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Brain Development in ADHD: Insights from NIMH Study on Cortical Thickness Differences

This study examines cortical thickness variations in individuals with ADHD compared to neurotypical (NV) individuals, using MRI classification and regression analyses. Findings indicate significant group differences in regional cortical thickness, with ADHD subjects showing global thinning of approximately 0.09 mm (p=0.02). Notably, specific areas associated with attention and executive function in the right hemisphere demonstrated distinct thinning, corroborated by longitudinal analyses and clinical outcomes. The results also underline volume differences in brain regions related to cognitive control, consistent with pediatric findings.

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Brain Development in ADHD: Insights from NIMH Study on Cortical Thickness Differences

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  1. Brain Development in ADHDThe NIMH Study

  2. Processing Steps in Pictures MRI Classification Extraction of Surfaces Blurred Thickness Map Cortical Thickness Longitudinal analyses using linear mixed model regression (Pinheiro and Bates 2000) Adjustment for multiple comparisons using false discovery rate at 0.05 (Genovese et al 2002)

  3. Regional Cortical Thickness: ADHD vs NV Unadjusted thickness difference (mm) Global difference = 0.09 mm; p=.02 a. Significant group differences- t values (adjusted for IQ & mean cortical thickness) b.

  4. Baseline Cortical Thinning Differs in AD/HD Subjects with Differing Clinical Outcomes t statistics -5 -3 (i) Worse outcome v. NV (ii) Worse v. better outcome (iii) Better outcome v NV Similar pattern if use DSM-IV definitions of persistent/remitted AD/HD Linear regression: thickness of L medial prefrontal cluster (R2=0.08, p<0.001), baseline teacher hyperactivity ratings (R2=0.04, p=0.03) associated with final C-GAS scores

  5. Cortical Thinning in Adults with ADHD - similar to pediatric A. Cortical thinning in ADHD in a distinct cortical network supporting attention in the right hemisphere involving the parietal lobule, documenting that ADHD in adults is associated with thinner cortex in the cortical networks that modulate attention and executive function. Makris et al. (2007) B. Adults with ADHD have volume differences in brain regions involved in attention and executive control. These data are largely consistent with studies of children. Seidman et al. (2006) Volume Decrease Volume Increase

  6. Shaw et al. 2006: “Children with ADHD had global thinning of the cortex (mean reduction, -0.09 mm; p=.02)”

  7. fMRI Activation Peaks in ADHD Studies (relative to controls) Superimposed on Regions of Significant Cortical Thinning in NIMH Sample (Shaw et al. 2005) T=-4 T=-2.1 Rubia (1999) – ADHD<NV – motor task Ernst (2003)- ADHD>NV affective decision making Durston (2003) – ADHD>NV go/no-go Booth (2005)- ADHD<NV go/no-go Rubia (1999)– ADHD<NV go/no-go (R side) Schulz (2004) ADHD>NV go/no-go Bush (1998)- ADHD<NV counting stroop Schweitzer (2004)- ADHD<NV PASAT

  8. fMRI Activation Peaks in ADHD Studies (relative to controls) Superimposed on Regions of Significant Cortical Thinning in NIMH Sample (Shaw et al. 2005) T=-4 T=-2.1 Rubia (1999) – ADHD<NV – motor task Ernst (2003)- ADHD>NV affective decision making Durston (2003) – ADHD>NV go/no-go Booth (2005)- ADHD<NV go/no-go Rubia (1999)– ADHD<NV go/no-go (R side) Schulz (2004) ADHD>NV go/no-go Bush (1998)- ADHD<NV counting stroop Schweitzer (2004)- ADHD<NV PASAT

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