Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls.
OBJECTIVE
To test by MRI-based morphometry the a priori hypotheses that developmental anomalies exist in attention-deficit hyperactivity disorder (ADHD) in left caudate and right prefrontal/frontal/ and/or posterior parietal hemispheric regions, in accord with neurochemical, neuronal circuitry and attentional network hypotheses, and prior imaging studies.


METHODS
Case-control study.


METHODS
Academic medical center.


METHODS
Fifteen male subjects with ADHD without comorbid diagnoses (aged 12.4 +/- 3.4 years) and 15 male normal controls (aged 14.4 +/- 3.4), group-matched for age, IQ, and handedness.


METHODS
Global and hemispheric regional volumes (in cm3) of cerebral hemispheres, cortex, white matter, ventricles, caudate, lenticulate, central gray nuclei, insula, amygdala, and hippocampus.


RESULTS
Despite similar hemispheric volumes, ADHD subjects had smaller volumes of (1) left total caudate and caudate head (p < 0.04), with reversed asymmetry (p < 0.03); (2) right anterior-superior (frontal) region en bloc (p < 0.03) and white matter (p < 0.01); (3) bilateral anterior-inferior region en bloc (p < 0.04); and (4) bilateral retrocallosal (parietal-occipital) region white matter (p < 0.03). Possible structural correlates of ADHD response to stimulants were noted in an exploratory analysis, with the smallest and symmetric caudate, and smallest left anterior-superior cortex volumes found in the responders, but reversed caudate asymmetry and the smallest retrocallosal white matter volumes noted in the nonresponders.


CONCLUSIONS
This study is the first to report localized hemispheric structural anomalies in ADHD, which are concordant with theoretical models of abnormal frontal-striatal and parietal function, and with possible differing morphologic substrates of response to stimulant medication.
Filipek
P A
PA
Department of Pediatrics, University of California College of Medicine, Irvine 92868-3298, USA.
Semrud-Clikeman
M
M
Steingard
R J
RJ
Renshaw
P F
PF
Kennedy
D N
DN
Biederman
J
J
D000293:Adolescent; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy; D001921:Brain / Q000473:pathology; D002421:Caudate Nucleus / Q000473:pathology; D002648:Child; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies