TITLE:
The relation between ADHD and ANS-CNS integration
AUTHORS:
Maiko Hayayashida, Tsuyoshi Miyaoka, Jun Horiguchi
KEYWORDS:
Attention Deficit Hyperactivity Disorder (ADHD); Iodine-123-Labeled Meta-Iodobenzylguanidine; Single Photon Emission Computed Tomography (SPECT); Norepinephrine (NE)
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.1,
January
7,
2014
ABSTRACT: Background: Attention deficit hyperactivity disorder
(ADHD) was long considered to be limited to children and adolescents, but it is
now known that ADHD symptoms may persist into adulthood. It is plausible that
the etiology of ADHD is not one-dimensional, but instead involves various
neuroanatomical and neurochemical systems, with the causes of the main abnormalities
believed to be catecholaminergic. Iodine-123-labeled meta-iodobenzylguanidine (123I-MIBG)
is a physiological analogue of norepinephrine (NE). To the best of our
knowledge, there are no reports about the abnormalities of MIBG scintigraphy in
patients with ADHD. The cases presented are male adult patients with different
comorbid psychiatric disorders. Case presentation: The cases presented are male
adult patients with different psychiatric disorders. Case 1 was a 52-year-old
male residential construction foreman, who had been diagnosed with acute schizophrenia-like psychotic disorder. 123I-MIBG planar and SPECTs of the studies were performed at 20 min (early phase) and 3 h
(late phase) after intravenous injection of 111 MBq. Planar images were
processed to determine the heart (H) to mediastinum (M) ratio (H/M). The early
and late H/M ratios were 1.22 and 1.07, respectively. Case 2 was a 52-year-old
male civil servant who was diagnosed with adjustment disorder. The early and
late H/M ratios were 1.98 and 2.08, respectively. Conclusion: Clinical studies
make it clear that symptoms of ADHD are more heterogenous and subtle in adults
than children. Adult ADHD is significantly commorbid with wide range of other
12-month disorders. MIBG imaging can be useful to diagnose patients with
preexisting psychiatric disorders and ADHD. It might be possible to diagnose
objectively though the psychiatric statuses resemble or coexist with other
psychiatric disorders. Needless to say, further research is important.