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Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls.

OBJECTIVE: To test by MRI-based morphometry the a priori hypotheses that developmental anomalies exist in attention-deficit hyperactivity disorder (ADHD) in left caudate and right prefrontal/frontal/ and/or posterior parietal hemispheric regions, in accord with neurochemical, neuronal circuitry and attentional network hypotheses, and prior imaging studies. DESIGN: Case-control study. SETTING: Academic medical center. PARTICIPANTS: Fifteen male subjects with ADHD without comorbid diagnoses (aged 12.4 +/- 3.4 years) and 15 male normal controls (aged 14.4 +/- 3.4), group-matched for age, IQ, and handedness. MAIN OUTCOME MEASURES: Global and hemispheric regional volumes (in cm3) of cerebral hemispheres, cortex, white matter, ventricles, caudate, lenticulate, central gray nuclei, insula, amygdala, and hippocampus. RESULTS: Despite similar hemispheric volumes, ADHD subjects had smaller volumes of (1) left total caudate and caudate head (p < 0.04), with reversed asymmetry (p < 0.03); (2) right anterior-superior (frontal) region en bloc (p < 0.03) and white matter (p < 0.01); (3) bilateral anterior-inferior region en bloc (p < 0.04); and (4) bilateral retrocallosal (parietal-occipital) region white matter (p < 0.03). Possible structural correlates of ADHD response to stimulants were noted in an exploratory analysis, with the smallest and symmetric caudate, and smallest left anterior-superior cortex volumes found in the responders, but reversed caudate asymmetry and the smallest retrocallosal white matter volumes noted in the nonresponders. CONCLUSIONS: This study is the first to report localized hemispheric structural anomalies in ADHD, which are concordant with theoretical models of abnormal frontal-striatal and parietal function, and with possible differing morphologic substrates of response to stimulant medication.

Pubmed ID: 9065532

Authors

  • Filipek PA
  • Semrud-Clikeman M
  • Steingard RJ
  • Renshaw PF
  • Kennedy DN
  • Biederman J

Journal

Neurology

Publication Data

March 28, 1997

Associated Grants

  • Agency: NICHD NIH HHS, Id: HD 27802
  • Agency: NINDS NIH HHS, Id: NS 20489
  • Agency: NINDS NIH HHS, Id: NS 24279

Mesh Terms

  • Adolescent
  • Analysis of Variance
  • Attention Deficit Disorder with Hyperactivity
  • Brain
  • Caudate Nucleus
  • Child
  • Humans
  • Intelligence Tests
  • Magnetic Resonance Imaging
  • Male
  • Regression Analysis
  • Retrospective Studies