Subcortical differences among youths with attention-deficit/hyperactivity disorder compared to those with bipolar disorder with and without attention-deficit/hyperactivity disorder.
BACKGROUND
A significant number of children with bipolar disorder (BP) have co-morbid attention-deficit/hyperactivity disorder (ADHD). It is unknown if these children have neuroimaging findings unique to their co-morbid presentation, or if their brain findings are similar to children diagnosed with BP alone.


METHODS
Fifty three children with Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) BP (23 with ADHD, 30 without), 29 healthy controls (HC), and 23 children with ADHD, similar in sex and age, had magnetic resonance imaging (MRI) scans on a 1.5T GE scanner. Volumetric assessments were performed for basal ganglia and limbic subcortical structures.


RESULTS
Youths with ADHD had smaller caudate and putamen volumes compared to both BP groups and they had moderately smaller total amygdala volumes compared to the other three groups. Youths with BP + ADHD had moderately larger nucleus accumbens volumes than HC, and females in both BP groups had smaller hippocampal volumes compared to ADHD and HC. No differences were found between the BP and BP + ADHD groups.


CONCLUSIONS
These data suggest that morphometric subcortical volumes in youths with BP + ADHD are more similar to those in youths with BP. They do not share subcortical neuroanatomic correlates with the ADHD group. These findings suggest that BP + ADHD is a subtype of pediatric BP rather than severe ADHD.
Lopez-Larson
Melissa
M
The Brain Institute, University of Utah, Salt Lake City, Utah 84108, USA. Melissa.Lopez-Larson@hsc.utah.edu
Michael
Emily S
ES
Terry
Janine E
JE
Breeze
Janis L
JL
Hodge
Steven M
SM
Tang
Lena
L
Kennedy
David N
DN
Moore
Constance M
CM
Makris
Nikos
N
Caviness
Verne S
VS
Frazier
Jean A
JA
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000473:pathology*; D001479:Basal Ganglia / Q000473:pathology*; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000473:pathology*; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008032:Limbic System / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D012737:Sex Factors