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March 01, 1997; 48 (3) Article

Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls

P. A. Filipek, M. Semrud-Clikeman, R. J. Steingard, P. F. Renshaw, D. N. Kennedy, J. Biederman
First published March 1, 1997, DOI: https://doi.org/10.1212/WNL.48.3.589
P. A. Filipek
MD
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M. Semrud-Clikeman
PhD
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R. J. Steingard
MD
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P. F. Renshaw
MD, PhD
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D. N. Kennedy
PhD
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J. Biederman
MD
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Citation
Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls
P. A. Filipek, M. Semrud-Clikeman, R. J. Steingard, P. F. Renshaw, D. N. Kennedy, J. Biederman
Neurology Mar 1997, 48 (3) 589-601; DOI: 10.1212/WNL.48.3.589

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Abstract

Article abstract-Objective: To test by MRI-based morphometry the a priori hypotheses that developmental anomalies exist in attention-deficit hyperactivity disorder (ADHD) in left caudate and right prefrontal/frontal/ and/or posterior parietal hemispheric regions, in accord with neurochemical, neuronal circuitry and attentional network hypotheses, and prior imaging studies. Design: Case-control study. Setting: Academic medical center. Participants: Fifteen male subjects with ADHD without comorbid diagnoses (aged 12.4 +/- 3.4 years) and 15 male normal controls (aged 14.4 +/- 3.4), group-matched for age, IQ, and handedness. Main outcome measures: Global and hemispheric regional volumes (in cm3) of cerebral hemispheres, cortex, white matter, ventricles, caudate, lenticulate, central gray nuclei, insula, amygdala, and hippocampus. Results: Despite similar hemispheric volumes, ADHD subjects had smaller volumes of (1) left total caudate and caudate head (p < 0.04), with reversed asymmetry (p < 0.03); (2) right anterior-superior (frontal) region en bloc (p < 0.03) and white matter (p < 0.01); (3) bilateral anterior-inferior region en bloc (p < 0.04); and (4) bilateral retrocallosal (parietal-occipital) region white matter (p < 0.03). Possible structural correlates of ADHD response to stimulants were noted in an exploratory analysis, with the smallest and symmetric caudate, and smallest left anterior-superior cortex volumes found in the responders, but reversed caudate asymmetry and the smallest retrocallosal white matter volumes noted in the nonresponders. Conclusions: This study is the first to report localized hemispheric structural anomalies in ADHD, which are concordant with theoretical models of abnormal frontal-striatal and parietal function, and with possible differing morphologic substrates of response to stimulant medication.

NEUROLOGY 1997;48: 589-601

  • Copyright 1997 by Advanstar Communications Inc.
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