TY - JOUR
T1 - Brain Imaging of the Cortex in ADHD: A Coordinated Analysis of Large-Scale Clinical and Population-Based Samples
AU - Hoogman, Martine
AU - Muetzel, Ryan
AU - Guimaraes, Joao P.
AU - Shumskaya, Elena
AU - Mennes, Maarten
AU - Zwiers, Marcel P.
AU - Jahanshad, Neda
AU - Sudre, Gustavo
AU - Wolfers, Thomas
AU - Earl, Eric A.
AU - Vila, Juan Carlos Soliva
AU - Vives-Gilabert, Yolanda
AU - Khadka, Sabin
AU - Novotny, Stephanie E.
AU - Hartman, Catharina A.
AU - Heslenfeld, Dirk J.
AU - Schweren, Lizanne J.S.
AU - Ambrosino, Sara
AU - Oranje, Bob
AU - Zeeuw, Patrick de
AU - Chaim-Avancini, Tiffany M.
AU - Rosa, Pedro G.P.
AU - Zanetti, Marcus V.
AU - Malpas, Charles B.
AU - Kohls, Gregor
AU - Polier, Georg G. von
AU - Seitz, Jochen
AU - Biederman, Joseph
AU - Doyle, Alysa E.
AU - Dale, Anders M.
AU - Erp, Theo G.M. van
AU - Epstein, Jeffery N.
AU - Jernigan, Terry L.
AU - Baur-Streubel, Ramona
AU - Ziegler, Georg C.
AU - Zierhut, Kathrin C.
AU - Schrantee, Anouk
AU - Høvik, Marie F.
AU - Lundervold, Astri J.
AU - Kelly, Clare
AU - McCarthy, Hazel
AU - Skokauskas, Norbert
AU - Tuura, Ruth L. O’Gorman
AU - Calvo, Anna
AU - Lera-Miguel, Sara
AU - Nicolau, Rosa
AU - Chantiluke, Kaylita C.
AU - Christakou, Anastasia
AU - Vance, Alasdair
AU - Cercignani, Mara
AU - Gabel, Matt C.
PY - 2019/7
Y1 - 2019/7
N2 - Objective: Neuroimaging studies show structural alterations of various brain regions in children and adults with attention deficit hyperactivity disorder (ADHD), although nonrepli-cations are frequent. The authors sought to identify cortical characteristics related to ADHD using large-scale studies. Methods: Cortical thickness and surface area (based on the Desikan–Killiany atlas) were compared between case subjects with ADHD (N=2,246) and control subjects (N=1,934) for children, adolescents, and adults separately in ENIGMA-ADHD, a consortium of 36 centers. To assess familial effects on cortical measures, case subjects, unaffected siblings, and control subjects in the NeuroIMAGE study (N=506) were compared. Associations of the attention scale from the Child Behavior Checklist with cortical measures were determined in a pediatric population sample (Generation-R, N=2,707). Results: In the ENIGMA-ADHD sample, lower surface area values were found in children with ADHD, mainly in frontal, cingulate, and temporal regions; the largest significant effect was for total surface area (Cohen’s d=20.21). Fusiform gyrus and temporal pole cortical thickness was also lower in children with ADHD. Neither surface area nor thickness differences were found in the adolescent or adult groups. Familial effects were seen for surface area in several regions. In an overlapping set of regions, surface area, but not thickness, was associated with attention problems in the Generation-R sample. Conclusions: Subtle differences in cortical surface area are widespread in children but not adolescents and adults with ADHD, confirming involvement of the frontal cortex and highlighting regions deserving further attention. Notably, the alterations behave like endophenotypes in families and are linked to ADHD symptoms in the population, extending evidence that ADHD behaves as a continuous trait in the population. Future longitudinal studies should clarify individual lifespan trajectories that lead to nonsignificant findings in adolescent and adult groups despite the presence of an ADHD diagnosis.
AB - Objective: Neuroimaging studies show structural alterations of various brain regions in children and adults with attention deficit hyperactivity disorder (ADHD), although nonrepli-cations are frequent. The authors sought to identify cortical characteristics related to ADHD using large-scale studies. Methods: Cortical thickness and surface area (based on the Desikan–Killiany atlas) were compared between case subjects with ADHD (N=2,246) and control subjects (N=1,934) for children, adolescents, and adults separately in ENIGMA-ADHD, a consortium of 36 centers. To assess familial effects on cortical measures, case subjects, unaffected siblings, and control subjects in the NeuroIMAGE study (N=506) were compared. Associations of the attention scale from the Child Behavior Checklist with cortical measures were determined in a pediatric population sample (Generation-R, N=2,707). Results: In the ENIGMA-ADHD sample, lower surface area values were found in children with ADHD, mainly in frontal, cingulate, and temporal regions; the largest significant effect was for total surface area (Cohen’s d=20.21). Fusiform gyrus and temporal pole cortical thickness was also lower in children with ADHD. Neither surface area nor thickness differences were found in the adolescent or adult groups. Familial effects were seen for surface area in several regions. In an overlapping set of regions, surface area, but not thickness, was associated with attention problems in the Generation-R sample. Conclusions: Subtle differences in cortical surface area are widespread in children but not adolescents and adults with ADHD, confirming involvement of the frontal cortex and highlighting regions deserving further attention. Notably, the alterations behave like endophenotypes in families and are linked to ADHD symptoms in the population, extending evidence that ADHD behaves as a continuous trait in the population. Future longitudinal studies should clarify individual lifespan trajectories that lead to nonsignificant findings in adolescent and adult groups despite the presence of an ADHD diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=85069237582&partnerID=8YFLogxK
U2 - 10.1176/appi.ajp.2019.18091033
DO - 10.1176/appi.ajp.2019.18091033
M3 - Article
SN - 0002-953X
VL - 176
SP - 531
EP - 542
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 7
ER -