Funktionelle Bildgebung kognitiver Prozesse bei der ADHS des Erwachsenenalters

R. C. Wolf; N. Vasic

doi:10.1055/s-0038-1628714

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2010; 29(01/02): 21-30
DOI: 10.1055/s-0038-1628714

Adhs

Schattauer GmbH

Funktionelle Bildgebung kognitiver Prozesse bei der ADHS des Erwachsenenalters

Functional neuroimaging of cognition in adults with ADHD

R. C. Wolf

¹Klinik für Psychiatrie und Psychotherapie III, Universität Ulm

,

N. Vasic

¹Klinik für Psychiatrie und Psychotherapie III, Universität Ulm

› Institutsangaben

Abstract

Zusammenfassung

Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) des Erwachsenenalters ist klinisch durch kognitive Defizite, impulsives Verhalten und motorische Überaktivität sowie daraus resultierende Einbußen des psychosozialen Leistungsniveaus charakterisiert. Über eine Störung der Aufmerksamkeit hinaus umfasst das kognitive Defizitmuster multiple Bereiche einschließlich des Gedächtnisses und der exekutiven Leistung. In dieser Übersicht sollen verfügbare funktionell bildgebende Untersuchungen kognitiver Prozesse bei der ADHS des Erwachsenenalters dargestellt und diskutiert werden. Ungeachtet der klinisch und methodisch heterogenen Datenlage weisen nuklearmedizinische und funktionelle magnetresonanztomografische Untersuchungen auf eine Störung lateral und medial präfrontaler, striataler und zerebellärer Areale hin, im Einklang mit strukturellen Veränderungen dieser Regionen, deren Responsivität auf Methylphenidat und der funktionellen Relevanz lateral und medial präfrontaler, striataler und zerebellärer Netzwerke. Der zunehmende Einsatz funktionell bildgebender Methoden bei der ADHS des Erwachsenenalters leistet sowohl einen wichtigen Beitrag bei der objektiven Beschreibung pathogenetisch bedeutsamer neuronaler Korrelate der Störung als auch bei der Charakterisierung kognitiver und neurofunktioneller Endophänotypen.

Summary

Attention-deficit/hyperactivity disorder (ADHD) is characterized by cognitive deficits, impulsive behavior, hyperactivity and resulting psychosocial impairment. Beyond attentional deficits, cognitive dysfunction has been described to encompass multiple domains including memory and executive skills. This review provides an overview and a discussion of functional neuroimaging studies investigating cognitive function in adult ADHD. Despite clinical and methodological heterogeneity, currently available functional neuroimaging data suggest a dysfunction of lateral and medial prefrontal, striatal and cerebellar regions. These findings are in accordance with structural abnormalities found in these areas, with frontostriatal responsivity to methylphenidate administration and with the functional relevance of frontostriatal networks. The increasing availability of functional imaging techniques and their application to ADHD has led to hypothesis-driven approaches regarding the neurobiological substrates of this disorder, and may contribute to the characterization of cognitive and neurofunctional endophenotypes.

Schlüsselwörter

ADHS - funktionelle Magnetresonanztomografie - Inhibition - Arbeitsgedächtnis - frontaler Kortex - funktionelle Konnektivität

Keywords

ADHD - functional magnetic resonance imaging - inhibition - working memory - frontal cortex - functional connectivity

Volltext

Referenzen

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