OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Relevant sex differences in symptomatology are discussed. This study compared brain neurometabolism in the anterior cingulate cortex (ACC) and left cerebellar hemisphere in age- and IQ-matched adult male (mADHD) and female (fADHD) ADHD patients. METHODS We studied 48 (ACC) and 42 (cerebellum) male/female pairs of stimulant-free patients with adult ADHD. Single voxel magnetic resonance spectroscopy (MRS) was used to investigate creatine (Cre), total choline (t-Cho), glutamate + glutamine (Glx), N-acetylaspartate, and myo-inositol. The mADHD and fADHD groups were compared using robust linear regression. The level of significance was corrected for multiple tests using the Benjamini-Hochberg approach. RESULTS For the ACC, the signals of Cre (p = 0.008) and t-Cho (p = 0.004) showed significant effects of the age covariate as well as an interaction of sex and age (Cre: p = 0.033; t-Cho: p = 0.040). For the Glx signal, an interaction of sex and age could also be observed (p = 0.033). For cerebellar neurometabolites, the signals of t-Cho (p = 0.049) and Glx (p = 0.049) showed significant effects of the factor sex. CONCLUSION This is the largest study yet to analyze sex differences in brain neurochemistry in adult patients with ADHD. Different age-dependent t-Cho signals in the ACC might be associated with delayed myelinization in mADHD. Further MRS studies in adult ADHD, accounting for possible sex effects, are warranted to validate the present findings.

中文翻译：

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成年多动症患者的神经化学性别差异：一项 MRS 研究。


目的 注意力缺陷/多动障碍（ADHD）是一种常见的神经发育障碍。讨论了症状学中的相关性别差异。这项研究比较了年龄和智商匹配的成年男性 (mADHD) 和女性 (fADHD) ADHD 患者前扣带皮层 (ACC) 和左小脑半球的脑神经代谢。方法 我们研究了 48 对（ACC）和 42 对（小脑）男性/女性未使用兴奋剂的成人 ADHD 患者。使用单体素磁共振波谱 (MRS) 来研究肌酸 (Cre)、总胆碱 (t-Cho)、谷氨酸 + 谷氨酰胺 (Glx)、N-乙酰天冬氨酸和肌醇。使用稳健线性回归对 mAADHD 和 fADHD 组进行比较。使用 Benjamini-Hochberg 方法对多个测试的显着性水平进行了校正。结果 对于 ACC，Cre (p = 0.008) 和 t-Cho (p = 0.004) 信号显示出年龄协变量的显着影响以及性别和年龄的交互作用（Cre：p = 0.033；t-Cho： p = 0.040）。对于 Glx 信号，还可以观察到性别和年龄的相互作用 (p = 0.033)。对于小脑神经代谢物，t-Cho (p = 0.049) 和 Glx (p = 0.049) 的信号显示出性别因素的显着影响。结论 这是迄今为止分析成年多动症患者大脑神经化学性别差异的最大研究。 ACC 中不同的年龄依赖性 t-Cho 信号可能与 mAADHD 的髓鞘化延迟有关。对成人 ADHD 进行进一步的 MRS 研究，考虑到可能的性别影响，有必要验证目前的研究结果。