Hippocampus and amygdala morphology in attention-deficit/hyperactivity disorder

被引:245
作者
Plessen, Kerstin J.
Bansal, Ravi
Zhu, Hongtu
Whiteman, Ronald
Amat, Jose
Quackenbush, Georgette A.
Martin, Laura
Durkin, Kathleen
Blair, Clancy
Royal, Jason
Hugdahl, Kenneth
Peterson, Bradley S.
机构
[1] Columbia Univ, Coll Phys & Surg, New York, NY 10032 USA
[2] New York State Psychiat Inst & Hosp, New York, NY 10032 USA
[3] Univ Bergen, Ctr Child & Adolescent Mental Hlth, Bergen, Norway
[4] Univ Bergen, Dept Biol & Med Psychol, Bergen, Norway
[5] Haukeland Hosp, N-5021 Bergen, Norway
[6] Penn State Univ, State Coll, University Pk, PA USA
关键词
D O I
10.1001/archpsyc.63.7.795
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Context: Limbic structures are implicated in the genesis of attention-deficit/hyperactivity disorder (ADHD) by the presence of mood and cognitive disturbances in affected individuals and by elevated rates of mood disorders in family members of probands with ADHD. Objective: To study the morphology of the hippocampus and amygdala in children with ADHD. Design: A cross-sectional case-control study of the hippocampus and amygdala using anatomical magnetic resonance imaging. Settings: University research institute. Patients: One hundred fourteen individuals aged 6 to 18 years, 51 with combined-type ADHD and 63 healthy controls. Main Outcome Measures: Volumes and measures of surface morphology for the hippocampus and amygdala. Results: The hippocampus was larger bilaterally in the ADHD group than in the control group (t=3.35; P=.002). Detailed surface analyses of the hippocampus further localized these differences to an enlarged head of the hippocampus in the ADHD group. Although conventional measures did not detect significant differences in amygdalar volumes, surface analyses indicated the presence of reduced size bilaterally over the area of the basolateral complex. Correlations with prefrontal measures suggested abnormal connectivity between the amygdala and prefrontal cortex in the ADHD group. Enlarged subregions of the hippocampus tended to accompany fewer symptoms. Conclusions: The enlarged hippocampus in children and adolescents with ADHD may represent a compensatory response to the presence of disturbances in the perception of time, temporal processing (eg, delay aversion), and stimulus seeking associated with ADHD. Disrupted connections between the amygdala and orbitofrontal cortex may contribute to behavioral disinhibition. Our findings suggest involvement of the limbic system in the pathophysiology of ADHD.
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收藏
页码:795 / 807
页数:13
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