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Tolonen T, Roine T, Alho K, Leppämäki S, Tani P, Koski A, Laine M, Salmi J. Abnormal wiring of the structural connectome in adults with ADHD. Netw Neurosci 2023; 7:1302-1325. [PMID: 38144696 PMCID: PMC10631790 DOI: 10.1162/netn_a_00326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/19/2023] [Indexed: 12/26/2023] Open
Abstract
Current knowledge of white matter changes in large-scale brain networks in adult attention-deficit/hyperactivity disorder (ADHD) is scarce. We collected diffusion-weighted magnetic resonance imaging data in 40 adults with ADHD and 36 neurotypical controls and used constrained spherical deconvolution-based tractography to reconstruct whole-brain structural connectivity networks. We used network-based statistic (NBS) and graph theoretical analysis to investigate differences in these networks between the ADHD and control groups, as well as associations between structural connectivity and ADHD symptoms assessed with the Adult ADHD Self-Report Scale or performance in the Conners Continuous Performance Test 2 (CPT-2). NBS revealed decreased connectivity in the ADHD group compared to the neurotypical controls in widespread unilateral networks, which included subcortical and corticocortical structures and encompassed dorsal and ventral attention networks and visual and somatomotor systems. Furthermore, hypoconnectivity in a predominantly left-frontal network was associated with higher amount of commission errors in CPT-2. Graph theoretical analysis did not reveal topological differences between the groups or associations between topological properties and ADHD symptoms or task performance. Our results suggest that abnormal structural wiring of the brain in adult ADHD is manifested as widespread intrahemispheric hypoconnectivity in networks previously associated with ADHD in functional neuroimaging studies.
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Affiliation(s)
- Tuija Tolonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Timo Roine
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
- Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Kimmo Alho
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- AMI Centre, Aalto Neuroimaging, Aalto University, Espoo, Finland
| | | | - Pekka Tani
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Anniina Koski
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Matti Laine
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Juha Salmi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
- AMI Centre, Aalto Neuroimaging, Aalto University, Espoo, Finland
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Parlatini V, Itahashi T, Lee Y, Liu S, Nguyen TT, Aoki YY, Forkel SJ, Catani M, Rubia K, Zhou JH, Murphy DG, Cortese S. White matter alterations in Attention-Deficit/Hyperactivity Disorder (ADHD): a systematic review of 129 diffusion imaging studies with meta-analysis. Mol Psychiatry 2023; 28:4098-4123. [PMID: 37479785 PMCID: PMC10827669 DOI: 10.1038/s41380-023-02173-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
Aberrant anatomical brain connections in attention-deficit/hyperactivity disorder (ADHD) are reported inconsistently across diffusion weighted imaging (DWI) studies. Based on a pre-registered protocol (Prospero: CRD42021259192), we searched PubMed, Ovid, and Web of Knowledge until 26/03/2022 to conduct a systematic review of DWI studies. We performed a quality assessment based on imaging acquisition, preprocessing, and analysis. Using signed differential mapping, we meta-analyzed a subset of the retrieved studies amenable to quantitative evidence synthesis, i.e., tract-based spatial statistics (TBSS) studies, in individuals of any age and, separately, in children, adults, and high-quality datasets. Finally, we conducted meta-regressions to test the effect of age, sex, and medication-naïvety. We included 129 studies (6739 ADHD participants and 6476 controls), of which 25 TBSS studies provided peak coordinates for case-control differences in fractional anisotropy (FA)(32 datasets) and 18 in mean diffusivity (MD)(23 datasets). The systematic review highlighted white matter alterations (especially reduced FA) in projection, commissural and association pathways of individuals with ADHD, which were associated with symptom severity and cognitive deficits. The meta-analysis showed a consistent reduced FA in the splenium and body of the corpus callosum, extending to the cingulum. Lower FA was related to older age, and case-control differences did not survive in the pediatric meta-analysis. About 68% of studies were of low quality, mainly due to acquisitions with non-isotropic voxels or lack of motion correction; and the sensitivity analysis in high-quality datasets yielded no significant results. Findings suggest prominent alterations in posterior interhemispheric connections subserving cognitive and motor functions affected in ADHD, although these might be influenced by non-optimal acquisition parameters/preprocessing. Absence of findings in children may be related to the late development of callosal fibers, which may enhance case-control differences in adulthood. Clinicodemographic and methodological differences were major barriers to consistency and comparability among studies, and should be addressed in future investigations.
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Affiliation(s)
- Valeria Parlatini
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Yeji Lee
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Siwei Liu
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thuan T Nguyen
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, National University of Singapore, Singapore, Singapore
| | - Yuta Y Aoki
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Aoki Clinic, Tokyo, Japan
| | - Stephanie J Forkel
- Donders Centre for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Centre for Neuroimaging Sciences, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
- Departments of Neurosurgery, Technical University of Munich School of Medicine, Munich, Germany
| | - Marco Catani
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Juan H Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Declan G Murphy
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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Ohnishi T, Toda W, Itagaki S, Sato A, Matsumoto J, Ito H, Ishii S, Miura I, Yabe H. Disrupted structural connectivity and less efficient network system in patients with the treatment-naive adult attention-deficit/hyperactivity disorder. Front Psychiatry 2023; 14:1093522. [PMID: 37009101 PMCID: PMC10061975 DOI: 10.3389/fpsyt.2023.1093522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder whose primary symptoms are hyperactivity, impulsivity, and inattention. Historically, ADHD was recognized as a disease of childhood and adolescence. However, many patients are known to have persistent symptoms into adulthood. Many researchers consider the neuropathology of ADHD to be based on abnormalities in multiple parallel and intersecting pathways rather than a single anatomical area, but such alterations remain to be clarified.MethodsUsing diffusion tensor imaging, we investigated differences in the global network metrics estimated by graph theory and the degree of connectivity between adjacent voxels within a white matter (WM) fascicle defined by the density of the diffusing spins (connectometry) between 19 drug-naive Japanese patients with adult ADHD and 19 matched healthy controls (HCs). In adult patients with ADHD, we examined the relationships between the symptomatology of ADHD and global network metrics and WM abnormalities.ResultsCompared with HCs, adult patients with ADHD showed a reduced rich-club coefficient and decreased connectivity in widely distributed WMs such as the corpus callosum, the forceps, and the cingulum bundle. Correlational analyses demonstrated that the general severity of ADHD symptoms was associated with several global network metrics, such as lower global efficiency, clustering coefficient, small worldness, and longer characteristic path length. The connectometry revealed that the severity of hyperactive/impulsive symptoms was associated with overconnectivity in the corticostriatal, corticospinal, and corticopontine tracts, the inferior fronto-occipital fasciculus, and the extreme capsule but dysconnectivity in the cerebellum. The severity of inattentive symptoms was associated with dysconnectivity in the intracerebellar circuit and some other fibers.ConclusionThe results of the present study indicated that patients with treatment-naive adult ADHD showed disrupted structural connectivity, which contributes to less efficient information transfer in the ADHD brain and pathophysiology of ADHD.Trial registrationUMIN Clinical Trials Registry (UMIN-CTR) UMIN000025183, Registered: 5 January 2017.
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Affiliation(s)
- Takashi Ohnishi
- Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan
- *Correspondence: Takashi Ohnishi
| | - Wataru Toda
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Aya Sato
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Junya Matsumoto
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Ito
- Department of Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
| | - Shiro Ishii
- Department of Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
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Zhou R, Dong P, Chen S, Qian A, Tao J, Zheng X, Cheng J, Yang C, Huang X, Wang M. The long-range white matter microstructural alterations in drug-naive children with ADHD: A tract-based spatial statistics study. Psychiatry Res Neuroimaging 2022; 327:111548. [PMID: 36279811 DOI: 10.1016/j.pscychresns.2022.111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND To investigate WM alterations, particularly the changes in long-range fibers, in drug-naive children with attention deficit hyperactivity disorder (ADHD), we conducted tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) data. MATERIALS AND METHODS In this study, 57 children with ADHD and 41 healthy controls (HCs) were enrolled. None of the enrolled ADHD children received any medication before data collection. WM changes were then correlated with clinical symptoms, including the hyperactivity index score and the impulsivity score. RESULTS ADHD children demonstrated decreased FA in the right forceps major, left inferior fronto-occipital fasciculus, and left genu Internal capsule. Moreover, higher RD was observed in the right forceps major, superior longitudinal fasciculus, and forceps major. The results of linear regression analysis including learning problem score, hyperactivity index score and impulsivity score showed that higher earning problem and hyperactivity/impulsivity symptom scores were negatively correlated with the mean FA value in the right forceps major, left IFOF and left genu Internal capsule. CONCLUSION Our results demonstrate that microstructural WM alterations and changes in the long-range WM connections are present in children with ADHD. We speculate that these changes may relate to the symptoms of hyperactivity and impulsivity.
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Affiliation(s)
- Ronghui Zhou
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Peng Dong
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo University, Ningbo 315000, China
| | - Shuangli Chen
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Andan Qian
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jiejie Tao
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiangwu Zheng
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jingliang Cheng
- Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Chuang Yang
- Department of Mental Health, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqi Huang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
| | - Meihao Wang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Chen IC, Chang CL, Chang MH, Ko LW. Atypical functional connectivity during rest and task-related dynamic alteration in young children with attention deficit hyperactivity disorder: An analysis using the phase-locking value. Psychiatry Clin Neurosci 2022; 76:235-245. [PMID: 35235255 DOI: 10.1111/pcn.13344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022]
Abstract
AIM The study investigated the electroencephalography (EEG) functional connectivity (FC) profiles during rest and tasks of young children with attention deficit hyperactivity disorder (ADHD) and typical development (TD). METHODS In total, 78 children (aged 5-7 years) were enrolled in this study; 43 of them were diagnosed with ADHD and 35 exhibited TD. Four FC metrics, coherence, phase-locking value (PLV), pairwise phase consistency, and phase lag index, were computed for feature selection to discriminate ADHD from TD. RESULTS The support vector machine classifier trained by phase-locking value (PLV) features yielded the best performance to differentiate the ADHD from the TD group and was used for further analysis. In comparing PLVs with the TD group at rest, the ADHD group exhibited significantly lower values on left intrahemispheric long interelectrode lower-alpha and beta as well as frontal interhemispheric beta frequency bands. However, the ADHD group showed higher values of central interhemispheric PLVs on the theta, higher-alpha, and beta bands. Regarding PLV alterations within resting and task conditions, left intrahemispheric long interelectrode beta PLVs declined from rest to task in the TD group, but the alterations did not differ in the ADHD group. Negative correlations were observed between frontal interhemispheric beta PLVs and the Disruptive Behavior Disorder Rating Scale as rated by teachers. CONCLUSIONS These results, which complement the findings of other sparse studies that have investigated task-related brain FC dynamics, particularly in young children with ADHD, can provide clinicians with significant and interpretable neural biomarkers for facilitating the diagnosis of ADHD.
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Affiliation(s)
- I-Chun Chen
- International Ph. D. Program in Interdisciplinary Neuroscience, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Physical Medicine and Rehabilitation, Ton-Yen General Hospital, Hsinchu, Taiwan
| | | | - Meng-Han Chang
- Department of Psychiatry, Ton-Yen General Hospital, Hsinchu, Taiwan
| | - Li-Wei Ko
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Electrical Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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ElShahawi HH, Effat SM, Shorab EM, Sakr HM, Azab SE, Aufa OM. Study of white matter integrity in fathers of children with attention deficit hyperactivity disorder. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Attention deficit hyperactivity disorder (ADHD) is an early-onset neurodevelopmental disorder that can extend into adulthood with multiple reported neuroimaging abnormalities. The focus of this research was to assess white matter impairments in ADHD children’s fathers with and without potential adult ADHD to see if these differences are connected with the persistence of ADHD into adulthood.
Results
The occurrence rate of the potential adult ADHD diagnosis among fathers of children with ADHD was 60%. There were statistically significant differences between fathers with ADHD and the non-ADHD population, due to the fact that the mean FA of the left superior corona radiata and the right posterior corona radiata were lower in the ADHD group than in the non-ADHD group, while the FA of the ADHD group was significantly greater than that of the non-ADHD group in terms of the left and right anterior thalamic radiations, the right superior longitudinal fasciculus and the left anterior corona radiata.
Conclusions
We observed an increased prevalence of ADHD in fathers of children diagnosed with ADHD. Fathers with potential adult ADHD have a variety of white matter abnormalities that reflect the neurobiological basis of ADHD, even in sub-threshold cases. This may provide insight into the neuroanatomical locations associated with the maintenance of ADHD throughout adulthood.
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Miettunen J, Haapea M, Björnholm L, Huhtaniska S, Juola T, Kinnunen L, Lehtiniemi H, Lieslehto J, Rautio N, Nordström T. Psychiatric research in the Northern Finland Birth Cohort 1986 - a systematic review. Int J Circumpolar Health 2019; 78:1571382. [PMID: 30744507 PMCID: PMC6374936 DOI: 10.1080/22423982.2019.1571382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Northern Finland Birth Cohort 1986 is a large population-based birth cohort, which aims to promote health and wellbeing of the population. In this paper, we systematically review the psychiatric research performed in the cohort until today, i.e. at the age of 32 years of the cohort (2018). We conducted a systematic literature search using the databases of PubMed and Scopus and complemented it with a manual search. We found a total of 94 articles, which were classified as examining ADHD, emotional and behavioural problems, psychosis risk or other studies relating to psychiatric subjects. The articles are mainly based on two large comprehensive follow-up studies of the cohort and several substudies. The studies have often used also nationwide register data. The studies have found several early predictors for the aforementioned psychiatric outcomes, such as problems at pregnancy and birth, family factors in childhood, physical inactivity and substance use in adolescence. There are also novel findings relating to brain imaging and cognition, for instance regarding familial risk of psychosis in relation to resting state functional MRI. The Northern Finland Birth Cohort 1986 has been utilised frequently in psychiatric research and future data collections are likely to lead to new scientifically important findings. Abbreviations: attention deficit hyperactivity disorder (ADHD); magnetic resonance imaging (MRI)
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Affiliation(s)
- Jouko Miettunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Marianne Haapea
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,c Department of Psychiatry , Oulu University Hospital , Oulu , Finland
| | - Lassi Björnholm
- c Department of Psychiatry , Oulu University Hospital , Oulu , Finland.,d Department of Psychiatry , Research Unit of Clinical Neuroscience, University of Oulu , Oulu , Finland
| | - Sanna Huhtaniska
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Teija Juola
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Lotta Kinnunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Heli Lehtiniemi
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
| | - Johannes Lieslehto
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Nina Rautio
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Tanja Nordström
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
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Sudre G, Mangalmurti A, Shaw P. Growing out of attention deficit hyperactivity disorder: Insights from the 'remitted' brain. Neurosci Biobehav Rev 2018; 94:198-209. [PMID: 30194962 DOI: 10.1016/j.neubiorev.2018.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/14/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022]
Abstract
We consider developmental and cognitive models to explain why some children 'grow out' of attention deficit hyperactivity disorder (ADHD) by adulthood. The first model views remission as a convergence towards more typical brain function and structure. In support, some studies find that adult remitters are indistinguishable from those who were never affected in the neural substrates of 'top-down' mechanisms of cognitive control, some 'bottom-up' processes of vigilance/response preparation, prefrontal cortical morphology and intrinsic functional connectivity. A second model postulates that remission is driven by the recruitment of new brain systems that compensate for ADHD symptoms. It draws support from demonstrations of atypical, but possibly beneficial, patterns of connectivity within the cognitive control network in adult remitters. The final model holds that some childhood ADHD anomalies show lifelong persistence, regardless of adult outcome, supported by shared reports of anomalies in remitters and persisters in posterior cerebral and striato-thalamic regions. The models are compatible: different processes driving remission might occur in different brain regions. These models provide a framework for future studies which might inform novel treatments to 'accelerate' remission.
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Affiliation(s)
- Gustavo Sudre
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States
| | - Aman Mangalmurti
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States.
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Li D, Li S, Zeng X. Analysis of alterations in white matter integrity of adult patients with comitant exotropia. J Int Med Res 2018; 46:1963-1972. [PMID: 29569963 PMCID: PMC5991243 DOI: 10.1177/0300060518763704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study was performed to investigate structural abnormalities of the white matter in patients with comitant exotropia using the tract-based spatial statistics (TBSS) method. Methods Diffusion tensor imaging data from magnetic resonance images of the brain were collected from 20 patients with comitant exotropia and 20 age- and sex-matched healthy controls. The FMRIB Software Library was used to compute the diffusion measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). These measures were obtained using voxel-wise statistics with threshold-free cluster enhancement. Results The FA values in the right inferior fronto-occipital fasciculus (IFO) and right inferior longitudinal fasciculus were significantly higher and the RD values in the bilateral IFO, forceps minor, left anterior corona radiata, and left anterior thalamic radiation were significantly lower in the comitant exotropia group than in the healthy controls. No significant differences in the MD or AD values were found between the two groups. Conclusions Alterations in FA and RD values may indicate the underlying neuropathologic mechanism of comitant exotropia. The TBSS method can be a useful tool to investigate neuronal tract participation in patients with this disease.
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Affiliation(s)
- Dan Li
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
| | - Shenghong Li
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
| | - Xianjun Zeng
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
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Aoki Y, Cortese S, Castellanos FX. Research Review: Diffusion tensor imaging studies of attention-deficit/hyperactivity disorder: meta-analyses and reflections on head motion. J Child Psychol Psychiatry 2018; 59:193-202. [PMID: 28671333 DOI: 10.1111/jcpp.12778] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Diffusion tensor imaging studies have shown atypical fractional anisotropy (FA) in individuals with attention-deficit/hyperactivity disorder (ADHD), albeit with conflicting results. We performed meta-analyses of whole-brain voxel-based analyses (WBVBA) and tract-based spatial statistics (TBSS) studies in ADHD, along with a qualitative review of TBSS studies addressing the issue of head motion, which may bias results. METHODS We conducted a systematic literature search (last search on April 1st, 2016) to identify studies comparing FA values between individuals with ADHD and typically developing (TD) participants. Signed differential mapping was used to compute effect sizes and integrate WBVBA and TBSS studies, respectively. TBSS datasets reporting no between-group motion differences were identified. RESULTS We identified 14 WBVBA (ADHDn = 314, TDn = 278) and 13 TBSS datasets (ADHDn = 557, TDn = 568). WBVBA meta-analysis showed both significantly lower and higher FA values in individuals with ADHD; TBSS meta-analysis showed significantly lower FA in ADHD compared with TD in four clusters: two in the corpus callosum (isthmus and posterior midbody), one in right inferior fronto-occipital fasciculus, and one in left inferior longitudinal fasciculus. However, four of six datasets confirming no group-differences in motion showed no significant between-group FA differences. CONCLUSIONS A growing diffusion tensor imaging (DTI) literature (total N = 1,717) and a plethora of apparent findings suggest atypical interhemispheric connection in ADHD. However, FA results in ADHD should be considered with caution, since many studies did not examine potential group differences in head motion, and most of the studies reporting no difference in motion showed no significant results. Future studies should address head motion as a priority and assure that groups do not differ in head motion.
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Affiliation(s)
- Yuta Aoki
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Samuele Cortese
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA.,Academic Unit of Psychology and Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, Southampton.,Solent NHS Trust, Southampton, UK
| | - Francisco Xavier Castellanos
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA.,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Wu ZM, Bralten J, Cao QJ, Hoogman M, Zwiers MP, An L, Sun L, Yang L, Zang YF, Franke B, Wang YF. White Matter Microstructural Alterations in Children with ADHD: Categorical and Dimensional Perspectives. Neuropsychopharmacology 2017; 42:572-580. [PMID: 27681441 PMCID: PMC5399244 DOI: 10.1038/npp.2016.223] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 11/09/2022]
Abstract
Studies of brain alterations in children with attention-deficit/hyperactivity disorder (ADHD) have shown heterogeneous results. The aims of the current study were to investigate white matter microstructure in children using both categorical and dimensional definitions of ADHD and to determine the functional consequences of observed alterations. In a large single-site sample of children (aged 8-15 years) with ADHD (n=83) and healthy controls (n=122), we used tract-based spatial statistics on diffusion tensor imaging data to investigate whole-skeleton differences of fractional anisotropy (FA), mean, axial, and radial diffusivity (MD, AD, RD), and mode of anisotropy related to ADHD status (categorical) and symptom severity (dimensional). For categorical differences observed, we analyzed their association with cognitive functioning in working memory and inhibition. Compared with healthy controls, children with ADHD showed decreased FA and increased RD in widespread, overlapping brain regions, mainly in corpus callosum (CC) and major tracts in the left hemisphere. Decreased FA was associated with inhibition performance in the participants with ADHD. Using dimensional definitions, greater hyperactivity/impulsivity symptom severity was associated with higher FA also in widespread regions, mainly in CC and major tracts in the right hemisphere. Our study showed white matter alterations to be related to ADHD status and symptom severity in patients. The coexistence of decreased FA and increased RD in the absence of alterations in MD or AD might indicate altered myelination as a pathophysiological factor in ADHD.
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Affiliation(s)
- Zhao-Min Wu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Qing-Jiu Cao
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Li An
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Li Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Li Yang
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yu-Feng Wang
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
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12
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A systematic review and meta-analysis of tract-based spatial statistics studies regarding attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev 2016; 68:838-847. [PMID: 27450582 DOI: 10.1016/j.neubiorev.2016.07.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 07/18/2016] [Accepted: 07/19/2016] [Indexed: 02/05/2023]
Abstract
Diffusion tensor imaging (DTI) studies that use tract-based spatial statistics (TBSS) have demonstrated the microstructural abnormalities of white matter (WM) in patients with attention-deficit/hyperactivity disorder (ADHD); however, robust conclusions have not yet been drawn. The present study integrated the findings of previous TBSS studies to determine the most consistent WM alterations in ADHD via a narrative review and meta-analysis. The literature search was conducted through October 2015 to identify TBSS studies that compared fractional anisotropy (FA) between ADHD patients and healthy controls. FA reductions were identified in the splenium of the corpus callosum (CC) that extended to the right cingulum, right sagittal stratum, and left tapetum. The first two clusters retained significance in the sensitivity analysis and in all subgroup analyses. The FA reduction in the CC splenium was negatively associated with the mean age of the ADHD group. We hypothesize that, in addition to the fronto-striatal-cerebellar circuit, the disturbed WM matter tracts that integrate the bilateral hemispheres and posterior-brain circuitries play a crucial role in the pathophysiology of ADHD.
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