Neuroanatomical correlates of attention-deficit-hyperactivity disorder accounting for comorbid oppositional defiant disorder and conduct disorder.
OBJECTIVE
An increasing number of neuroimaging studies have been conducted to uncover the pathophysiology of attention-deficit-hyperactivity disorder (ADHD). The findings are inconsistent, however, at least partially due to methodological differences. In the present study voxel-based morphometry (VBM) was used to evaluate brain morphology in ADHD subjects after taking into account the confounding effect of oppositional defiant disorder (ODD) and conduct disorder (CD) comorbidity.


METHODS
Eighteen children with ADHD and 17 age- and gender-matched typically developing subjects underwent high-spatial resolution magnetic resonance imaging. The regional gray matter volume differences between the children with ADHD and controls were examined with and without accounting for comorbid ODD and CD in a voxel-by-voxel manner throughout the entire brain.


RESULTS
The VBM indicated significantly smaller regional gray matter volume in regions including the bilateral temporal polar and occipital cortices and the left amygdala in subjects with ADHD compared with controls. Significantly smaller regional gray matter volumes were demonstrated in more extensive regions including the bilateral temporal polar cortices, bilateral amygdala, right occipital cortex, right superior temporal sulcus, and left middle frontal gyrus after controlling for the confounding effect of comorbid ODD and CD.


CONCLUSIONS
Morphological abnormalities in ADHD were seen not only in the regions associated with executive functioning but also in the regions associated with social cognition. When the effect of comorbid CD and ODD was taken into account, there were more extensive regions with significantly smaller volume in ADHD compared to controls.
Sasayama
Daimei
D
Department of Psychiatry, Shinshu University Hospital, Japan. sasayama@shinshu-u.ac.jp
Hayashida
Ayako
A
Yamasue
Hidenori
H
Harada
Yuzuru
Y
Kaneko
Tomoki
T
Kasai
Kiyoto
K
Washizuka
Shinsuke
S
Amano
Naoji
N
D000293:Adolescent; D000679:Amygdala / Q000473:pathology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000473:pathology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications* / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D019955:Conduct Disorder / Q000150:complications* / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000473:pathology; D011569:Psychiatric Status Rating Scales; D013702:Temporal Lobe / Q000473:pathology