title: Brain structural deficits and working memory fMRI dysfunction in young adults who were diagnosed with ADHD in adolescence.
abstract: When adolescents with ADHD enter adulthood, some no longer meet disorder diagnostic criteria but it is unknown if biological and cognitive abnorma lities persist. We tested the hypothesis that people diagnosed with ADHD during adolescence present residual brain abnormalities both in brain structure and in working memory brain function. 83 young adults (aged 20-24 years) from the Northern Finland 1986 Birth Cohort were classified as diagnosed with ADHD in adolescence (adolescence ADHD, n = 49) or a control group (n = 34). Only one patient had received medication for ADHD. T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. A sub-sample of both groups (ADHD, n = 21; controls n = 23) also performed a Sternberg working memory task whilst acquiring fMRI data. Areas of structural difference were used as a region of interest to evaluate the implications that structural abnormalities found in the ADHD group might have on working memory function. There was lower grey matter volume bilaterally in adolescence ADHD participants in the caudate (p < 0.05 FWE corrected across the whole brain) at age 20-24. Working memory was poorer in adolescence ADHD participants, with associated failure to show normal load-dependent caudate activation. Young adults diagnosed with ADHD in adolescence have structural and functional deficits in the caudate associated with abnormal working memory function. These findings are not secondary to stimulant treatment, and emphasise the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time.
authors: Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
authors: Andres
authors: A
authors: Roman-Urrestarazu
authors: Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Päivi
authors: P
authors: Lindholm
authors: Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Irma
authors: I
authors: Moilanen
authors: Department of Diagnostic Radiology, Institute of Diagnostics, Oulu University Hospital, Oulu, Finland.
authors: Vesa
authors: V
authors: Kiviniemi
authors: Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Public Health Sciences and General Practice, Institute of Health Sciences, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Jouko
authors: J
authors: Miettunen
authors: Department of Diagnostic Radiology, Institute of Diagnostics, Oulu University Hospital, Oulu, Finland.
authors: Erika
authors: E
authors: Jääskeläinen
authors: Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Pirjo
authors: P
authors: Mäki
authors: Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Public Health Sciences and General Practice, Institute of Health Sciences, University of Oulu, Oulu, Finland.
authors: Tuula
authors: T
authors: Hurtig
authors: Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Hanna
authors: H
authors: Ebeling
authors: Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
authors: Jennifer H
authors: JH
authors: Barnett
authors: Department of Diagnostic Radiology, Institute of Diagnostics, Oulu University Hospital, Oulu, Finland.|Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.|Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
authors: Juha
authors: J
authors: Nikkinen
authors: Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.|NIHR Cambridge Biomedical Research Centre, Cambridge, UK.|Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
authors: John
authors: J
authors: Suckling
authors: Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.|NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
authors: Peter B
authors: PB
authors: Jones
authors: Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors: Juha
authors: J
authors: Veijola
authors: Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK. gm285@cam.ac.uk.|NIHR Cambridge Biomedical Research Centre, Cambridge, UK. gm285@cam.ac.uk.|Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. gm285@cam.ac.uk.
authors: Graham K
authors: GK
authors: Murray
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000523:psychology; D008570:Memory, Short-Term / Q000502:physiology; D010775:Photic Stimulation / Q000379:methods; D011597:Psychomotor Performance / Q000502:physiology; D055815:Young Adult
keywords: ADHD; Hyperkinetic; MRI; Memory; Neuroanatomy; VBM