약물치료력이 없는 주의력결핍 과잉행동장애 소아청소년에서 후두-측두 연결성：확산 텐서 영상 예비 연구
Occipito-Temporal Connectivity in Medication-Naïve ADHD Children：Preliminary Diffusion Tensor Imaging Study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
본 연구에서는 ADHD에서의 후두-측두엽 신경회로의 병태생리 및 임상적 의의를 알아보고자, 약물에 노출된 과거력이 없는 ADHD 소아청소년군과 정상 대조군에서 DTI 및 다양한 신경인지검사, 임상척도평가를 시행하였다. 이에 대한 예비적인 연구 결과로, ADHD군은 정상군에 비해 시각적 연수수행검사, 시각적 작업기억검사에서 유의한 저하를 보였으며, ILF와 IOFF를 공통적으로 포함하는 후두-측두엽 신경회로인 ROI에서 FA값의 유의한 저하를 보였다. 그러나 ADHD군에서 ROI에서의 FA값과 임상척도평가 및 신경인지검사 결과와의 유의한 상관관계는 보이지 않았다. 향후 보다 많은 수를 대상으로 한 후속 연구를 통하여 보다 나은 정보를 얻을 수 있을 것이라 기대한다.
Abstract
Objectives: Occipito-temporal connectivity was explored using diffuse tensor imaging (DTI) and its correlation to behavioral symptoms and neurocognitive functions in medication-naı¨ve attentiondeficit/hyperactivity disorder (ADHD) children and adolescents. Methods: Eleven medication-naı¨ve children and adolescents with ADHD (mean age 11.5±.3) and 9 age- and gender-matched healthy volunteers (mean age 11.4±2.5) were measured for mean fractional anisotropy (FA) values with DTI and clinical assessments. The FA values for the region of interest (ROI) which contained both inferior longitudinal fasciculus (ILF) and inferior occipito-frontal fasciculus (IOFF), were compared in ADHD and gender- and age-matched healthy control groups and the relationship between clinical and neurocognitive variables was explored. Results: The ADHD group exhibited significantly higher scores on the Korean ADHD Rating Scale (p<0.001), the Korean Conners Parent Rating Scale (p<0.001), the computerized Continuous Performance Test, and the Visual (omission error, commission error, mean time, and variability)(p<0.01), and significantly decreased scores on the Finger Window Test (p<0.01). Mean FA values from the left-side ROI were significantly lower in the ADHD group compared with healthy controls after controlling for age (p<0.05). In the ADHD group, FA values from the left-side of the ROI did not show significant correlation with clinical rating or neurocognitive tests. Conclusion: Our results suggest that one of the core pathophysiology hallmarks in child ADHD may be abnormal anatomical connectivity in the occipito-frontal and/or occipito-temporal pathway, both of which are related to visual information processing. To confirm such an anatomical deficit and its association with clinical or neurocognitive symptoms in ADHD, further studies using larger sample sizes are needed.
참고문헌 (36)
- Shallice T, "Executive function profile of children with attention deficit hyperactivity disorder", Dev Neuropsychol, 21, pp.43~71 (2002)
- Lijffijt M, "A meta-analytic review of stopping performance in attention-deficit", hyperactivity disorder: deficient inhibitory motor control?, 2005, pp.114, 216~222
- Lewis SJ, "Striatal contributions to working memory: a functional magnetic resonance imaging study in humans", Eur J Neurosci, 19, pp.755~760 (2004)
- Casey BJ, "Frontostriatal connectivity and its role in cognitive control in parent-child dyads with ADHD", Am J Psychiatry, 164, pp.1729~1736 (2007)
- Ashtari M, "Attention-deficit", hyperactivity disorder: a preliminary diffusion tensor imaging study, 2005, pp.57, 448~455
- McAlonan GM, "Mapping brain structure in attention deficit-hyperactivity disorder: a voxel-based MRI study of regional grey and white matter volume", Psychiatry Res, 154, pp.171~180 (2007)
- Vance A, "Right parietal dysfunction in children with attention deficit hyperactivity disorder, combined type: a functional MRI study", Mol Psychiatry, 12, pp.826~832 (2007)
- Valera EM, "Functional neuroanatomy of working memory in adults with attention-deficit", hyperactivity disorder, 2005, pp.57, 439~447
- 최지욱, "주의력결핍 과잉행동장애 아동에서 틱 장애 동반 여부에 따른 확산 텐서 영상 비교 연구", 신경정신의학, 47(5), pp.493~502 (2008), 대한신경정신의학회
- Hanna-Pladdy B, "Dysexecutive syndromes in neurologic disease", J Neurol Phys Ther, 31, pp.119~127 (2007)
- Buckner RL, "Memory and executive function in aging and AD: multiple factors that cause decline and reserve factors that compensate", Neuron, 44, pp.195~208 (2004)
- Mahurin RK, "Executive-frontal lobe cognitive dysfunction in schizophrenia: a symptom subtype analysis", Psychiatry Res, 79, pp.139~149 (1998)
- Nichols SL, "A review of the validity of laboratory cognitive tasks used to assess symptoms of ADHD", Child Psychiatry Hum Dev, 34, pp.297~315 (2004)
- Gathercole SE, "Practitioner review: short-term and working memory impairments in neurodevelopmental disorders: diagnosis and remedial support", J Child Psychol Psychiatry, 47, pp.4~15 (2006)
- Ranganath C, "Working memory for visual objects: complementary roles of inferior temporal, medial temporal, and prefrontal cortex", Neuroscience, 139, pp.227~289 (2006)
- Catani M, "Occipito-temporal connections in the human brain", Brain, 126, pp.2093~2107 (2003)
- Taylor WD, "Diffusion tensor imaging: background, potential, and utility in psychiatric research", Biol Psychiatry, 55, pp.201~207 (2004)
- Leo D, "Altered midbrain dopaminergic neurotransmission during development in an animal model of ADHD", Neurosci Biobehav Rev, 27, pp.661~669 (2003)
- Sekine Y, "Association of dopamine transporter loss in the orbitofrontal and dorsolateral prefrontal cortices with methamphetamine-related psychiatric symptoms", Am J Psychiatry, 160, pp.1699~1701 (2003)
- 김영신, "The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version (K-SADS-PL-K)", Yonsei Medical Journal, 45(1), pp.81~89 (2004), 연세대학교의과대학
- 신민섭, "한국판 IOWA 코너스 평정 척도의 개발", 신경정신의학, 44(1), pp.82~88 (2005), 대한신경정신의학회
- 소유경, "한국어판 부모, 교사 ADHD 평가 척도의 신뢰도와 타당도 연구", 신경정신의학, 41(2), pp.283~289 (2002), 대한신경정신의학회
- 박경숙, "KEDI-WISC검사요강" (1987), 한국교육개발원
- Shin MS, "A study of the development and standardization of ADHD diagnostic system", Korean J Child and Adol Psychiatr, 11, pp.91~99 (2000)
- Benton AL, "Multilingual Aphasia Examination" (1983), AJA Assopciates
- Pineda DA, "The role of neuropsychologic tests in the diagnosis of attention deficit hyperactivity disorder", Pediatr Neurol, 36, pp.373~381 (2007)
- Frazier TW, "Meta-analysis of intellectual and neuropsychological test performance in attention-deficit", hyperactivity disorder, 2004, pp.18, 543~555
- Trangkasombat U, "Clinical characteristics of ADHD in Thai children", J Med Assoc Thai, 91, pp.1894~1898 (2008)
- Hastings RP, "Symptoms of ADHD and their correlates in children with intellectual disabilities", Res Dev Disabil, 26, pp.456~468 (2005)
- Pavuluri MN, "Diffusion tensor imaging study of white matter fiber tracts in pediatric bipolar disorder and attention-deficit", hyperactivity disorder, 2009, pp.65, 586~593
- Silk TJ, "Whitematter abnormalities in attention deficit hyperactivity disorder: a diffusion tensor imaging study", Hum Brain Mapp, 30, pp.2757~2765 (2009)
- Powell HW, "Noninvasive in vivo demonstration of the connections of the human parahippocampal gyrus", Neuroimage, 22, pp.740~747 (2004)
- Danziger S, "Contributions of the human pulvinar to linking vision and action", Cogn Affect Behav Neurosci, 4, pp.89~99 (2004)
- Bauer RM, "Visual memory and perceptual impairments in prosopagnosia", J Clin Neuroophthalmol, 4, pp.39~46 (1984)
- Gerlach C, "Brain activity related to integrative processes in visual object recognition: bottom-up integration and the modulatory influence of stored knowledge", Neuropsychologia, 40, pp.1254~1267 (2002)
- Dennis M, "Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders", J Int Neuropsychol Soc, 15, pp.331~343 (2009)