White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder
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Background Attention-deficit/hyperactivity disorder (ADHD) is increasingly conceived as reflecting altered functional and structural brain connectivity. The latter can be addressed with diffusion tensor imaging (DTI). We examined fractional anisotropy (FA), a DTI index related to white matter structural properties, in adult male subjects diagnosed with ADHD in childhood (probands) and matched control subjects without childhood ADHD. Additionally, we contrasted FA among probands with and without current ADHD in adulthood and control subjects.Methods Participants were from an original cohort of 207 boys and 178 male control subjects. At 33-year follow-up, analyzable DTI scans were obtained in 51 probands (41.3 ± 2.8 yrs) and 66 control subjects (41.2 ± 3.1 yrs). Voxel-based FA was computed with tract-based spatial statistics, controlling for multiple comparisons.Results Probands with childhood ADHD exhibited significantly lower FA than control subjects without childhood ADHD in the right superior and posterior corona radiata, right superior longitudinal fasciculus, and in a left cluster including the posterior thalamic radiation, the retrolenticular part of the internal capsule, and the sagittal stratum (p<.05, corrected). Fractional anisotropy was significantly decreased relative to control subjects in several tracts in both probands with current and remitted ADHD, who did not differ significantly from each other. Fractional anisotropy was not significantly increased in probands in any region.Conclusions Decreased FA in adults with childhood ADHD regardless of current ADHD might be an enduring trait of ADHD. White matter tracts with decreased FA connect regions involved in high-level as well as sensorimotor functions, suggesting that both types of processes are involved in the pathophysiology of ADHD.
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Functional and structural deficits in frontal lobe and thalamus are associated with the emergence of ADHD.
“Studies suggest that functional and structural deficits in frontal lobe and thalamus are associated with the emergence of ADHD (Proal et al., 2011; Xia et al., 2012; Cortese et al., 2013; Shaw et al., 2015);”
From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Cortese et al., 2013
The Discussion (page not provided) reports white-matter alterations in pathways connected to frontal regions and in the posterior thalamic radiation among adults with childhood ADHD. It also describes frontal abnormalities reported in structural and functional studies. It does not establish functional or structural deficits in the thalamus itself or link these abnormalities to the emergence of ADHD. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA number of existing cross-sectional and longitudinal studies in patients with cADHD support the role of subcortical structures in the emergence of ADHD by showing that reduction of GM volume in thalamus and striatum, and disruption of WM integrity in the major association and projection tracts, contribute to the etiology of ADHD.
“A number of existing cross-sectional and longitudinal studies in patients with cADHD support the role of subcortical structures in the emergence of ADHD by showing that reduction of GM volume in thalamus and striatum, and disruption of WM integrity in the major association and projection tracts, contribute to the etiology of ADHD (Xia et al., 2012; Cortese et al., 2013; Shaw et al., 2015).”
From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Cortese et al., 2013
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- Authors
- Cortese, S., Imperati, D., Zhou, J., Proal, E., Klein, R. G., Mannuzza, S., Ramos-Olazagasti, M. A., Milham, M. P., Kelly, C., & Castellanos, F. X.
- Affiliations
- Université de Tours (FR)
- NYU Langone Health (US)
- Agency for Science, Technology and Research (SG)
- Nathan Kline Institute for Psychiatric Research (US)
- Corresponding author
- Cortese, Samuele
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 74
- Issue
- 8
- Pages
- 591-598
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC3720804
- OpenAlex
- W2052598588
- Cited by
- 127
- References
- 71
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 2 · 2023: 8 · 2022: 14 · 2021: 6 · 2020: 11 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 12 · 2015: 22 · 2014: 14 · 2013: 3
- FWCI
- 12.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- National Institutes of Health (5t32mh067763-10)
- National Institute of Mental Health (R01MH018579, T32MH-067763)
- National Institute on Drug Abuse (R01DA016979)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, white matter changes, fractional anisotropy, corona radiata, superior longitudinal fasciculus, thalamic radiation, internal capsule, long-term follow-up, adult ADHD, brain connectivity, white matter tracts
- MeSH terms
- Adult, Age Factors, Attention Deficit Disorder with Hyperactivity, Brain, Follow-Up Studies, Humans, Male, Diffusion Tensor Imaging
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