Cerebral Cortex Advance Access published online on September 30, 2007
Cerebral Cortex, doi:10.1093/cercor/bhm156
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Attention and Executive Systems Abnormalities in Adults with Childhood ADHD: A DT-MRI Study of Connections
1 Harvard Medical School Departments of Neurology and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02129, USA, 2 MGH/MIT/HMS Athinoula A. Martinos Center for Functional and Structural Biomedical Imaging, Charlestown, MA 02129, USA, 3 Department of Community Health, Brown University, Providence, RI 02912, USA, 4 Harvard Medical School Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02129, USA, 5 Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Fruit Street, Warren 7, Boston, MA 02114, USA, 6 PhD Program in Behavioral Neuroscience, Boston University School of Medicine, Boston, MA 02118, USA, 7 Harvard Medical School, Department of Psychiatry, Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
Address correspondence to Nikos Makris, MD, PhD. Email: nikos{at}cma.mgh.harvard.edu.
Attention-deficit/hyperactivity disorder (ADHD) is hypothesized to be due, in part, to structural defects in brain networks influencing cognitive, affective, and motor behaviors. Although the current literature on fiber tracts is limited in ADHD, gray matter abnormalities suggest that white matter (WM) connections may be altered selectively in neural systems. A prior study (Ashtari et al. 2005), using diffusion tensor magnetic resonance imaging (DT-MRI), showed alterations within the frontal and cerebellar WM in children and adolescents with ADHD. In this study of adults with childhood ADHD, we hypothesized that fiber pathways subserving attention and executive functions (EFs) would be altered. To this end, the cingulum bundle (CB) and superior longitudinal fascicle II (SLF II) were investigated in vivo in 12 adults with childhood ADHD and 17 demographically comparable unaffected controls using DT-MRI. Relative to controls, the fractional anisotropy (FA) values were significantly smaller in both regions of interest in the right hemisphere, in contrast to a control region (the fornix), indicating an alteration of anatomical connections within the attention and EF cerebral systems in adults with childhood ADHD. The demonstration of FA abnormalities in the CB and SLF II in adults with childhood ADHD provides further support for persistent structural abnormalities into adulthood.
Key Words: ADHD • association fiber pathways • cingulum bundle • DT-MRI • pregenual and dorsal anterior cingulate white matter • superior longitudinal fascicle II