注意缺陷多动障碍共患阅读障碍:认知-脑-基因的多维度研究进展  

The Multidimensional Research Progress in Attention-deficit/Hyperactivity Disorder Comorbid With Dyslexia:From Gene,Brain to Behavior

作　　者：王久菊[1,2] 孙黎 舒华[3] 刘璐[1,2] 王玉凤[1,2] WANG Jiu-Ju;SUN Li;SHU Hua;LIU Lu;WANG Yu-Feng(Peking University Sixth Hospital/Institute of Mental Health,Beijing 100191,China;NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100191,China;State Key Laboratory of Cognitive Neuroscience and Learning&IDG/McGovern Institute for Brain Research,Beijing Normal University,Beijing 100875,China)

机构地区：[1]北京大学第六医院/精神卫生研究所,北京100191 [2]国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100191 [3]北京师范大学认知神经科学与学习国家重点实验室,北京100875

出　　处：《生物化学与生物物理进展》2020年第11期1135-1144,共10页Progress In Biochemistry and Biophysics

基　　金：国家重点研发计划(2016YFC1306103);国家自然科学基金(81873802,31900752);国家重点基础研究发展计划(2014CB846104)资助项目。

摘　　要：注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)和发展性阅读障碍(developmental dyslexia,DD)是两种常见的神经发育性障碍,二者共患的比率高达25%~48%.本文拟从认知-脑-基因等多个维度对ADHD共患DD的研究进展进行综述.ADHD和DD共患的共同认知损害可能是加工速度缺陷,其作为内表型能够很好地帮助解释遗传因素如何通过影响认知功能进而导致出现ADHD共患DD的临床表型.而国内对ADHD共患DD的研究较少,已有的多项研究仅关注ADHD伴学习障碍,但缺乏标准的DD临床诊断标准.本文指出了统一诊断标准、结合多学科研究以及未来个体化训练的必要性.Attention-deficit/hyperactivity disorder(ADHD)and Developmental dyslexia(DD)are two common neurodevelopmental disorders,the comorbidity rate of them is as high as 25%~48%.In this paper,we reviewed and summarized the research progresses of ADHD comorbid with DD from multiple dimensions including cognitive psychology,neurophysiology(brain imaging)and molecular genetics.Three main theoretical models have been yielded for the neuropathological mechanisms of ADHD comorbid with DD,including phenocopy hypothesis,cognitive subtype hypotheses and common etiology hypothesis;whereas most of the evidence from the existing literature supported the common etiological hypothesis.Results in cognitive psychology indicated that the shared cognitive impairment in ADHD and DD might be the deficit of processing speed,which should be closely related to the comorbid status.The key imaging features related to ADHD comorbid with DD might include the structural and functional alteration in frontal lobes(especially the dorsal lateral prefrontal cortex),caudate nucleus and anterior cingulate gyrus,and hemispheric asymmetry.For genetics,linkage studies suggested the potential association of the chromosome region of 6 p21-22 with both ADHD and DD.In this region,two key genes,DCDC2 and KIAA0319,have attracted much attention and were studied as important candidate genes for ADHD and DD.Several other candidate genes would be also worthy of exploration to illustrate the common and shared genetic background of these two disorders,such as ADRA2A,DYX1C1,DRD4.It is worth noting that the shared genetic factors of DD and ADHD may mainly affect the inattentive symptom and reading ability simultaneously,rather than hyperactive/impulsive symptoms.To further illustrate the neuropathologic mechanisms of ADHD comorbid with DD clearly and comprehensively,further multidimensional studies are needed to elucidate how the genetic susceptibility factors influence the brain structure and function,affect the cognition functions(e.g.processing speed)subsequently and

关 键 词：注意缺陷多动障碍 发展性阅读障碍 加工速度缺陷 

分 类 号：R749.94[医药卫生—神经病学与精神病学]