title: Gray matter alterations in adults with attention-deficit/hyperactivity disorder identified by voxel based morphometry.
abstract: BACKGROUND
  Gray and white matter volume deficits have been reported in many structural magnetic resonance imaging (MRI) studies of children with attention-deficit/hyperactivity disorder (ADHD); however, there is a paucity of structural MRI studies of adults with ADHD. This study used voxel based morphometry and applied an a priori region of interest approach based on our previous work, as well as from well-developed neuroanatomical theories of ADHD.
  
  
  METHODS
  Seventy-four adults with DSM-IV ADHD and 54 healthy control subjects comparable on age, sex, race, handedness, IQ, reading achievement, frequency of learning disabilities, and whole brain volume had an MRI on a 1.5T Siemens scanner. A priori region of interest hypotheses focused on reduced volumes in ADHD in dorsolateral prefrontal cortex, anterior cingulate cortex, caudate, putamen, inferior parietal lobule, and cerebellum. Analyses were carried out by FSL-VBM 1.1.
  
  
  RESULTS
  Relative to control subjects, ADHD adults had significantly smaller gray matter volumes in parts of six of these regions at p ≤ .01, whereas parts of the dorsolateral prefrontal cortex and inferior parietal lobule were significantly larger in ADHD at this threshold. However, a number of other regions were smaller and larger in ADHD (especially fronto-orbital cortex) at this threshold. Only the caudate remained significantly smaller at the family-wise error rate.
  
  
  CONCLUSIONS
  Adults with ADHD have subtle volume reductions in the caudate and possibly other brain regions involved in attention and executive control supporting frontostriatal models of ADHD. Modest group brain volume differences are discussed in the context of the nature of the samples studied and voxel based morphometry methodology.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. lseidman@bidmc.harvard.edu
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Lichen
authors.initials: L
authors.lastname: Liang
authors.forename: Eve M
authors.initials: EM
authors.lastname: Valera
authors.forename: Michael C
authors.initials: MC
authors.lastname: Monuteaux
authors.forename: Ariel
authors.initials: A
authors.lastname: Brown
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kaiser
authors.forename: Thomas
authors.initials: T
authors.lastname: Spencer
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Nikos
authors.initials: N
authors.lastname: Makris
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*