title: Unique white matter microstructural patterns in ADHD presentations-a diffusion tensor imaging study.
abstract: Attention-deficit/hyperactivity disorder predominantly inattentive (ADHD-PI) and combined (ADHD-C) presentations are likely distinct disorders that differ neuroanatomically, neurochemically, and neuropsychologically. However, to date, little is known about specific white matter (WM) regions differentiating ADHD presentations. This study examined differences in WM microstructure using diffusion tensor imaging (DTI) data from 20 ADHD-PI, 18 ADHD-C, and 27 typically developed children. Voxel-wise analysis of DTI measurements in major fiber bundles was carried out using tract-based spatial statistics (TBSS). Clusters showing diffusivity abnormalities were used as regions of interest for regression analysis between fractional anisotropy (FA) and neuropsychological outcomes. Compared to neurotypicals, ADHD-PI children showed higher FA in the anterior thalamic radiations (ATR), bilateral inferior longitudinal fasciculus (ILF), and in the left corticospinal tract (CST). In contrast, the ADHD-C group exhibited higher FA in the bilateral cingulum bundle (CB). In the ADHD-PI group, differences in FA in the left ILF and ATR were accompanied by axial diffusivity (AD) abnormalities. In addition, the ADHD-PI group exhibited atypical mean diffusivity in the forceps minor (FMi) and left ATR and AD differences in right CB compared to healthy subjects. Direct comparison between ADHD presentations demonstrated radial diffusivity differences in FMi. WM clusters with FA irregularities in ADHD were associated with neurobehavioral performance across groups. In conclusion, differences in WM microstructure in ADHD presentations strengthen the theory that ADHD-PI and ADHD-C are two distinct disorders. Regions with WM irregularity seen in both ADHD presentations might serve as predictors of executive and behavioral functioning across groups. Hum Brain Mapp 37:3323-3336, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.|Multimodal and Functional Neuroimaging Research Group, CEITEC-Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
authors.forename: Alena
authors.identifier: 0000-0002-9188-4280
authors.initials: A
authors.lastname: Svatkova
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Igor
authors.initials: I
authors.lastname: Nestrasil
authors.affiliation: Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Kyle
authors.initials: K
authors.lastname: Rudser
authors.affiliation: Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan.
authors.forename: Jodene
authors.initials: J
authors.lastname: Goldenring Fine
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Jesse
authors.initials: J
authors.lastname: Bledsoe
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Margaret
authors.initials: M
authors.lastname: Semrud-Clikeman
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002648:Child; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D066127:White Matter / Q000473:pathology*
keywords: ADHD combined; ADHD preferentially inattentive; executive and behavioral performance; fractional anisotropy; white matter microstructure