Emotional dysregulation and stimulant medication in adult ADHD.

IF 4.1 2区 医学 Q2 NEUROSCIENCES
Journal of Psychiatry & Neuroscience Pub Date : 2024-08-09 Print Date: 2024-07-01 DOI:10.1503/jpn.240009
Myrto Sklivanioti Greenfield, Yanlu Wang, J Paul Hamilton, Per Thunberg, Mussie Msghina
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Abstract

Background: Emotional dysregulation affects up to two-thirds of adult patients with attention-deficit/hyperactivity disorder (ADHD) and is increasingly seen as a core ADHD symptom that is clinically associated with greater functional impairment and psychiatric comorbidity. We sought to investigate emotional dysregulation in ADHD and explored its neural underpinnings.

Methods: We studied emotion induction and regulation in a clinical cohort of adult patients with ADHD before and after a stimulant challenge. We compared patients with age- and gender-matched healthy controls using behavioural, structural, and functional measures. We hypothesized that patients would demonstrate aberrant emotion processing compared with healthy controls, and sought to find whether this could be normalized by stimulant medication.

Results: Behaviourally, the ADHD group showed reduced emotion induction and regulation capacity. Brain imaging revealed abberant activation and deactivation patterns during emotion regulation, lower grey-matter volume in limbic and paralimbic areas, and greater grey-matter volume in visual and cerebellar areas, compared with healthy controls. The behavioural and functional deficits seen in emotion induction and regulation in the ADHD group were not normalized by stimulant medication.

Conclusion: Patients with ADHD may have impaired emotion induction and emotion regulation capacity, but these deficits are not reversed by stimulant medication. These results have important clinical implications when assessing which aspects of emotional dysregulation are relevant for patients and if and how traditional ADHD pharmacotherapy affects emotion induction and emotion regulation.

成人多动症患者的情绪失调和兴奋剂药物治疗。
背景:多达三分之二的成年注意力缺陷/多动障碍(ADHD)患者会受到情绪失调的影响,而且情绪失调日益被视为ADHD的核心症状,在临床上与更大的功能障碍和精神疾病合并症相关。我们试图研究ADHD的情绪失调,并探索其神经基础:我们研究了一组临床成年多动症患者在兴奋剂挑战前后的情绪诱导和调节。我们使用行为、结构和功能测量方法将患者与年龄和性别匹配的健康对照组进行了比较。我们假设,与健康对照组相比,患者会表现出异常的情绪处理能力,并试图找出是否可以通过兴奋剂药物治疗使其恢复正常:结果:从行为上看,多动症组患者的情绪诱导和调节能力均有所下降。与健康对照组相比,大脑成像显示情绪调节过程中的激活和失活模式失常,边缘区和旁边缘区的灰质体积较小,而视觉区和小脑区的灰质体积较大。ADHD组在情绪诱导和调节方面的行为和功能缺陷并没有因为服用兴奋剂而恢复正常:结论:多动症患者的情绪诱导和情绪调节能力可能受损,但这些缺陷不会因兴奋剂药物治疗而逆转。这些结果对于评估情绪失调的哪些方面与患者有关,以及传统的多动症药物治疗是否会影响情绪诱导和情绪调节以及如何影响情绪诱导和情绪调节具有重要的临床意义。
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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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