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Evaluación de la vía de recompensa de la dopamina en el TDAH: implicaciones clínicas

Nora D Volkow¹, Gene-Jack Wang, Scott H Kollins

¹National Institute on Drug Abuse, 6001 Executive Blvd, Room 5274, MSC 9581, Bethesda, MD 20892, USA. nvolkow@nida.nih.gov

|September 10, 2009

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Los adultos con trastorno por déficit de atención e hiperactividad (TDAH) muestran una reducción de los marcadores sinápticos de dopamina en la vía de recompensa del cerebro. Estas reducciones de los transportadores y receptores de dopamina se correlacionan con los síntomas de falta de atención, lo que sugiere una base biológica para los déficits de motivación de recompensa en el TDAH.

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Área de la Ciencia:

La neurociencia es la neurociencia.
La psiquiatría es la psiquiatría.
La neuroimagen es una técnica de neuroimagen.

Sus antecedentes:

El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno psiquiátrico prevalente en la infancia que a menudo persiste en la edad adulta.
Las personas con TDAH con frecuencia muestran déficits en la motivación de recompensa.
La vía de recompensa de la dopamina del mesoaccumbens está implicada en el procesamiento de la recompensa.

Objetivo del estudio:

Investigar las bases biológicas de los déficits de recompensa/motivación en el TDAH.
Para obtener imágenes de componentes clave de la vía de recompensa de la dopamina del cerebro (mesoaccumbens) en adultos con TDAH.

Principales métodos:

La tomografía por emisión de positrones (PET) se utilizó para medir los marcadores sinápticos de la dopamina.
Los transportadores de dopamina (DAT) y los receptores D2 / D3 se cuantificaron utilizando radioligandos específicos.
El estudio incluyó a 53 adultos no medicados con TDAH y 44 controles sanos.

Principales resultados:

Se observó una menor unión específica de los transportadores de dopamina (DAT) y los receptores D2 / D3 en adultos con TDAH en comparación con los controles.
Estas reducciones se encontraron en regiones clave de la vía de recompensa, incluido el núcleo accumbens, el cerebro medio y el caudado.
Las calificaciones de atención se correlacionaron significativamente con la disponibilidad de receptores DAT y D2 / D3 en múltiples regiones del cerebro.

Conclusiones:

Una reducción en los marcadores sinápticos de dopamina dentro de la vía de recompensa de la dopamina se asocia con el TDAH.
Estas alteraciones neurobiológicas pueden ser la base de los déficits de recompensa-motivación observados en individuos con TDAH.
Los hallazgos destacan el papel del sistema de dopamina en la fisiopatología del TDAH y la presentación de los síntomas.