title: Disturbed structural connectivity is related to inattention and impulsivity in adult attention deficit hyperactivity disorder.
abstract: Inattention and impulsivity are the most prominent clinical features of attention deficit hyperactivity disorder (ADHD) in adulthood. Structural and functional neuroimaging studies of subjects with ADHD have demonstrated abnormalities in several brain areas, including fronto-striatal and fronto-cerebellar networks. Mostly, these studies were based on volumetric measurements and have been conducted in children. We investigated white matter (WM) integrity and correlation with measures of attention and impulsivity in adult patients with ADHD adopting diffusion tensor imaging (DTI). N = 37 (21 males) never-medicated adult patients with ADHD combined subtype and N = 34 (16 males) healthy controls were investigated. ADHD diagnosis (DSM-IV) was assessed with clinical interviews and rating scales, subjects also underwent a large neuropsychological test battery including tests of attention and impulsivity. DTI was acquired, and group differences of fractional anisotropy (FA) and mean diffusivity (MD) as well as correlation analyses with measures of attentional performance and impulsivity were calculated using voxel-based analyses. In adult patients with ADHD, we found reduced FA as well as higher MD bilaterally in orbitomedial prefrontal WM and in the right anterior cingulate bundle, while elevated FA was present bilaterally in temporal WM structures. Measures of attention were correlated with DTI parameters in the right superior longitudinal fasciculus, whereas measures of impulsivity were correlated with FA in right orbitofrontal fibre tracts. This is the first DTI study demonstrating disturbed structural connectivity of the frontal-striatal circuitry in adult patients with ADHD. Moreover, a direct correlation between WM integrity and measures of attention and impulsivity is shown.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. andreas_konrad@gmx.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Konrad
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Dielentheis
authors.forename: Dschamil
authors.initials: D
authors.lastname: El Masri
authors.forename: Martin
authors.initials: M
authors.lastname: Bayerl
authors.forename: Christoph
authors.initials: C
authors.lastname: Fehr
authors.forename: Thomas
authors.initials: T
authors.lastname: Gesierich
authors.forename: Goran
authors.initials: G
authors.lastname: Vucurevic
authors.forename: Peter
authors.initials: P
authors.lastname: Stoeter
authors.forename: Georg
authors.initials: G
authors.lastname: Winterer
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007175:Impulsive Behavior / Q000473:pathology*; D008297:Male; D009434:Neural Pathways / Q000473:pathology*; D009483:Neuropsychological Tests