Basal ganglia surface morphology and the effects of stimulant medications in youth with attention deficit hyperactivity disorder.
OBJECTIVE
Disturbances in the basal ganglia portions of cortico-striato-thalamo-cortical circuits likely contribute to the symptoms of attention deficit hyperactivity disorder (ADHD). The authors examined the morphologic features of the basal ganglia nuclei (caudate, putamen, and globus pallidus) in children with ADHD.


METHODS
A total of 104 individuals (combined-type ADHD patients: N=47; healthy comparison subjects: N=57), aged 7 to 18 years, were examined in a cross-sectional case-control study using anatomical magnetic resonance imaging. Conventional volumes and the surface morphology for the basal ganglia were measured.


RESULTS
Overall volumes were significantly smaller only in the putamen. Analysis of the morphological surfaces revealed significant inward deformations in each of the three nuclei, localized primarily in portions of these nuclei that are components of limbic, associative, and sensorimotor pathways in the cortico-striato-thalamo-cortical circuits in which these nuclei reside. The more prominent these inward deformations were in the patient group, the more severe the ADHD symptoms. Surface analyses also demonstrated significant outward deformations of all basal ganglia nuclei in the ADHD children treated with stimulants compared with those ADHD youth who were untreated. These stimulant-associated enlargements were in locations similar to the reduced volumes detected in the ADHD group relative to the comparison group. The outward deformations associated with stimulant medications attenuated the statistical effects of the primary group comparisons.


CONCLUSIONS
These findings potentially represent evidence of anatomical dysregulation in the circuitry of the basal ganglia in children with ADHD and suggest that stimulants may normalize morphological features of the basal ganglia in children with the disorder.
Sobel
Loren J
LJ
Department of Psychiatry, New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
Bansal
Ravi
R
Maia
Tiago V
TV
Sanchez
Juan
J
Mazzone
Luigi
L
Durkin
Kathleen
K
Liu
Jun
J
Hao
Xuejun
X
Ivanov
Iliyan
I
Miller
Ann
A
Greenhill
Laurence L
LL
Peterson
Bradley S
BS
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D001479:Basal Ganglia / Q000187:drug effects* / Q000473:pathology*; D002421:Caudate Nucleus / Q000187:drug effects / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005917:Globus Pallidus / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000187:drug effects / Q000473:pathology; D011699:Putamen / Q000187:drug effects / Q000473:pathology; D012720:Severity of Illness Index
D000697:Central Nervous System Stimulants