title: Altered white matter tract property related to impaired focused attention, sustained attention, cognitive impulsivity and vigilance in attention-deficit/ hyperactivity disorder.
abstract: BACKGROUND
  The neural substrate for clinical symptoms and neuropsychological performance in individuals with attention-deficit/hyperactivity disorder (ADHD) has rarely been studied and has yielded inconsistent results. We sought to compare the microstructural property of fibre tracts associated with the prefrontal cortex and its association with ADHD symptoms and a wide range of attention performance in youth with ADHD and healthy controls.
  
  
  METHODS
  We assessed youths with ADHD and age-, sex-, handedness-, coil- and intelligence-matched controls using the Conners' Continuous Performance Test (CCPT) for attention performance and MRI. The 10 target tracts, including the bilateral frontostriatal tracts (caudate to dorsolateral prefrontal cortex, ventrolateral prefrontal cortex and orbitofrontal cortex), superior longitudinal fasciculus (SLF) and cingulum bundle were reconstructed using diffusion spectrum imaging tractography. We computed generalized fractional anisotropy (GFA) values to indicate tract-specific microstructural property.
  
  
  RESULTS
  We included 50 youths with ADHD and 50 healthy controls in our study. Youths with ADHD had lower GFA in the left frontostriatal tracts, bilateral SLF and right cingulum bundle and performed worse in the CCPT than controls. Furthermore, alteration of the right SLF GFA was most significantly associated with the clinical symptom of inattention in youths with ADHD. Finally, youths with ADHD had differential association patterns of the 10 fibre tract GFA values with attention performance compared with controls.
  
  
  CONCLUSIONS
  Ten of the youths with ADHD were treated with methylphenidate, which may have long-term effects on microstructural property.
  
  
  CONCLUSIONS
  Our study highlights the importance of the SLF, cingulum bundle and frontostriatal tracts for clinical symptoms and attention performance in youths with ADHD and demonstrates the involvement of different fibre tracts in attention performance in these individuals.
authors: From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan ( Chiang, Gau); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (Chiang, Gau); Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan (Chiang); Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (Chen, Tseng, Lo); Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan (Tseng, Gau); Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Tseng); Department of Psychology, School of Occupational Therapy, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan (Gau).
authors: Huey-Ling
authors: HL
authors: Chiang
authors: From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan ( Chiang, Gau); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (Chiang, Gau); Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan (Chiang); Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (Chen, Tseng, Lo); Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan (Tseng, Gau); Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Tseng); Department of Psychology, School of Occupational Therapy, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan (Gau).
authors: Yu-Jen
authors: YJ
authors: Chen
authors: From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan ( Chiang, Gau); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (Chiang, Gau); Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan (Chiang); Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (Chen, Tseng, Lo); Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan (Tseng, Gau); Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Tseng); Department of Psychology, School of Occupational Therapy, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan (Gau).
authors: Yu-Chun
authors: YC
authors: Lo
authors: From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan ( Chiang, Gau); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (Chiang, Gau); Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan (Chiang); Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (Chen, Tseng, Lo); Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan (Tseng, Gau); Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Tseng); Department of Psychology, School of Occupational Therapy, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan (Gau).
authors: Wen-Yih I
authors: WY
authors: Tseng
authors: From the Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan ( Chiang, Gau); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (Chiang, Gau); Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan (Chiang); Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (Chen, Tseng, Lo); Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan (Tseng, Gau); Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (Tseng); Department of Psychology, School of Occupational Therapy, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan (Gau).
authors: Susan S
authors: SS
authors: Gau
mesh_terms: D000293:Adolescent; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016022:Case-Control Studies; D002648:Child; D003071:Cognition; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007175:Impulsive Behavior; D008279:Magnetic Resonance Imaging; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059906:Neuroimaging / Q000379:methods*; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D066127:White Matter
chemical_list: D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate