Cerebral Small Vessel Disease in Adult Attention-Deficit Hyperactivity Disorder
Prof. Dr. Edna Grünblatt
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital
University of Zürich
PD Dr. med. Paul Gerson Unschuld
Zentrum für dementielle Erkrankungen und Altersgesundheit, Klinik für Alterspsychiatrie, PUK
2020- on going
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inability to sustain attention, inappropriate levels of hyperactivity and impulsivity. By definition, ADHD symptoms emerge during childhood and substantially impair academic development and social relationships. ADHD causes high levels of emotional distress in affected patients. Causality of ADHD is complex and involves multiple genetic factors and early life experiences that affect brain maturation. In adults a diagnosis of ADHD typically is associated with a high prevalence of cardiovascular risk factors such as increased rates of smoking and increased prevalence of obesity and diabetes. It is known that ADHD may result from disrupted neural brain development. It is also known that there is a high degree of interdependence between the development of neural and vascular brain structures. Based on this knowledge we propose a novel approach at cerebral vascular dysfunction in adult ADHD. We hypothesize that ADHD is closely associated with increased cerebral small vessel disease (cSVD) at middle age. We further hypothesize that cSVD constitutes a particular long-term risk for impaired mental health of adult ADHD patients during aging.
AIMS. This pilot project aims at providing first data informing on a relationship between a diagnosis of adult ADHD, comorbid vascular disease, and brain pathology. The following specific questions will be addressed: 1.) Does the extent of cSVD differ between adult ADHD and age matched healthy controls? 2.) What brain regions are affected by vascular pathology in adult ADHD? 3.) Is cSVD in adult ADHD associated with alterations in systemic markers of increased risk for cardiovascular disease?