Trajectories of Cerebral Cortical Development in Childhood and Adolescence and Adult Attention-Deficit/Hyperactivity Disorder
Open accessAbstract
Background Childhood attention-deficit/hyperactivity disorder (ADHD) persists into adulthood in around half of those affected, constituting a major public health challenge. No known demographic, clinical, or neuropsychological factors robustly explain the clinical course, directing our focus to the brain. Herein, we link the trajectories of cerebral cortical development during childhood and adolescence with the severity of adult ADHD.Methods Using a longitudinal study design, 92 participants with ADHD had childhood (mean 10.7 years, SD 3.3) and adult clinical assessments (mean 23.8 years, SD 4.3) with repeated neuroanatomic magnetic resonance imaging. Contrast was made against 184 matched typically developing volunteers.Results Attention-deficit/hyperactivity disorder persisted in 37 (40%) subjects and adult symptom severity was linked to cortical trajectories. Specifically, as the number of adult symptoms increased, particularly inattentive symptoms, so did the rate of cortical thinning in the medial and dorsolateral prefrontal cortex. For each increase of one symptom of adult ADHD, the rate of cortical thinning increased by .0018 mm (SE = .0004, t = 4.2, p < .0001), representing a 5.6% change over the mean rate of thinning for the entire group. These differing trajectories resulted in a convergence toward typical dimensions among those who remitted and a fixed, nonprogressive deficit in persistent ADHD. Notably, cortical thickening or minimal thinning (greater than -.007 mm/year) was found exclusively among individuals who remitted.Conclusions Adult ADHD status is linked with the developmental trajectories of cortical components of networks supporting attention, cognitive control, and the default mode network. This informs our understanding of the developmental pathways to adult ADHD.
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New research is beginning to define neural predictors and correlates of remission in ADHD.
“New research is indeed beginning to define neural predictors and correlatesof r emission 94,95,253 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [95]
The Results report cortical trajectories associated with adult ADHD outcome: the remitted group converged toward typical cortical dimensions, supporting neural correlates of remission. But the same section says no baseline cortical regions were associated with adult symptoms, so this study does not establish a neural predictor of remission. (LLM, conf=0.87)
Experimental — accuracy not yet measuredFindings of fronto-parietal dysfunction in adult ADHD persisters are in line with evidence that attention deficits typically persist in adult ADHD and with evidence for abnormal cortical thinning in lateral fronto-parietal regions in ADHD persisters, but not remitters.
“The findings of fronto-parietal dysfunction- which mediates attention- in adult ADHD persisters is in line with evidence that attention deficits typically persist in adult ADHD and with evidence for abnormal cortical thinning in lateral fronto-parietal regions in ADHD persisters, but not remitters (Shaw et al., 2013).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Shaw et al., 2013
The Introduction and Results report that inattentive symptoms are more persistent than hyperactive-impulsive symptoms. The Results and Discussion link persistent ADHD to different cortical trajectories, including in dorsolateral prefrontal cortex, but the right parietal association did not survive correction for multiple comparisons. The Results also describe a fixed cortical deficit in persisters, not a significantly abnormal thinning rate relative to typically developing participants. (LLM, conf=0.87)
Experimental — accuracy not yet measuredRemission of ADHD has been associated with normalization of abnormalities as measured by activation during functional imaging tasks, cortical thinning and structural and functional brain connectivity.
“Remission of ADHD has been associated with normalization of abnormalities as measured by activation during functional imaging tasks 90 , cortical thinning 91 and structural and functional brain connectivity 92-95 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [95]
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Mu, S., Wu, H., Zhang, J., & Chang, C. (2022) · Cerebral Cortex · doi:10.1093/cercor/bhab276 · Cited by 29 · see citing works
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Early Predictors of De Novo and Subthreshold Late-Onset ADHD in a Child and Adolescent Cohort
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- Authors
- Shaw, P., Malek, M., Watson, B., Greenstein, D., de Rossi, P., & Sharp, W.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Shaw, Philip
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 74
- Issue
- 8
- Pages
- 599-606
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC5922431
- OpenAlex
- W2074018760
- Cited by
- 303
- References
- 59
- Citations by year
- 2026: 24 · 2025: 22 · 2024: 16 · 2023: 17 · 2022: 24 · 2021: 15 · 2020: 27 · 2019: 19 · 2018: 25 · 2017: 22 · 2016: 41 · 2015: 23 · 2014: 20 · 2013: 7
- FWCI
- 21.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Human Genome Research Institute (ZIAHG200378)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- adult ADHD, persistent ADHD, childhood ADHD, cortical development, cortical thinning, cortical thickening, prefrontal cortex, medial prefrontal cortex, dorsolateral prefrontal cortex, inattentive symptoms, symptom severity, remission, cognitive control, default mode network, developmental trajectories
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Cerebral Cortex, Child, Female, Humans, Longitudinal Studies, Male, Young Adult
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