Max JE, Fox PT, Lancaster J, Kochunov P, Mathews K, Manes F, Robertson BA, Arndt S, Robin DA, Lansing AE.  Putamen lesions and the development of attention-deficit/hyperactivity symptomatology. Journal of the American Academy of Child and Adolescent Psychiatry 2002

Putamen lesions and the development of attention-deficit/hyperactivity symptomatology.

Autores Max JE, Fox PT, Lancaster J, Kochunov P, Mathews K, Manes F, Robertson BA, Arndt S, Robin DA, Lansing AE. 
Año 2002
Journal  Max JE, Fox PT, Lancaster J, Kochunov P, Mathews K, Manes F, Robertson BA, Arndt S, Robin DA, Lansing AE. 
Volumen 41(5): 563-571
Abstract  OBJECTIVE: To investigate the association between focal stroke lesions of the putamen and either attention-deficit/hyperactivity disorder or traits of the disorder (ADHD/Traits). METHOD: Twenty-five children with focal stroke lesions were studied with standardized psychiatric assessments and anatomic brain magnetic resonance imaging. The pattern of lesion overlap in subjects with ADHD/Traits was determined. RESULTS: Fifteen of 25 subjects had ADHD/Traits. The densest area of overlapping lesions (n = 7) in subjects with ADHD/Traits included the posterior ventral putamen. The median lesion volume was 9.7 cm3, and the distribution was highly skewed. Lesion volume was not associated with ADHD/Traits. Therefore the following analyses focused on the 13 subjects with lesions < 10 cm3: ADHD/Traits were exhibited in 6/7 subjects with putamen lesionsversus 2/6 with no putamen lesions (Fisherexacttestp= .1). Half (4/8) of the subjects with ADHD/Traits had overlapping lesions encompassing the posterior ventral putamen. None of the 5 subjects without ADHD/Traits had lesions in this empirically derived region of interest (Fisher exact test p = .1). CONCLUSIONS: Lesions within the dopamine-rich ventral putamen, which is part of the ventral or limbic striatum, tended to increase the risk of ADHD/Traits. ADHD/Traits may therefore be a disinhibition syndrome associated with dysfunction in this cortical-striato-thalamocortical loop.
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