A Shrinking Brain or a Visit to the Shrink? The Curious Case of ADHD

Mental Health


A meta-analysis of pooled individual data from cohorts of cases and controls found that participants with attention deficit hyperactivity disorder (ADHD) from 23 sites in North and South America, Europe and China had smaller amygdala, accumbens, and hippocampus volumes compared to healthy controls.

 

Previously, meta-analyses of clinical data revealed reduced volumes of basal ganglia, caudate, cerebellum, front and temporal gray matter in patients with ADHD with strong correlation between ADHD symptoms and volumetric brain measures. However, covariates such as age and medication were limitations in these meta-analyses. Therefore, the ENIGMA ADHD Working Group aggregated structural MRI data from participants with ADHD and healthy controls across 60 years of the lifespan. The ENIGMA group, led by Martine Hoogman at the Department of Human Genetics from the Radboud University Medical Center in the Netherlands, acquired structural T1 weighted brain magnetic resonance imaging (MRI) data. These scans were from subcortical brain regions as theories surrounding neurodevelopment consistently report abnormalities in these subcortical volumes in ADHD.

The ENIGMA group, led by Martine Hoogman at the Department of Human Genetics from the Radboud University Medical Center in the Netherlands, acquired structural T1 weighted brain magnetic resonance imaging (MRI) data. These scans were from subcortical brain regions as theories surrounding neurodevelopment consistently report abnormalities in these subcortical volumes in ADHD.Data from 1713 patients with ADHD and 1529 healthy controls revealed that patients with ADHD had smaller volumes for the

Data from 1713 patients with ADHD and 1529 healthy controls revealed that patients with ADHD had smaller volumes for the accumbens, amygdala, caudate, hippocampus, putamen and intra-cranial volume, with effect sizes being higher in children, where the prevalence of ADHD is 5.3%.Compared to previous studies where other brain structures were identified as being smaller in ADHD,

Compared to previous studies where other brain structures were identified as being smaller in ADHD, Hoogman and colleagues found that the amygdala, accumbens and hippocampus volumes were newly identified as being smaller in ADHD patients. The effect of reduced brain volumes in ADHD patients is mostly exerted on emotional regulation, motivation, and memory. These results suggest that ADHD is a disorder of the brain, particularly a delayed maturation of the brain and are not influenced by comorbid disorders and medication. The study comes with several caveats – mostly related to the observations made with regard to effect of age, particularly when the sample size for various age groups was too small to rule out site-biases. Nevertheless, this is the first study of its kind that examined patients with ADHD in a

Nevertheless, this is the first study of its kind that examined patients with ADHD in a meta-analysis and found clinically relevant findings that provide hypotheses for basic research into the implications of smaller brain volumes on neural stem cells, synapse formation, brain function and brain phenotypes. The important question now is whether therapeutic modulation is possible and how, if ever, is ADHD modified by the second brain in our bodies, the microbiome.

 

Written By: Joseph M. Anthony, PhD



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