改善了对有和没有产前酒精暴露的注意缺陷多动障碍之间神经发育差异的理解(ADHDPAE和ADHD-PAE,分别)是需要的。在这里,我们评估了ADHD+PAE儿童与家族性ADHD-PAE儿童和典型发育中(TD)儿童的转眼期(皮质折叠).
ADHD+PAE(n=37),ADHD-PAE(n=25),和TD儿童(n=27),8-13岁,在面部形态学上进行了比较,神经行为学,和神经影像学评估。使用一般线性建模在组间比较了局部旋转指数(LGI)图。使用多元偏最小二乘法评估ADHD±PAE儿童的LGI与临床行为参数之间的关系。
在许多地区,ADHD+PAE和ADHD-PAE组显示出显著较低的LGI(相对于TD)。在内侧前额叶重叠,顶叶,和颞枕骨皮质(p<0.001)。然而,在ADHD+PAE组中,左中背外侧前额叶皮质的LGI独特地降低(p<0.001)。偏最小二乘分析确定了一个显著的潜在变量(占交叉块相关性的59.3%,p<0.001),反映了前额叶(包括左中背外侧)下LGI的轮廓之间的显着关系,岛屿,扣带回,temporal,和顶骨皮质和PAE的临床行为特征,包括平坦的philtrum和上朱红色边界,智商较低,行为调节得分较差,和更大的多动/冲动。
患有ADHD+PAE的儿童独特地表现出下中背外侧LGI,广泛的低LGI与更严重的面部畸形和神经行为障碍有关。这些发现增加了对PAE症状的大脑基础的洞察力,基于ADHD+PAE的客观鉴别诊断,可能告知更有针对性的ADHD治疗ADHD-PAE.
An improved understanding of the neurodevelopmental differences between attention deficit hyperactivity disorder with and without prenatal alcohol exposure (ADHD + PAE and ADHD-PAE, respectively) is needed. Herein, we evaluated gyrification (cortical folding) in children with ADHD + PAE compared to that in children with familial ADHD-PAE and typically developing (TD) children.
ADHD + PAE (n = 37), ADHD-PAE (n = 25), and TD children (n = 27), aged 8-13 years, were compared on facial morphological, neurobehavioral, and neuroimaging assessments. Local gyrification index (LGI) maps were compared between groups using general linear modelling. Relationships between LGI and clincobehavioral parameters in children with ADHD ± PAE were evaluated using multivariate partial least squares.
ADHD + PAE and ADHD-PAE groups showed significantly lower LGI (relative to TD) in numerous regions, overlapping in medial prefrontal, parietal, and temporo-occipital cortices (p < 0.001). However, LGI in left mid-dorsolateral prefrontal cortex was uniquely lower in the ADHD + PAE group (p < 0.001). Partial least squares analysis identified one significant latent variable (accounting for 59.3 % of the crossblock correlation, p < 0.001), reflecting a significant relationship between a profile of lower LGI in prefrontal (including left mid-dorsolateral), insular, cingulate, temporal, and parietal cortices and a clinicobehavioral profile of PAE, including a flat philtrum and upper vermillion border, lower IQ, poorer behavioral regulation scores, and greater hyperactivity/impulsivity.
Children with ADHD + PAE uniquely demonstrate lower mid-dorsolateral LGI, with widespread lower LGI related to more severe facial dysmorphia and neurobehavioral impairments. These findings add insight into the brain bases of PAE symptoms, potentially informing more targeted ADHD treatments based on an objective differential diagnosis of ADHD + PAE vs. ADHD-PAE.