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Genetics of childhood disorders: XVII. ADHD, part 1: The executive functions and ADHD

JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY 2000年第8期39卷 1064-1068页

作者： Barkley, RA Univ Massachusetts Sch Med Dept Psychiat Worcester MA 01655 USA Univ Massachusetts Sch Med Dept Neurol Worcester MA 01655 USA

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that affects individuals, their families and society. Barkley reviews the concept of executive functioning and the role the frontal cortex ha... 详细信息

关键词：注意力缺陷障碍伴多动/遗传学注意力缺陷障碍伴多动/病理生理学注意力缺陷障碍伴多动/心理学儿童发育认知记忆模型理论额叶前皮质/病理生理学儿童人类

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Physiological dysfunction of the dorsolateral prefrontal cortex in schizophrenia revisited

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CEREBRAL CORTEX 2000年第11期10卷 1078-1092页

作者： Callicott, JH Bertolino, A Mattay, VS Langheim, FJP Duyn, J Coppola, R Goldberg, TE Weinberger, DR NIMH Clin Brain Disorders Branch IRP NIH Bethesda MD 20892 USA NIH Lab Diagnost Radiol Res CC Bethesda MD 20892 USA

Evidence implicates subtle neuronal pathology of the prefrontal cortex (PFC) in schizophrenia, but how this pathology is reflected in physiological neuroimaging experiments remains controversial. We investigated PFC function in schizophrenia using functional magnetic resonance imaging (fMRI) and a parametric version of the n-back working memory (WM) task. In a group of patients who performed relatively well on this task, there were three fundamental deviations from the 'healthy' pattern of PFC fMRI activation to varying WM difficulty. The first characteristic was a greater magnitude of PFC fMRI activation in the context of slightly impaired WM performance (i.e. physiological inefficiency). The second was that the significant correlations between behavioral WM performance and dorsal PFC fMRI activation were in opposite directions in the two groups. Third, the magnitude of the abnormal dorsal PFC fMRI response was predicted by an assay of N-acetylaspartate concentrations (NAA) in dorsal PFC, a measure of neuronal pathology obtained using proton magnetic resonance spectroscopy. Patients had significantly lower dorsal PFC NAA than controls and dorsal PFC NAA inversely predicted the fMRI response in dorsal PFC (areas 9, 46) to varying WM difficulty - supporting the assumption that abnormal PFC responses arose from abnormal PFC neurons. These data suggest that under certain conditions the physiological ramifications of dorsal PFC neuronal pathology in schizophrenia includes exaggerated and inefficient cortical activity, especially of dorsal PFC.

关键词：方差分析天冬氨酸/类似物和衍生物天冬氨酸/代谢磁共振成像记忆/生理学额叶前皮质/病理学额叶前皮质/病理生理学精神分裂症/病理学精神分裂症/病理生理学青少年成年人女(雌)性人类男(雄)性

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Orbital and medial prefrontal cortex and psychostimulant abuse: Studies in animal models

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CEREBRAL CORTEX 2000年第3期10卷 326-333页

作者： Porrino, LJ Lyons, D Wake Forest Univ Sch Med Dept Physiol & Pharmacol Ctr Neurobiol Invest Abused Drugs Winston Salem NC 27157 USA

One approach to pursuing questions about the neural substrates that support substance abuse-related behaviors involves the use of animal models. Carefully controlled animal experiments can be conducted without the confounds commonly found in studies of human addicts, such as polydrug abuse, variable drug history and premorbid psychiatric conditions. The present paper considers the orbitofrontal and related limbic prefrontal cortex in the context of such models of substance abuse. first, the importance of recognizing the heterogeneous structural and functional nature of orbitofrontal cortex in both rodents and primates is addressed, and the results of studies involving the prefrontal cortex in substance abuse-related behaviors are considered in light of this diversity. Second, data from metabolic mapping studies are described that indicate that the pattern of functional activity within medial and orbitofrontal cortex shifts as the duration of exposure to drugs such as cocaine is extended. These functional differences, in turn, may reflect progressive phases of the addictive process. In order to understand the neurobiological consequences of long-term drug use, it will be important to establish the differing roles played by distinct anatomical territories within orbital and medial prefrontal cortex during the course of chronic substance abuse.

关键词：中枢神经系统刺激剂/药理学疾病模型动物额叶前皮质/药物作用额叶前皮质/病理生理学物质相关性障碍/病理生理学动物人类

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Emotional bias and inhibitory control processes in mania and depression

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PSYCHOLOGICAL MEDICINE 1999年第6期29卷 1307-1321页

作者： Murphy, FC Sahakian, BJ Rubinsztein, JS Michael, A Rogers, RD Robbins, TW Paykel, ES Univ Cambridge Dept Psychiat Cambridge CB2 1TN England Univ Cambridge Dept Expt Psychol Cambridge CB2 1TN England

Background. Despite markedly different clinical presentations, few studies have reported differences in neuropsychological functioning between mania and depression. The disinhibited behaviour characteristic of mania and evidence that subgenual prefrontal cortex is differentially activated in mania and depression both suggest that dissociable deficits will emerge on tasks that require inhibitory control and are subserved by ventromedial prefrontal cortex. Methods. Manic patients and controls undertook computerized neuropsychological tests of memory and planning ability. In addition, manic and depressed patients were directly compared with controls on a novel affective shifting task that requires inhibitory control over different components of cognitive and emotional processing. Results. Manic patients were impaired on tests of memory and planning. Importantly, affective shifting performance of manic patients differed from that of depressed patients. Manic patients were impaired in their ability to inhibit behavioural responses and focus attention, but depressed patients were impaired in their ability to shift the focus of attention. Depressed patients exhibited an affective bias for negative stimuli, and we believe this to be the first demonstration of an affective bias for positive stimuli in manic patients. Conclusions. Observed impairments on tests of memory and planning suggest a global pathology for mania consistent with previous profiles for this disorder and similar to established profiles for depression. The results on the affective shifting task demonstrate the presence of mood-congruent bias and dissociable components of inhibitory control in mania and depression. Against a background of memory and planning impairments in the two groups, these findings are consistent with a role for the ventromedial prefrontal cortex in mediating mood-cognition relationships.

关键词：注意力/生理学双相情感障碍/诊断双相情感障碍/病理生理学双相情感障碍/心理学情绪/生理学回忆/生理学神经抑制/生理学神经心理学测验额叶前皮质/病理生理学问题解决/生理学成年人女(雌)性人类男(雄)性

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Functional anatomy of verbal fluency in people with schizophrenia and those at genetic risk - Focal dysfunction and distributed disconnectivity reappraised

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BRITISH JOURNAL OF PSYCHIATRY 2000年第1期176卷 52-60页

作者： Spence, SA Liddle, PF Stefan, MD Hellewell, JSE Sharma, T Friston, KJ Hirsch, SR Frith, CD Murray, RM Deakin, JFW Grasby, PM Hammersmith Hosp Div Neurosci Imperial CollCyclotron Unit Sch MedMed Res Council London England Univ British Columbia Dept Psychiat Vancouver BC V5Z 1M9 Canada Inst Psychiat Dept Psychol Med London SE5 8AF England Univ Manchester Dept Psychiat & Behav Sci Manchester M13 9PL Lancs England Neurol Inst Wellcome Dept Cognit Neurol London England Charing Cross Hosp Imperial Coll Sch Med London England

Background PET studies of verbal fluency in schizophrenia report a failure of 'deactivation' of left superior temporal gyrus (STG) in the presence of activation of left dorsolateral prefrontal cortex (DLPFC), which deficit has been attributed to underlying 'functional disconnectivity'. Aim To test whether these findings provide trait-markers for schizophrenia. Method We used (H2O)-O-15 PET to examine verbal fluency in 10 obligate carriers of the predisposition to schizophrenia, 10 stable patients and 10 normal controls. Results We found no evidence of a failure of left STG deactivation in carriers or patients. Instead, patients failed to deactivate the precuneus relative to other groups. We found no differences in functional connectivity between left DLPFC and left STG but patients exhibited significant disconnectivity between left DLPFC and anterior cingulate cortex. Conclusions Failure of left STG 'deactivation' and left fronto-temporal disconnectivity are not consistent findings in schizophrenia;neither are they trait-markers for genetic risk. Prefrontal functional disconnectivity here may characterise the schizophrenic phenotype. Declaration of interest No conflict of interest. Financial support detailed in Acknowledgements.

关键词：杂合子额叶前皮质/病理生理学额叶前皮质/放射性核素显像精神分裂症/遗传学精神分裂症/病理生理学精神分裂症/放射性核素显像言语障碍/遗传学言语障碍/病理生理学言语障碍/放射性核素显像颞叶/病理生理学颞叶/放射性核素显像体层摄影术发射型计算机/方法人类男(雄)性

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The missing link: a failure of fronto-hippocampal integration in schizophrenia

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NATURE NEUROSCIENCE 1998年第4期1卷 266-267页

作者： Fletcher, P Inst Neurol Dept Cognit Neurol London WC1N 3BG England

Schizophrenics perform poorly on memory tasks, A new study suggests that this may be due to abnormal interactions between the hippocampus and prefrontal cortex.

关键词：额叶/病理生理学海马/病理生理学记忆/生理学额叶前皮质/病理生理学精神分裂症/病理生理学精神分裂症心理学人类

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Anterior cingulate and prefrontal cortex: who's in control?

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NATURE NEUROSCIENCE 2000年第5期3卷 421-423页

作者： Cohen, JD Botvinick, M Carter, CS Princeton Univ Dept Psychol Princeton NJ 08544 USA Univ Pittsburgh Dept Psychiat Pittsburgh PA 15213 USA Carnegie Mellon Univ Dept Psychol Pittsburgh PA 15213 USA

A sophisticated study of error-related brain potentials in patients with prefrontal lesions addresses how we monitor performance and adjust cognitive control based on task demands.

关键词：行为/生理学脑损害慢性/病理生理学脑图认知/生理学诱发电位/生理学扣带回/生理学扣带回/病理生理学模型神经学额叶前皮质/损伤额叶前皮质/生理学额叶前皮质/病理生理学精神运动性行为/生理学人类

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Agency and the self model

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CONSCIOUSNESS AND COGNITION 1999年第3期8卷 387-389页

作者： Gallese, V Univ Parma Ist Fisiol Umana I-43100 Parma Italy

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Negative symptoms in schizophrenia: Neurobiological models and treatment response

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HARVARD REVIEW OF PSYCHIATRY 1998年第2期6卷 59-77页

作者： Goff, DC Evins, AE Harvard Univ Sch Med Consolidated Dept Psychiat Boston MA USA Massachusetts Gen Hosp Psychot Disorders Program Boston MA 02114 USA

Evidence from lesioning studies and neuroimaging has linked negative symptoms to dysfunction of the prefrontal cortex, the limbic system, and the basal ganglia. Although such symptoms have been most strongly associated with dopaminergic hypoactivity in the prefrontal cortex, other neurotransmitters including norepinephrine, serotonin, and the excitatory amino acids may also play a role. In some patients moderate doses of conventional neuroleptics clearly improve negative symptoms;the response of such symptoms is relatively greater with clozapine and probably with certain serotonin-dopamine antagonists. Recent studies demonstrating improvement of negative symptoms when conventional neuroleptics are augmented with selective serotonin-reuptake inhibitors or with agents active at the glycine-modulatory site of the glutamatergic N-methyl-D-aspartate receptor complex suggest that further amelioration of primary negative symptoms may be possible through pharmacological strategies involving multiple neurotransmitter systems.

关键词：抗震颤麻痹药/治疗应用抗精神病药/治疗应用基底神经节/病理生理学剂量效应关系药物兴奋性氨基酸激动剂/治疗应用边缘系统/病理生理学神经递质药/代谢额叶前皮质/病理生理学精神分裂症/药物疗法精神分裂症/代谢精神分裂症/病理生理学人类

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Neuropsychological correlates of violence and aggression: An extension to suicidal behavior

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PERCEPTUAL AND MOTOR SKILLS 1999年第2期89卷 389-392页

作者： Lester, D Stockton State Coll Psychol Program Pomona NJ 08240 USA

This paper presents evidence that neuropsychological syndromes which characterize some externally violent people may also explain some suicidal behavior, particularly in adolescents and those who repeat their suicidal... 详细信息

关键词：青春期心理学攻击/生理学攻击/心理学谵妄痴呆遗忘认知障碍/病理生理学癫痫颞叶/病理生理学神经心理学测验额叶前皮质/病理生理学复发性别因素自杀/心理学自杀/统计学和数值数据暴力/心理学青少年女(雌)性人类男(雄)性

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