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Subcortical differences among youths with attention-deficit/hyperactivity disorder compared to those with bipolar disorder with and without attention-deficit/hyperactivity disorder.

INTRODUCTION: A significant number of children with bipolar disorder (BP) have co-morbid attention-deficit/hyperactivity disorder (ADHD). It is unknown if these children have neuroimaging findings unique to their co-morbid presentation, or if their brain findings are similar to children diagnosed with BP alone. METHOD: Fifty three children with Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) BP (23 with ADHD, 30 without), 29 healthy controls (HC), and 23 children with ADHD, similar in sex and age, had magnetic resonance imaging (MRI) scans on a 1.5T GE scanner. Volumetric assessments were performed for basal ganglia and limbic subcortical structures. RESULTS: Youths with ADHD had smaller caudate and putamen volumes compared to both BP groups and they had moderately smaller total amygdala volumes compared to the other three groups. Youths with BP + ADHD had moderately larger nucleus accumbens volumes than HC, and females in both BP groups had smaller hippocampal volumes compared to ADHD and HC. No differences were found between the BP and BP + ADHD groups. CONCLUSION: These data suggest that morphometric subcortical volumes in youths with BP + ADHD are more similar to those in youths with BP. They do not share subcortical neuroanatomic correlates with the ADHD group. These findings suggest that BP + ADHD is a subtype of pediatric BP rather than severe ADHD.

Pubmed ID: 19232021


  • Lopez-Larson M
  • Michael ES
  • Terry JE
  • Breeze JL
  • Hodge SM
  • Tang L
  • Kennedy DN
  • Moore CM
  • Makris N
  • Caviness VS
  • Frazier JA


Journal of child and adolescent psychopharmacology

Publication Data

February 23, 2009

Associated Grants

  • Agency: NIMH NIH HHS, Id: K01 MH001978
  • Agency: NIMH NIH HHS, Id: K08 MH001573
  • Agency: NIMH NIH HHS, Id: K08 MH001573-02
  • Agency: NIMH NIH HHS, Id: R01 MH083320
  • Agency: NIMH NIH HHS, Id: R01 MH083320-01A2
  • Agency: NCRR NIH HHS, Id: U24 RR021382
  • Agency: NCRR NIH HHS, Id: U24 RR021382-01

Mesh Terms

  • Attention Deficit Disorder with Hyperactivity
  • Basal Ganglia
  • Bipolar Disorder
  • Child
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Limbic System
  • Magnetic Resonance Imaging
  • Male
  • Sex Factors