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Eur Child Adolesc Psychiatry. 2016 Jul;25(7):701-10. doi: 10.1007/s00787-015-0784-3. Epub 2015 Oct 27.

The influence of comorbid oppositional defiant disorder on white matter microstructure in attention-deficit/hyperactivity disorder.

Author information

1
Department of Clinical Neuropsychology, Faculty of Psychology and Education, VU University Amsterdam, van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. h.van.ewijk@vu.nl.
2
Department of Clinical Neuropsychology, Faculty of Psychology and Education, VU University Amsterdam, van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
3
Department of Cognitive Psychology, VU University Amsterdam, Amsterdam, The Netherlands.
4
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
5
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, USA.
6
Departments of Human Genetics and Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
7
Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
8
Karakter, Child and Adolescent Psychiatry, University Center Nijmegen in Nijmegen, Nijmegen, The Netherlands.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are highly comorbid disorders. ADHD has been associated with altered white matter (WM) microstructure, though the literature is inconsistent, which may be due to differences in the in- or exclusion of participants with comorbid ODD. WM abnormalities in ODD are still poorly understood, and it is unclear whether comorbid ODD in ADHD may have confounded the current ADHD literature. Diffusion Tensor Imaging (DTI) was used to compare fractional anisotropy (FA) and mean diffusivity (MD) between ADHD patients with (n = 42) and without (n = 117) comorbid ODD. All participants were between 8-25 years and groups did not differ in mean age or gender. Follow-up analyses were conducted to examine the role of antisocial behaviour (conduct problems) on FA and MD values in both groups. Comorbid ODD in ADHD was associated with lower FA in left frontotemporal WM, which appeared independent of ADHD symptoms. FA was negatively associated with antisocial behaviour in ADHD + ODD, but not in ADHD-only. Comorbid ODD is associated with WM abnormalities in individuals with ADHD, which appears to be independent of ADHD symptoms. Altered WM microstructure in comorbid ODD may play a role in inconsistencies in the current DTI literature in ADHD. Altered development of these tracts may contribute to social-emotional and cognitive problems in children with oppositional and antisocial behaviour.

KEYWORDS:

ADHD; Antisocial behaviour; Comorbidity; Diffusion Tensor Imaging; Oppositional defiant disorder; White matter microstructure

PMID:
26507746
PMCID:
PMC4932146
DOI:
10.1007/s00787-015-0784-3
[Indexed for MEDLINE]
Free PMC Article

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