADHD (including those who did or did not respond to methylphenidate, based on at least 30% symptom improvement at 2 months) and controls. We investigated differences in tract metrics between controls and the whole ADHD sample and between controls and treatment-response groups using sensitivity analyses. Finally, we analyzed the association between the tract metrics and cliniconeuropsychological profiles.

Results: We included 60 participants with ADHD (including 42 treatment responders and 18 nonresponders) and 20 control participants. In the whole ADHD sample, MCP fractional anisotropy (FA; t 78 = 3.24, p = 0.002) and hindrance modulated orientational anisotropy (HMOA; t 78 = 3.01, p = 0.004) were reduced, and radial diffusivity (RD) in the right ICP was increased (t 78 = -2.84, p = 0.006), compared with controls. Although case-control differences in MCP FA and HMOA, which reflect white-matter microstructural organization, were driven by both treatment response groups, only responders significantly differed from controls in right ICP RD, which relates to myelination (t 60 = 3.14, p = 0.003). Hindrance modulated orientational anisotropy of the MCP was significantly positively associated with hyperactivity measures.

Limitations: This study included only male adults with ADHD. Further research needs to investigate potential sex- and development-related differences.

Conclusion: These results support the role of the cerebellar networks, especially of the MCP, in adult ADHD pathophysiology and should encourage further investigation.

Clinical trial registration: NCT03709940.

成人注意力缺陷/多动症的小脑网络改变
背景介绍注意力缺陷/多动障碍(ADHD)是一种神经发育性疾病,通常会持续到成年。大脑连通性的基本改变已被确定,但一些相关的连通性,如小脑中、上、下 peduncles(分别为 MCP、SCP 和 ICP),在很大程度上仍未被探索;因此,我们试图研究小脑 peduncles 是否有助于成人多动症的病理生理学:我们应用扩散加权球形去卷积 tractography 技术解剖了患有 ADHD 的男性成人患者(包括那些对哌醋甲酯有反应或无反应的患者,以 2 个月时症状改善至少 30% 为依据)和对照组的小脑脚。我们通过敏感性分析研究了对照组与整个多动症样本之间以及对照组与治疗反应组之间在神经束指标方面的差异。最后,我们分析了道指标与临床神经心理学特征之间的关联:我们纳入了 60 名多动症患者(包括 42 名治疗应答者和 18 名非应答者)和 20 名对照组患者。在整个多动症样本中,与对照组相比,MCP分数各向异性(FA;t 78 = 3.24,p = 0.002)和阻碍调制定向各向异性(HMOA;t 78 = 3.01,p = 0.004)降低,右ICP的径向扩散率(RD)增加(t 78 = -2.84,p = 0.006)。虽然反映白质微结构组织的 MCP FA 和 HMOA 的病例对照差异由两个治疗反应组驱动,但只有反应者的右 ICP RD 与对照组有显著差异,这与髓鞘化有关(t 60 = 3.14,p = 0.003)。阻碍调节的MCP方向各向异性与多动测量显著正相关:局限性:本研究仅包括患有多动症的男性成年人。结论:这些结果支持了大脑皮层在多动症中的作用:这些结果支持小脑网络,尤其是MCP在成人ADHD病理生理学中的作用,应鼓励进一步研究:临床试验注册:NCT03709940。
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来源期刊
CiteScore
6.80
自引率
2.30%
发文量
51
审稿时长
2 months
期刊介绍: The Journal of Psychiatry & Neuroscience publishes papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders. This includes studies on patients with psychiatric disorders, healthy humans, and experimental animals as well as studies in vitro. Original research articles, including clinical trials with a mechanistic component, and review papers will be considered.
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