A Systematic Review of Imaging Studies in the Combined and Inattentive Subtypes of Attention Deficit Hyperactivity Disorder

Saad, Jacqueline F.; Griffiths, Kristi R.; Korgaonkar, Mayuresh S.

doi:10.3389/fnint.2020.00031

Cited by 59 publications

(54 citation statements)

References 106 publications

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“…Fall and colleagues [ 49 ] indirectly support these findings reporting mean reaction times correlated with MD values in the striatum and thalamus in ADHD-C compared to controls. Interestingly, these results are consistent with studies using structural gray matter and resting state functional connectivity, reported in a recent review [ 50 ] which have shown disruptions in the motor network in ADHD-C. Whether these structural connectivity disruptions or the absence of WM abnormalities attribute to functional deficits associated with the subtypes of ADHD, remain unconfirmed.…”

Section: Discussionsupporting

confidence: 91%

No support for white matter connectivity differences in the combined and inattentive ADHD presentations

et al. 2021

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Evidence from functional neuroimaging studies support neural differences between the Attention Deficit Hyperactivity Disorder (ADHD) presentation types. It remains unclear if these neural deficits also manifest at the structural level. We have previously shown that the ADHD combined, and ADHD inattentive types demonstrate differences in graph properties of structural covariance suggesting an underlying difference in neuroanatomical organization. The goal of this study was to examine and validate white matter brain organization between the two subtypes using both scalar and connectivity measures of brain white matter. We used both tract-based spatial statistical (TBSS) and tractography analyses with network-based Statistics (NBS) and graph-theoretical analyses in a cohort of 35 ADHD participants (aged 8–17 years) defined using DSM-IV criteria as combined (ADHD-C) type (n = 19) or as predominantly inattentive (ADHD-I) type (n = 16), and 28 matched neurotypical controls. We performed TBSS analyses on scalar measures of fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivity to assess differences in WM between ADHD types and controls. NBS and graph theoretical analysis of whole brain inter-regional tractography examined connectomic differences and brain network organization, respectively. None of the scalar measures significantly differed between ADHD types or relative to controls. Similarly, there were no tractography connectivity differences between the two subtypes and relative to controls using NBS. Global and regional graph measures were also similar between the groups. A single significant finding was observed for nodal degree between the ADHD-C and controls, in the right insula (corrected p = .029). Our result of no white matter differences between the subtypes is consistent with most previous findings. These findings together might suggest that the white matter structural architecture is largely similar between the DSM-based ADHD presentations is similar to the extent of being undetectable with the current cohort size.

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Section: Discussionsupporting

confidence: 91%

No support for white matter connectivity differences in the combined and inattentive ADHD presentations

et al. 2021

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“…There is a vast collection of extant literature on neurobiological correlates of ADHD that could ultimately inform a precision medicine approach [ 13 , 14 ]. In this review, we focus on deficient fronto-striatal connectivity driven by atypical balance of neural excitation and inhibition (E/I).…”

Section: Introduction: Need For Precision Medicine Care In Adhdmentioning

confidence: 99%

Precision Medicine Care in ADHD: The Case for Neural Excitation and Inhibition

2021

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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has become increasingly prevalent worldwide. Its core symptoms, including difficulties regulating attention, activity level, and impulses, appear in early childhood and can persist throughout the lifespan. Current pharmacological options targeting catecholamine neurotransmissions have effectively alleviated symptoms in some, but not all affected individuals, leaving clinicians to implement trial-and-error approach to treatment. In this review, we discuss recent experimental evidence from both preclinical and human studies that suggest imbalance of excitation/inhibition (E/I) in the fronto-striatal circuitry during early development may lead to enduring neuroanatomical abnormality of the circuitry, causing persistence of ADHD symptoms in adulthood. We propose a model of precision medicine care that includes E/I balance as a candidate biomarker for ADHD, development of GABA-modulating medications, and use of magnetic resonance spectroscopy and scalp electrophysiology methods to monitor the effects of treatments on shifting E/I balance throughout the lifespan.

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“…Furthermore, structural and functional imaging studies have shown evidence of altered brain volumes in ADHD leading to dysfunction in fronto-subcortical pathways [ 11 ]. A recent fMRI study noted that the altered connectivity in the cerebellar network was present in the combined type of ADHD (inattentive and hyperactive) as compared with alterations in the cingulo-frontoparietal attention and visual networks found in the predominately inattentive subtype [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Chiari Malformation and Attention Deficit Hyperactivity Disorder

DuBow

Mourot

Tourjman

2020

Case Reports in Medicine

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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Chiari malformations (CM), first described approximately a hundred years ago, refer to a spectrum of hindbrain malformations characterized by cerebellar herniation through the foramen magnum. We present the case of a 28-year-old woman with ADHD and concurrent Chiari malformation type I (CM-I) that was diagnosed by CT scan. There is growing evidence supporting the role of the cerebellum and its associated structures in the pathophysiology of ADHD. Thus, a cerebellar malformation such as CM may impact neurological circuitry in a manner favoring the development of a neuropsychiatric disorder such as ADHD. Our case highlights the need for further studies pertaining to the role of the cerebellum in the pathophysiology of ADHD and the importance of considering the presence of CM when evaluating a patient with ADHD.

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A Systematic Review of Imaging Studies in the Combined and Inattentive Subtypes of Attention Deficit Hyperactivity Disorder

Cited by 59 publications

References 106 publications

No support for white matter connectivity differences in the combined and inattentive ADHD presentations

No support for white matter connectivity differences in the combined and inattentive ADHD presentations

Precision Medicine Care in ADHD: The Case for Neural Excitation and Inhibition

Chiari Malformation and Attention Deficit Hyperactivity Disorder

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