Article

Diffusion tensor imaging in attention deficit/hyperactivity disorder: A systematic review and meta-anlysis

Department of Clinical Neuropsychology, VU University Amsterdam, The Netherlands.
Neuroscience & Biobehavioral Reviews (Impact Factor: 10.28). 01/2012; 36(4):1093-106. DOI: 10.1016/j.neubiorev.2012.01.003
Source: PubMed

ABSTRACT Diffusion tensor imaging (DTI) allows in vivo examination of the microstructural integrity of white matter brain tissue. A systematic review and quantitative meta-analysis using GingerALE were undertaken to compare current DTI findings in patients with ADHD and healthy controls to further unravel the neurobiological underpinnings of the disorder. Online databases were searched for DTI studies comparing white matter integrity between ADHD patients and healthy controls. Fifteen studies met inclusion criteria. Alterations in white matter integrity were found in widespread areas, most consistently so in the right anterior corona radiata, right forceps minor, bilateral internal capsule, and left cerebellum, areas previously implicated in the pathophysiology of the disorder. Current literature is critically discussed in terms of its important methodological limitations and challenges, and guidelines for future DTI research are provided. While more research is needed, DTI proves to be a promising technique, providing new prospects and challenges for future research into the pathophysiology of ADHD.

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    • "The thalamocortical circuitry undergoes rapid morphological growth to adapt to the needs of numerous sensorimotor, cognitive, and attentional functions in early life (Gilmore et al., 2012; Holland et al., 2014; Qiu et al., 2013). Thalamocortical dysconnectivity, both structural and functional, has been implicated in children with autism spectrum disorder (Nair et al., 2013), attention deficit hyperactivity disorder (ADHD; Bush, 2011; Van Ewijka et al., 2012), and schizophrenia (Jones, 1997; Woodward et al., 2012). Abnormal thalamic development has also been found in preterm infants (Ball et al., 2012; Srinivasan et al., 2007), and survivors often suffer from cognitive and behavioral deficits and have an increased risk of developing autism and ADHD (D'Onofrio et al., 2013; Delobel-Ayoub et al., 2009). "
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    • "Moreover, tractography algorithms can use diffusion tensor information to estimate the location and direction of fiber tracts. DTI has been used to characterize abnormal white matter diffusion properties in a range of diseases, including psychiatric disorders involving psychosis and disturbances in mood and attention [4,5,8,9]. "
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    • "Given that youths with ADHD tend to show EF deficits (Gau & Shang, 2010; Chamberlain et al. 2011), school adjustment problems (Sonuga-Barke, 2003; Biederman et al. 2004; Loe & Feldman, 2007; Wu & Gau, 2013) and disturbed white matter integrity (Liston et al. 2011; van Ewijk et al. 2012), we conducted this study not only to examine the degree of impairment in these aspects in youths with ADHD, as compared to TD youths, but also to investigate the linkage between frontostriatal tract integrity, EF, ADHD symptoms and school functioning . We focused on frontostriatal tracts because review studies have suggested that abnormalities in the structural and functional connectivity in the frontostriatal–cerebellar circuitry may be implicated in the pathophysiology of ADHD (Bush et al. 2005; Konrad & Eickhoff, 2010; Cubillo et al. 2012; van Ewijk et al. 2012) and that disturbed microstructural integrity in the frontostriatal network in ADHD represents one of the best-replicated findings (Ashtari et al. 2005; Silk et al. 2009; Davenport et al. 2010; Kobel et al. 2010; Li et al. 2010; Peterson et al. 2011; de Zeeuw et al. 2012; Tamm et al. 2012). Specifically, we hypothesized that ADHD symptoms and EF deficits may be the mechanisms linking disturbed frontostriatal tracts integrity and school dysfunctioning. "
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