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Cerebral Cortex Advance Access published online on August 18, 2006
Cerebral Cortex, doi:10.1093/cercor/bhl047
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Article

Cortical Thinning of the Attention and Executive Function Networks in Adults with Attention-Deficit/Hyperactivity Disorder

Nikos Makris 1 *, Joseph Biederman 2, Eve M. Valera 2, George Bush 3, Jonathan Kaiser 1, David N. Kennedy 1, Verne S. Caviness 1, Stephen V. Faraone 4, and Larry J. Seidman 5

1 Departments of Neurology and Radiology Services, Center for Morphometric Analysis, Health Sciences & Technology Athinoula A. Martinos Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; Health Sciences & Technology Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
2 Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, MA 02129, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
3 Health Sciences & Technology Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
4 Departments of Psychiatry and Neuroscience & Physiology, State University of New York Upstate Medical University, Syracuse, NY 13210, USA
5 Health Sciences & Technology Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA; Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, MA 02129, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; Department of Psychiatry, Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA

* To whom correspondence should be addressed.
Nikos Makris, E-mail: nikos{at}cma.mgh.harvard.edu


  Abstract

Attention-deficit/hyperactivity disorder (ADHD) has been associated with structural alterations in brain networks influencing cognitive and motor behaviors. Volumetric studies in children identify abnormalities in cortical, striatal, callosal, and cerebellar regions. In a prior volumetric study, we found that ADHD adults had significantly smaller overall cortical gray matter, prefrontal, and anterior cingulate volumes than matched controls. Thickness and surface area are additional indicators of integrity of cytoarchitecture in the cortex. To expand upon our earlier results and further refine the regions of structural abnormality, we carried out a structural magnetic resonance imaging study of cortical thickness in the same sample of adults with ADHD (n = 24) and controls (n = 18), hypothesizing that the cortical networks underlying attention and executive function (EF) would be most affected. Compared with healthy adults, adults with ADHD showed selective thinning of cerebral cortex in the networks that subserve attention and EF. In the present study, we found significant cortical thinning in ADHD in a distinct cortical network supporting attention especially in the right hemisphere involving the inferior parietal lobule, the dorsolateral prefrontal, and the anterior cingulate cortices. This is the first documentation that ADHD in adults is associated with thinner cortex in the cortical networks that modulate attention and EF.

Keywords: ADHD; attention; cerebral cortex; cortical thickness; executive function.
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