Widespread Cortical Thinning Is a Robust Anatomical Marker for Attention-Deficit/Hyperactivity Disorder

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 48; no. 10; pp. 1014 - 1022
• Main Authors: Narr, Katherine L., Ph.D, Woods, Roger P., M.D, Lin, James, B.S, Kim, John, B.A, Phillips, Owen R., B.S, Del'Homme, Melissa, Ph.D, Caplan, Rochelle, M.D, Toga, Arthur W., Ph.D, McCracken, James T., M.D, Levitt, Jennifer G., M.D
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01-10-2009; Elsevier; Elsevier BV
• Subjects: Adolescent; Adolescents; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - pathology; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit disorders. Hyperactivity; Attention Deficit Hyperactivity Disorder; Biological and medical sciences; Brain; Brain Mapping; Cerebral Cortex - pathology; Child; Child clinical studies; Children; Children & youth; Childrens health; Cortex; Cross-Sectional Studies; Discovery; Evidence; Female; gray matter thickness; Humans; Hyperactivity; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Medical sciences; Neurological Organization; Neurology; NMR; Nuclear magnetic resonance; Organ Size - physiology; pediatric; Pediatrics; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reference Values; Research Methodology; Science Education; structural imaging; cortex; structural imaging; gray matter thickness; pediatric; Human; Pediatrics; Imaging; Grey matter; Attention disorder with hyperactivity; Child
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1097/CHI.0b013e3181b395c0

Abstract Objective This cross-sectional study sought to confirm the presence and regional profile of previously reported changes in laminar cortical thickness in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) compared with typically developing control subjects. Method High-resolution magnetic resonance images were obtained from 22 (19 male and 3 female subjects; mean age 11.7 years) children and adolescents with ADHD and 22 age- and sex-matched control subjects (mean age 11.7 years). Brain tissue volumes were estimated for each subject. Cortical pattern matching methods were used to sample measures of laminar thickness at high spatial frequency across homologous regions of the cortex. Volume and thickness measures were compared across diagnostic groups with and without controlling for general intelligence. False discovery rate correction confirmed regional results. Results The subjects with ADHD exhibited significant reductions in overall brain volume, gray matter volume, and mean cortical thickness compared with the controls, whereas white matter volumes were significantly increased in ADHD. Highly significant cortical thinning (false discovery rate-corrected p < .0006) was observed over large areas of the frontal, temporal, parietal, and occipital association cortices and aspects of motor cortex but not within the primary sensory regions. Conclusions Cortical thickness reductions present a robust neuroanatomical marker for child and adolescent ADHD. Observations of widespread cortical thinning expand on earlier cross-sectional findings and provide further evidence to support that the neurobiological underpinnings of ADHD extend beyond prefrontal and subcortical circuits.