Childhood psychiatric disorders as anomalies in neurodevelopmental trajectories
Open accessAbstract
Childhood psychiatric disorders are rarely static; rather they change over time and longitudinal studies are ideally suited to capture such dynamic processes. Using longitudinal data, insights can be gained into the nature of the perturbation away from the trajectory of typical development in childhood disorders. Thus, some disorders may reflect a delay in neurodevelopmental trajectories. Our studies in children with attention-deficit/hyperactivity disorder (ADHD) suggest that cortical development is delayed with a rightward shift along the age axis in cortical trajectories, most prominent in prefrontal cortical regions. Other disorders may be characterized by differences in the velocity of trajectories: the basic shape of neurodevelopmental curves remains intact, but with disrupted tempo. Thus, childhood onset schizophrenia is associated with a marked increase during adolescence in the velocity of loss of cerebral gray matter. By contrast, in childhood autism there is an early acceleration of brain growth, which overshoots typical dimensions leading to transient cerebral enlargement. Finally, there may be more profound deviations from typical neurodevelopment, with a complete "derailing" of brain growth and a loss of the features which characterize typical brain development. An example is the almost complete silencing of white matter growth during adolescence of patients with childhood onset schizophrenia. Adopting a longitudinal perspective also readily lends itself to the understanding of the neural bases of differential clinical outcomes. Again taking ADHD as an example, we found that remission is associated with convergence to the template of typical development, whereas persistence is accompanied by progressive divergence away from typical trajectories.
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A recent review suggests that remission in ADHD with age may be linked to normalization of initial delays or deficits in brain networks, whereas persistence into adolescence may be associated with a lack of normalization and perhaps a more deviant trajectory of brain growth.
“A recent review focusing on trajectories of brain development (Shaw, Gogtay, & Rapoport, 2010) suggests that remission in ADHD with age may be linked to a normalization of initial delays or deficits in brain networks, whereas ADHD persistence into adolescence may be associated with a lack of normalization and perhaps a more deviant trajectory of brain growth.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Shaw et al., 2010
The group treated consistently with stimulant medication appeared to show normalization in the trajectory of brain development, but this group was self-selected and may differ on other factors related to outcome.
“Surprisingly, the group that had been treated consistently with stimulant medication appeared to show normalization in the trajectory of brain development (for a review see Shaw et al (2010)), but this group was self-selected and may differ on other factors related to outcome.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Shaw et al (2010)
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- Authors
- Shaw, P., Gogtay, N., & Rapoport, J.
- Affiliations
- National Institute of Mental Health (US)
- Corresponding author
- Shaw, Philip
- ORCID
- Shaw, Philip
- Venue
- Human Brain Mapping
- Publisher
- Wiley
- Published
- 2010-05-14
- Volume
- 31
- Issue
- 6
- Pages
- 917-925
- ISSN
- 1065-9471 (ISSN-L)
- 1097-0193
- PMC
- PMC6870870
- OpenAlex
- W2095832213
- Cited by
- 216
- References
- 15
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 16 · 2023: 6 · 2022: 11 · 2021: 7 · 2020: 15 · 2019: 8 · 2018: 22 · 2017: 11 · 2016: 10 · 2015: 21 · 2014: 19 · 2013: 12 · 2012: 21
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Brain Mapping (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- child psychopathology, neurodevelopmental trajectories, attention deficit hyperactivity disorder, childhood schizophrenia, autism spectrum disorder, cortical development, prefrontal cortex, gray matter loss, white matter development, longitudinal brain development, remission
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Mental Disorders, Brain, Child, Humans
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