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Hum Brain Mapp. 2019 Jun 15;40(9):2677-2698. doi: 10.1002/hbm.24552. Epub 2019 Feb 19.

Comorbidity of reading disabilities and ADHD: Structural and functional brain characteristics.

Langer N1,2,3,4,5, Benjamin C1,6, Becker BLC1,7, Gaab N1,2.

Author information

Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland.
University Research Priority Program (URPP) Dynamics of Healthy Aging, Zurich, Switzerland.
Neuroscience Center Zurich (ZNZ), Zurich, Switzerland.
Neurology, Neurosurgery & Psychology, Yale University, New Haven, Connecticut.
University of California, Berkeley, California.


Reading disabilities (RD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common developmental disorders. RD and ADHD frequently co-occur, which raises questions about how the disorders interact and to what extent they can be differentiated. To date, the underlying neural mechanisms leading to RD-ADHD comorbidity (COM) are not understood. In this study, structural and functional magnetic resonance imaging (fMRI) were combined with comprehensive behavioral testing in order to characterize the behavior, brain structure, and neural correlates of executive function, phonological processing and reading fluency in 60 children with clinical diagnoses of RD, ADHD, or COM, and controls. Whole-brain analyses of variance were performed on cortical thickness values and on the data of the three fMRI tasks to investigate overall group differences. To validate these findings, a region of interest analysis was performed in regions that have previously been shown to exhibit group differences in children with RD or ADHD using the same paradigms. The neuroimaging results demonstrated structural and functional atypicalities for COM in regions that are frequently associated with deficits in children with isolated ADHD or RD. A combination of shared and distinctive brain alterations between the clinical groups was identified, supporting the multiple deficit model for ADHD, RD, and its comorbidity.


ADHD; comorbidity; cortical thickness; fMRI; reading disability

[Available on 2020-06-15]

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