title: Brain alterations in adult ADHD: effects of gender, treatment and comorbid depression.
abstract: Children with attention-deficit/hyperactivity disorder (ADHD) have smaller volumes of total brain matter and subcortical regions, but it is unclear whether these represent delayed maturation or persist into adulthood. We performed a structural MRI study in 119 adult ADHD patients and 107 controls and investigated total gray and white matter and volumes of accumbens, caudate, globus pallidus, putamen, thalamus, amygdala and hippocampus. Additionally, we investigated effects of gender, stimulant treatment and history of major depression (MDD). There was no main effect of ADHD on the volumetric measures, nor was any effect observed in a secondary voxel-based morphometry (VBM) analysis of the entire brain. However, in the volumetric analysis a significant gender by diagnosis interaction was found for caudate volume. Male patients showed reduced right caudate volume compared to male controls, and caudate volume correlated with hyperactive/impulsive symptoms. Furthermore, patients using stimulant treatment had a smaller right hippocampus volume compared to medication-naïve patients and controls. ADHD patients with previous MDD showed smaller hippocampus volume compared to ADHD patients with no MDD. While these data were obtained in a cross-sectional sample and need to be replicated in a longitudinal study, the findings suggest that developmental brain differences in ADHD largely normalize in adulthood. Reduced caudate volume in male patients may point to distinct neurobiological deficits underlying ADHD in the two genders. Smaller hippocampus volume in ADHD patients with previous MDD is consistent with neurobiological alterations observed in MDD.
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands.
authors.forename: A Marten H
authors.initials: AM
authors.lastname: Onnink
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands.
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Zwiers
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands; Department of Language and Genetics, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: Hoogman
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Human Genetics, Nijmegen, The Netherlands.
authors.forename: Jeanette C
authors.initials: JC
authors.lastname: Mostert
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands.
authors.forename: Cornelis C
authors.initials: CC
authors.lastname: Kan
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatric University Centre, Nijmegen, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Buitelaar
authors.affiliation: Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Human Genetics, Nijmegen, The Netherlands. Electronic address: b.franke@gen.umcn.nl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Franke
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D012737:Sex Factors
chemical_list: D000697:Central Nervous System Stimulants
keywords: Adult ADHD; Depression; Gender; Treatment; VBM; Volumetry