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Structural MRI Shows Only Modest Brain Measure Differences in Children With ADHD
Children ages 9 and 10 with attention-deficit/hyperactivity disorder (ADHD) differed only modestly from peers without ADHD on structural magnetic resonance imaging (MRI) brain measures, according to study findings published in The Lancet Psychiatry.
“Structural neuroimaging research has identified a variety of abnormalities in cortical and subcortical structures in children with ADHD. However, studies to date have not employed large, non-referred samples, complete with data on potential confounding variables,” explained lead author Joel Bernanke, MD, of the New York State Psychiatric Institute, New York City, and coauthors in the study background.
For the study, Dr Bernanke and colleagues used baseline demographic, clinical, and neuroimaging data for 10,736 children ages 9 and 10 from the Adolescent Brain and Cognitive Development Study, the largest pediatric brain imaging study in the United States. The sample spanned 5592 boys and 5139 girls, among whom 949 were diagnosed with ADHD and 9787 were not.
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Researchers found just 11 significant differences across 79 brain measures of cortical thickness, cortical area, and subcortical volume in the full model, which included potential confounding variables selected a priori. All differences indicated reductions in brain measures for children with ADHD, according to the study.
Cohen's d values were small, researchers added, ranging from −0.11 to −0.06. They were not meaningfully changed when a more restrictive comparison group or alternative diagnostic methods were used.
“Future studies might need to incorporate other MRI modalities, novel statistical approaches, or alternative diagnostic classifications,” researchers advised, “particularly for research aimed at developing ADHD diagnostic biomarkers.”
The authors speculated that findings could be explained by the older ages of the study participants or by fewer children with severe cases of ADHD in the sample.
“It’s important to note that ADHD can be impairing,” said study senior author Jonathan Posner, MD, of the Duke University Department of Psychiatry & Behavioral Sciences, Durham, NC. “Treatments help with that. And while we don’t have good evidence of structural differences appearing in MRI scans, that could well speak to the limitations of the technology, not of ADHD being outside of biology.”
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