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Towards further understanding of the co-morbidity between attention deficit hyperactivity disorder and bipolar disorder: a MRI study of brain volumes.

BACKGROUND: Although attention deficit hyperactivity disorder (ADHD) and bipolar disorder (BPD) co-occur frequently and represent a particularly morbid clinical form of both disorders, neuroimaging research addressing this co-morbidity is scarce. Our aim was to evaluate the morphometric magnetic resonance imaging (MRI) underpinnings of the co-morbidity of ADHD with BPD, testing the hypothesis that subjects with this co-morbidity would have neuroanatomical correlates of both disorders. METHOD: Morphometric MRI findings were compared between 31 adults with ADHD and BPD and with those of 18 with BPD, 26 with ADHD, and 23 healthy controls. The volumes (cm(3)) of our regions of interest (ROIs) were estimated as a function of ADHD status, BPD status, age, sex, and omnibus brain volume using linear regression models. RESULTS: When BPD was associated with a significantly smaller orbital prefrontal cortex and larger right thalamus, this pattern was found in co-morbid subjects with ADHD plus BPD. Likewise, when ADHD was associated with significantly less neocortical gray matter, less overall frontal lobe and superior prefrontal cortex volumes, a smaller right anterior cingulate cortex and less cerebellar gray matter, so did co-morbid ADHD plus BPD subjects. CONCLUSIONS: Our results support the hypothesis that ADHD and BPD independently contribute to volumetric alterations of selective and distinct brain structures. In the co-morbid state of ADHD plus BPD, the profile of brain volumetric abnormalities consists of structures that are altered in both disorders individually. Attention to co-morbidity is necessary to help clarify the heterogeneous neuroanatomy of both BPD and ADHD.

Pubmed ID: 17935640


  • Biederman J
  • Makris N
  • Valera EM
  • Monuteaux MC
  • Goldstein JM
  • Buka S
  • Boriel DL
  • Bandyopadhyay S
  • Kennedy DN
  • Caviness VS
  • Bush G
  • Aleardi M
  • Hammerness P
  • Faraone SV
  • Seidman LJ


Psychological medicine

Publication Data

July 29, 2008

Associated Grants

  • Agency: NIMH NIH HHS, Id: F32 MH 065040-01A1
  • Agency: NIMH NIH HHS, Id: MH 16259
  • Agency: NIMH NIH HHS, Id: MH 56956
  • Agency: NIMH NIH HHS, Id: MH 57934
  • Agency: NIMH NIH HHS, Id: MH 63951
  • Agency: NICHD NIH HHS, Id: MH/HD 62152
  • Agency: NCRR NIH HHS, Id: P41 RR 14075

Mesh Terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity
  • Bipolar Disorder
  • Brain
  • Case-Control Studies
  • Comorbidity
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Organ Size