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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.
CONCLUSIONS: This study included only male adults with ADHD. Further research needs to investigate potential sex- and development-related differences.
CONCLUSIONS: These results support the role of the cerebellar networks, especially of the MCP, in adult ADHD pathophysiology and should encourage further investigation.
BACKGROUND: NCT03709940.
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.
CONCLUSIONS: This study included only male adults with ADHD. Further research needs to investigate potential sex- and development-related differences.
CONCLUSIONS: These results support the role of the cerebellar networks, especially of the MCP, in adult ADHD pathophysiology and should encourage further investigation.
BACKGROUND: NCT03709940.
摘要：
背景：注意缺陷/多动障碍（ADHD）是一种神经发育疾病，通常持续到成年期。已经确定了大脑连通性的潜在改变，但也有一些相关的联系，比如中间，上级,和下小脑柄（MCP，SCP,ICP,分别)，大部分仍未开发；因此，我们试图调查小脑柄是否与成人ADHD的病理生理学有关.
方法：我们应用扩散加权球形反卷积纤维束成像技术解剖了患有ADHD的成年男性（包括对哌醋甲酯有反应或没有反应的男性，基于2个月时至少30%的症状改善)和对照。我们使用敏感性分析调查了对照和整个ADHD样本之间以及对照和治疗反应组之间的道指标差异。最后,我们分析了道指标与临床神经心理状况之间的关联.
结果：我们包括60名患有ADHD的参与者（包括42名治疗应答者和18名无应答者）和20名对照参与者。在整个多动症样本中，MCP分数各向异性(FA;t78=3.24,p=0.002)和位阻调制取向各向异性(HMOA;t78=3.01,p=0.004)降低,右ICP的径向扩散率（RD）增加（t78=-2.84，p=0.006），与对照组相比。尽管MCPFA和HMOA的病例对照差异，反映白质微结构组织，由两个治疗反应组驱动，在正确的ICPRD中，只有响应者与对照组显着不同，与髓鞘形成有关(t60=3.14，p=0.003)。阻碍调节MCP的取向各向异性与多动措施显着相关。
结论：本研究仅包括患有ADHD的成年男性。进一步的研究需要调查潜在的性别和发展相关的差异。
结论：这些结果支持小脑网络的作用，尤其是MCP,在成人ADHD的病理生理学方面，应鼓励进一步研究。
背景：NCT03709940。
方法：我们应用扩散加权球形反卷积纤维束成像技术解剖了患有ADHD的成年男性（包括对哌醋甲酯有反应或没有反应的男性，基于2个月时至少30%的症状改善)和对照。我们使用敏感性分析调查了对照和整个ADHD样本之间以及对照和治疗反应组之间的道指标差异。最后,我们分析了道指标与临床神经心理状况之间的关联.
结果：我们包括60名患有ADHD的参与者（包括42名治疗应答者和18名无应答者）和20名对照参与者。在整个多动症样本中，MCP分数各向异性(FA;t78=3.24,p=0.002)和位阻调制取向各向异性(HMOA;t78=3.01,p=0.004)降低,右ICP的径向扩散率（RD）增加（t78=-2.84，p=0.006），与对照组相比。尽管MCPFA和HMOA的病例对照差异，反映白质微结构组织，由两个治疗反应组驱动，在正确的ICPRD中，只有响应者与对照组显着不同，与髓鞘形成有关(t60=3.14，p=0.003)。阻碍调节MCP的取向各向异性与多动措施显着相关。
结论：本研究仅包括患有ADHD的成年男性。进一步的研究需要调查潜在的性别和发展相关的差异。
结论：这些结果支持小脑网络的作用，尤其是MCP,在成人ADHD的病理生理学方面，应鼓励进一步研究。
背景：NCT03709940。
