Effects of cognitive-behavioral therapy on regional homogeneity changes in adults with attention-deficit/hyperactivity disorder / 中国心理卫生杂志

ABSTRACT

Objective:To determine the effects of cognitive-behavioral therapy (CBT) on resting-state brain functional changes in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Participants including 10 adults with ADHD aged 18-65 years,diagnosed with the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 12 age-and gender-matched healthy controls.The ADHD symptoms and executives functions were assessed using the ADHD Rating Scale (ADHD-RS) and Behavior Rating Inventory of Executive Function (BRIEF) respectively and resting-state functional magnetic resonance imaging were acquired before and after 12-session,CBT for ADHD patients.The healthy controls were also scanned.We used the regional homogeneity (ReHo) to capture the changes of regional brain function between pre-and post-CBT in ADHD for measuring the effects of CBT.Results:After CBT,the total scores of ADHD-RS [(43 ± 7) vs.(31 ± 7),P ＜ 0.01],the subscale of inattention and subscale of hyperactivity/impulsivity were decreased in ADHD adults.As for the executive functions,the subs cales of monitor [(15 ± 2) vs.(11 ± 2),P ＜ 0.01] and organization [(19 ± 5) vs.(14 ± 4),P ＜ 0.01] in BRIEF were reduced significantly in adults with ADHD after CBT training.The ReHo was increased in the regions involved in default mode network and fronto-parietal network,i.e.,right parahippocampa gyrus,fight precentral gyms,fight postcentral gyms and left postcentral gyrus (Voxels with P ＜ 0.05 and cluster size ＞3051mm3,which resulted in a corrected threshold of P ＜ 0.01 determined by AlphaSim).Conclusion:These findings support that CBT could selectively modulate the regional brain function in the default mode network and fronto-parietal network which may contribute to the improvement of ADHD symptoms and executive functions.