Structural brain imaging of attention-deficit/hyperactivity disorder

被引:477
作者
Seidman, LJ
Valera, EM
Makris, N
机构
[1] Massachusetts Gen Hosp, Pediat Psychopharmacol Unit, Boston, MA USA
[2] Massachusetts Gen Hosp, Psychiat Neurosci Program, Boston, MA USA
[3] Massachusetts Mental Hlth Ctr, Commonwealth Res Ctr, Neuropsychol Lab, Boston, MA 02115 USA
[4] Massachusetts Mental Hlth Ctr, Lab Psychiat Epidemiol & Genet, Boston, MA 02115 USA
[5] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[6] Harvard Univ, Sch Med, Neurol & Radiol Serv, Boston, MA 02115 USA
[7] Massachusetts Gen Hosp, Ctr Morphometr Anal, Boston, MA 02114 USA
关键词
attention-deficit/hyperactivity disorder; structural brain imaging; MRI;
D O I
10.1016/j.biopsych.2004.11.019
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Many investigators have hypothesized that attention-deficit/hyperactivity disorder (ADHD) involves structural and functional brain abnormalities in frontal-striatal circuitry. Although our review suggests that there is substantial support for this hypothesis, a growing literature demonstrates widespread abnormalities affecting other cortical regions and the cerebellum. Because there is only one report studying adults with ADHD, this summary is based on children. A key limitation of the literature is that most of the studies until recently, have been underpowered, using samples of fewer than 20 subjects per group. Nevertheless, these studies are largely consistent with the most comprehensive and definitive study (Castellanos et al 2002). Moreover, studies differ in the degree to which they address the influence of medications, comorbidities, or gender, and most have not addressed potentially important sources of heterogeneity such as family, history of ADHD, subtype, or perinatal complications. Despite these limitations, a relatively consistent picture has emerged. The most replicated alterations in ADHD in childhood include significantly smaller volumes in the dorsolateral prefrontal cortex, caudate, pallidum, corpus callosum, and cerebellum. These results suggest that the brain is altered in a more widespread manner than has been previously hypothesized. Developmental studies are needed to address the evolution of this brain disorder into adulthood.
引用
收藏
页码:1263 / 1272
页数:10
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