The Cerebral Blood Flow Abnormalities in Children with Attention Deficit /Hyperactivity Disorder: Controlled Study Using SPECT ROI Method / 신경정신의학

ABSTRACT

OBJECTIVE: This study was conducted to test the hypothesis that children with Attention Deficit Hyperactivity Disorder(ADHD) might have distinctive findings from normal controls in brain Single Photon Emission Computed Tomography(SPECT) and to figure out the possible pathophysiology of this disorder. METHOD: By DSM-IV criteria, we selected 21 pure ADHD through various assessment scales, psychometric tools and neuropsychological battery. All the patients were studied by 99m Tc-HMPAO Brain SPECT. Three transaxial brain slices delineating anatomically defined region of interest at approximately 2, 4, 6cm above the orbitomeatal line were used with the average number of counts for each region of interest normalized to the area of cerebral maximal uptake. Eleven normal controls were recruited from age, sex, IQ- matched children whose previous SPECT findings had been normal. RESULT: Comparing ADHD group and control, we found highly significantly decreased cererbral blood flow in both frontal lobes, caudate nuclei and thalamus in ADHD group. Addtionally, ADHD group showed reduction of blood flow in some parietal and temporal lobe areas compared with normal group, but the statistical significance in parietal and temporal areas was vanished after Bonferrroni correction due to multiple comparison. CONCLUSION: These findings implied that the rCBF reduction in ADHD in frontal lobe, caudate and thalamic areas might be related with the pathophysiogy of ADHD.