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Arch Gen Psychiatry. 2011 Nov;68(11):1122-34. doi: 10.1001/archgenpsychiatry.2011.117.

Brain gray matter deficits at 33-year follow-up in adults with attention-deficit/hyperactivity disorder established in childhood.

Author information

1
Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, New York University Langone School of Medicine, USA.

Abstract

CONTEXT:

Volumetric studies have reported relatively decreased cortical thickness and gray matter volumes in adults with attention-deficit/hyperactivity disorder (ADHD) whose childhood status was retrospectively recalled. We present, to our knowledge, the first prospective study combining cortical thickness and voxel-based morphometry in adults diagnosed as having ADHD in childhood.

OBJECTIVES:

To test whether adults with combined-type childhood ADHD exhibit cortical thinning and decreased gray matter in regions hypothesized to be related to ADHD and to test whether anatomic differences are associated with a current ADHD diagnosis, including persistent vs remitting ADHD.

DESIGN:

Cross-sectional analysis embedded in a 33-year prospective follow-up at a mean age of 41.2 years.

SETTING:

Research outpatient center.

PARTICIPANTS:

We recruited probands with ADHD from a cohort of 207 white boys aged 6 to 12 years. Male comparison participants (n = 178) were free of ADHD in childhood. We obtained magnetic resonance images in 59 probands and 80 comparison participants (28.5% and 44.9% of the original samples, respectively).

MAIN OUTCOME MEASURES:

Whole-brain voxel-based morphometry and vertexwise cortical thickness analyses.

RESULTS:

The cortex was significantly thinner in ADHD probands than in comparison participants in the dorsal attentional network and limbic areas (false discovery rate < 0.05, corrected). In addition, gray matter was significantly decreased in probands in the right caudate, right thalamus, and bilateral cerebellar hemispheres. Probands with persistent ADHD (n = 17) did not differ significantly from those with remitting ADHD (n = 26) (false discovery rate < 0.05). At uncorrected P < .05, individuals with remitting ADHD had thicker cortex relative to those with persistent ADHD in the medial occipital cortex, insula, parahippocampus, and prefrontal regions.

CONCLUSIONS:

Anatomic gray matter reductions are observable in adults with childhood ADHD, regardless of the current diagnosis. The most affected regions underpin top-down control of attention and regulation of emotion and motivation. Exploratory analyses suggest that diagnostic remission may result from compensatory maturation of prefrontal, cerebellar, and thalamic circuitry.

[Indexed for MEDLINE]
Free PMC Article

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