Meta-analysis of structural and functional alterations of brain in patients with attention-deficit/hyperactivity disorder

Abstract

BackgroundA large and growing body of neuroimaging research has concentrated on patients with attention-deficit/hyperactivity disorder (ADHD), but with inconsistent conclusions. This article was intended to investigate the common and certain neural alterations in the structure and function of the brain in patients with ADHD and further explore the differences in brain alterations between adults and children with ADHD.MethodsWe conducted an extensive literature search of whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies associated with ADHD. Two separate meta-analyses with the seed-based d mapping software package for functional neural activation and gray matter volume (GMV) were carried out, followed by a joint analysis and a subgroup analysis.ResultsThis analysis included 29 VBM studies and 36 fMRI studies. Structurally, VBM analysis showed that the largest GMV diminutions in patients with ADHD were in several frontal-parietal brain regions, the limbic system, and the corpus callosum. Functionally, fMRI analysis discovered significant hypoactivation in several frontal-temporal brain regions, the right postcentral gyrus, the left insula, and the corpus callosum.ConclusionThis study showed that abnormal alterations in the structure and function of the left superior frontal gyrus and the corpus callosum may be the key brain regions involved in the pathogenesis of ADHD in patients and may be employed as an imaging metric for patients with ADHD pending future research. In addition, this meta-analysis discovered neuroanatomical or functional abnormalities in other brain regions in patients with ADHD as well as findings that can be utilized to guide future research.

Cortical and Subcortical Structural Differences in Psychostimulant-Free ADHD Youth With and Without a Family History of Bipolar I Disorder: A Cross-Sectional Morphometric Comparison

“…In contrast to prior meta-analyses [19,20], low-risk ADHD subjects did not exhibit any signi cant cortical thickness or subcortical de cits compared with HC. The only signi cant morphological abnormality exhibited by the LR group was greater right pars opercularis surface area.…”

“…Speci cally, ADHD youth with a BD family history exhibited smaller bilateral thalamic, hippocampal, and left caudate volumes, and lower parietal, temporal and anterior cingulate cortex (ACC) surface area, compared with HC. Some of these regional de cits have previously been reported in youth with ADHD, including smaller caudate and hippocampus volumes [19,20], as well as rst-episode BD patients, including smaller temporal, parietal, orbitofrontal, and superior frontal cortical volumes [21,22]. Moreover, unaffected subjects with a BD family history exhibited reduced orbitofrontal and superior frontal cortical volumes [32,56].…”

“…The initial onset of both ADHD and BD commonly occurs during a developmental period associated with progressive cortical and subcortical structural maturational changes [16][17][18]. Consistent with a perturbation in maturational trajectories, meta-analyses of cross-sectional structural imaging studies indicate that youth with ADHD [19,20] or rst-episode BD [21,22] exhibit regional alterations in cortical and subcortical gray matter volumes compared with typically developing youth. Speci cally, ADHD youth exhibit decreased gray matter volumes in bilateral frontal gyri, bilateral superior temporal gyri, amygdala and hippocampus, and increased gray matter volumes in left middle occipital gyrus and striatum, while BD youth exhibit decreased gray matter volumes in anterior cingulate cortex, medial superior frontal gyrus and gyrus rectus, and increased gray matter volumes in posterior cingulate cortex and striatum.…”

Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder

“…In a study with a relatively large sample size of adult ADHD patients, gray matter abnormalities in localized prefrontal and cerebellar regions were associated with working memory and inattention symptoms (Duan et al, 2018), and these results were found to be consistent with the theory of cognition dysfunction mediated by inferior fronto-striato-cerebellar network in ADHD (Rubia, 2011). In a recent meta-analysis, it was suggested that abnormal alterations in the structure and function of the left superior frontal gyrus and corpus callosum may be key brain regions involved in the pathogenesis of ADHD (Yu et al, 2023). Further studies investigating the neural correlates of the ToM in ADHD are needed.…”

Cortical gray-white matter contrast abnormalities in male children with attention deficit hyperactivity disorder

“…At present, many studies have found that the overall brain volume of ADHD patients decreases by 3−5%, and gray matter is affected first (Greven et al, 2015), and the cortical thickness of frontal lobe, temporal lobe and insular lobe were also decreased (Hoogman et al, 2019;Maier et al, 2023). In terms of gray matter volume, studies have found that ADHD patients have reduced cortical gray matter volume in the right basal ganglia and insula (Norman et al, 2016), and the gray matter volume in the amygdala and hippocampus were also decreased (Yu et al, 2022). Furthermore, in a study on gender differences, it was found that the gray matter volume of the left lingual gyrus is reduced in male children with ADHD (Gonchigsuren et al, 2022).…”