Meta-Analysis of Structural Imaging Findings in Attention-Deficit/Hyperactivity Disorder

Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Biological Psychiatry (Impact Factor: 10.25). 06/2007; 61(12):1361-9. DOI: 10.1016/j.biopsych.2006.06.011
Source: PubMed

ABSTRACT Although there are many structural neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) in children, there are inconsistencies across studies and no consensus regarding which brain regions show the most robust area or volumetric reductions relative to control subjects. Our goal was to statistically analyze structural imaging data via a meta-analysis to help resolve these issues.
We searched the MEDLINE and PsycINFO databases through January 2005. Studies must have been written in English, used magnetic resonance imaging, and presented the means and standard deviations of regions assessed. Data were extracted by one of the authors and verified independently by another author.
Analyses were performed using STATA with metan, metabias, and metainf programs. A meta-analysis including all regions across all studies indicated global reductions for ADHD subjects compared with control subjects, standardized mean difference=.408, p<.001. Regions most frequently assessed and showing the largest differences included cerebellar regions, the splenium of the corpus callosum, total and right cerebral volume, and right caudate. Several frontal regions assessed in only two studies also showed large significant differences.
This meta-analysis provides a quantitative analysis of neuroanatomical abnormalities in ADHD and information that can be used to guide future studies.

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Available from: Larry J Seidman, Sep 05, 2015
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    • "Finally, in one previous study restricted to female participants, Castellanos et al. (2001) found no significant differences between girls with ADHD and TD girls when measuring the volumes of the caudate nucleus, globus pallidus, frontal lobe (total volume)) and cerebellum, while girls with ADHD exhibited decreased grey matter volumes of the posterior inferior lobule in the cerebellar vermis when compared to TD girls (Castellanos et al., 2001). This limited number of studies suggest that girls with ADHD may not exhibit the structural abnormalities of the basal ganglia consistently reported in predominantly male ADHD samples (Valera et al., 2007; Nakao et al., 2011; Frodl and Skokauskas, 2012). "
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    • "According to some theories of ADHD, executive function impairments underlie behavioral disturbances and are central to the disorder (Barkley, 1997; Zelazo and Muller, 2002). Consistent with this, results from a meta-analysis of structural neuroimaging studies indicate that ADHD is associated with neuroanatomical abnormalities in areas of the brain related to executive function (Valera et al., 2007). There are a number of possible reasons for why the common cognitive deficits of the groups might be so pervasive. "
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    • "Structural neuroimaging studies on attention deficit/hyperactivity disorder (ADHD) have focused primarily on anatomical alterations in prefronto-striatal circuitry (Seidman et al., 2005; Valera et al., 2007). Functional and structural brain abnormalities in prefrontal cortex (primarily, dorsolateral and ventrolateral regions) and dorsal striatum have been strongly linked with response inhibition, one of the most consistently implicated deficits in ADHD (Hart et al., 2013). "
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