RESUMO
Next to environmental factors and problems with interpersonal interaction in family represent developmental findings the basic of understanding these disorders (ADHD, conduct disorders, obsessive-compulsive disorders, tic disorders etc.). Knowledges of neurodevelopment disorders represent new possibilities of prevention and treatment.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno da Conduta , Transtorno Obsessivo-Compulsivo , Transtornos de Tique , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Comorbidade , Transtorno da Conduta/fisiopatologia , Humanos , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtornos de Tique/fisiopatologiaRESUMO
OBJECTIVES: ADHD is one of the most significant diagnostic units in child and adolescent psychiatry. The occurrence in children is 5-6% and 50-80% continued to adult age. The presence of individual genes (polymorphism) on particular symptoms and processes in ADHD are not known. It is estimated that ADHD symptoms are up to 80% to genetic. The higher density of resultant DAT 1 protein was observed in ADHD patients in comparison with controls. The question was if DAT 1 10/10 predicted bad prognoses in long term therapy. METHODS: We compared 30 ADHD DAT 1 10/10 adolescents treated for 5-6 years. Patients with 30 control adolescents. They were the same age of probands and controls. All these subjects were examined by child psychiatry scales (Conners, Achenbach ). Biological changes were tested by MRI specific CNS volumometry. RESULTS: We didn't confirm bad prognoses in long term therapy with methylphenidate or atomoxetine in ADHD children DAT 1 10/10 in long term therapy. In MRI specific CNS volumometry were not identify any differences in controls and ADHD probands. Gray matter thickness was significantly higher in prefrontal and occipital areas in patients compared to control in prefrontal and occipital areas with cluster-wise p-value<0.05. By this method were not identify any cerebrum damage in long term therapy by methylphenidate and atomoxetine.
Assuntos
Inibidores da Captação Adrenérgica/uso terapêutico , Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo/diagnóstico por imagem , Estimulantes do Sistema Nervoso Central/uso terapêutico , Proteínas da Membrana Plasmática de Transporte de Dopamina/genética , Metilfenidato/uso terapêutico , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/genética , Encéfalo/patologia , Feminino , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Occipital/diagnóstico por imagem , Lobo Occipital/patologia , Tamanho do Órgão , Polimorfismo Genético , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/patologia , PrognósticoRESUMO
We discussed the cross section studies and the meta-analysis of published data in children and adolescents with ADHD (both drug naive and receiving stimulant medications), in comparison with healthy children and adolescents of the same age. In children and adolescents with ADHD the deceleration of the maturation dynamics of discrete CNS structures is found, volume reduction and decreased grey matter in prefrontal and occipital regions, which is accompanied by reverse asymmetry of the basal ganglia volume (putamen, nucleus caudate). The above mentioned developmental characteristics are valid only for the ADHD children, who have not been treated by stimulant medications. The stimulant treatment eliminates the mentioned changes into various extend. These developmental changes of CNS structures volume are missing in girls.