title: White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is increasingly conceived as reflecting altered functional and structural brain connectivity. The latter can be addressed with diffusion tensor imaging (DTI). We examined fractional anisotropy (FA), a DTI index related to white matter structural properties, in adult male subjects diagnosed with ADHD in childhood (probands) and matched control subjects without childhood ADHD. Additionally, we contrasted FA among probands with and without current ADHD in adulthood and control subjects.
  
  
  METHODS
  Participants were from an original cohort of 207 boys and 178 male control subjects. At 33-year follow-up, analyzable DTI scans were obtained in 51 probands (41.3 ± 2.8 yrs) and 66 control subjects (41.2 ± 3.1 yrs). Voxel-based FA was computed with tract-based spatial statistics, controlling for multiple comparisons.
  
  
  RESULTS
  Probands with childhood ADHD exhibited significantly lower FA than control subjects without childhood ADHD in the right superior and posterior corona radiata, right superior longitudinal fasciculus, and in a left cluster including the posterior thalamic radiation, the retrolenticular part of the internal capsule, and the sagittal stratum (p<.05, corrected). Fractional anisotropy was significantly decreased relative to control subjects in several tracts in both probands with current and remitted ADHD, who did not differ significantly from each other. Fractional anisotropy was not significantly increased in probands in any region.
  
  
  CONCLUSIONS
  Decreased FA in adults with childhood ADHD regardless of current ADHD might be an enduring trait of ADHD. White matter tracts with decreased FA connect regions involved in high-level as well as sensorimotor functions, suggesting that both types of processes are involved in the pathophysiology of ADHD.
authors.affiliation: Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, New York University Langone School of Medicine, New York; Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy; UMR_S INSERM U 930, CNRS ERL 3106, François-Rabelais University, Child Psychiatry Centre, University Hospital, Tours, France. Electronic address: samuele.cortese@gmail.com.
authors.forename: Samuele
authors.initials: S
authors.lastname: Cortese
authors.forename: Davide
authors.initials: D
authors.lastname: Imperati
authors.forename: Juan
authors.initials: J
authors.lastname: Zhou
authors.forename: Erika
authors.initials: E
authors.lastname: Proal
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Klein
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mannuzza
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ramos-Olazagasti
authors.forename: Michael P
authors.initials: MP
authors.lastname: Milham
authors.forename: Clare
authors.initials: C
authors.lastname: Kelly
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Castellanos
mesh_terms: D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male
keywords: ADHD; DTI; fractional anisotropy; longitudinal follow-up; neuroimaging; pathophysiology