Structural neuroimaging in children with ADHD

As described in this issue of The Lancet Psychiatry, Joel Bernanke and colleagues 1 Bernanke J Alex Luna A Chang L Bruno E Dworkin J Posner J Structural brain measures among children with and without ADHD in the Adolescent Brain and Cognitive Development Study cohort: a cross-sectional US population-based study. Lancet Psychiatry. 2022; (published online Feb 7.)https://doi.org/10.1016/S2215-0366(21)00505-8 Google Scholar leveraged clinical and neuroimaging data from the Adolescent Brain and Cognitive Development (ABCD) Study 2 Garavan H Bartsch H Conway K et al. Recruiting the ABCD sample: design considerations and procedures. Dev Cogn Neurosci. 2018; 32: 16-22 Google Scholar to produce the largest structural MRI study of ADHD to date, in a sample representative of children aged 9–10 years old in the USA. Bernanke and colleagues compared children with and without ADHD on 79 brain measures: thickness and area of 35 cortical regions, eight subcortical volume measures, and estimated total intracranial volume (ETIV). Fewer significant group differences emerged than expected, and effect sizes, ranging from −0·11 to −0·06, were smaller than those previously reported, most notably in the ENIGMA study. 3 Hoogman M Bralten J Hibar DP et al. Subcortical brain volume differences of participants with ADHD across the lifespan: an ENIGMA collaboration. Lancet Psychiatry. 2017; 4: 310 Google Scholar , 4 Hoogman M Muetzel R Guimaraes JP et al. Brain imaging of the cortex in ADHD: a coordinated analysis of large-scale clinical and population-based samples. Am J Psychiatry. 2019; 176: 531-542 Google Scholar There were no significant differences in cortical thickness or subcortical volume, and only ten of 35 cortical areas, along with ETIV, differed between the groups. Given these findings, the authors conclude that in the general population, children aged 9–10 years old with ADHD differ only modestly from unaffected peers on structural MRI measures. Structural brain measures among children with and without ADHD in the Adolescent Brain and Cognitive Development Study cohort: a cross-sectional US population-based studyIn a sample representative of the general population, children aged 9–10 years with ADHD differed only modestly on structural brain measures from their unaffected peers. Future studies might need to incorporate other MRI modalities, novel statistical approaches, or alternative diagnostic classifications, particularly for research aimed at developing ADHD diagnostic biomarkers. Full-Text PDF