title: Is the spatial distribution of brain lesions associated with closed-head injury predictive of subsequent development of attention-deficit/hyperactivity disorder? Analysis with brain-image database.
abstract: OBJECTIVE
  To determine whether there is an association between the spatial distribution of lesions detected at magnetic resonance (MR) imaging of the brain in children after closed-head injury and the development of secondary attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Data obtained from 76 children without prior history of ADHD were analyzed. MR images were obtained 3 months after closed-head injury. After manual delineation of lesions, images were registered to the Talairach coordinate system. For each subject, registered images and secondary ADHD status were integrated into a brain-image database, which contains depiction (visualization) and statistical analysis software. Using this database, we assessed visually the spatial distributions of lesions and performed statistical analysis of image and clinical variables.
  
  
  RESULTS
  Of the 76 children, 15 developed secondary ADHD. Depiction of the data suggested that children who developed secondary ADHD had more lesions in the right putamen than children who did not develop secondary ADHD; this impression was confirmed statistically. After Bonferroni correction, we could not demonstrate significant differences between secondary ADHD status and lesion burdens for the right caudate nucleus or the right globus pallidus.
  
  
  CONCLUSIONS
  Closed-head injury-induced lesions in the right putamen in children are associated with subsequent development of secondary ADHD. Depiction software is useful in guiding statistical analysis of image data.
authors.affiliation: Department of Biostatistics, School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21287-7619, USA. ehh@jhmi.edu
authors.forename: E H
authors.initials: EH
authors.lastname: Herskovits
authors.forename: V
authors.initials: V
authors.lastname: Megalooikonomou
authors.forename: C
authors.initials: C
authors.lastname: Davatzikos
authors.forename: A
authors.initials: A
authors.lastname: Chen
authors.forename: R N
authors.initials: RN
authors.lastname: Bryan
authors.forename: J P
authors.initials: JP
authors.lastname: Gerring
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D002421:Caudate Nucleus / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000473:pathology*; D005917:Globus Pallidus / Q000293:injuries*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011699:Putamen / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000473:pathology*