Study: Neuroimaging Patterns Predict Pinpointed ADHD Symptoms

October 1, 2018

Brain patterns documented in MRI scans, used in conjunction with behavioral and demographic data, may be used to predict specific ADHD symptoms in children. This is the finding of a recent study¹ published in the American Journal of Psychiatry, wherein researchers examined the MRI scans of 160 Australian children between ages 9 and 12 and identified four pervasive brain ‘profiles’ indicative of specific ADHD symptoms.

The study, which used advanced magnetic resonance imaging (MRI) modeling to document changes in the brain from multiple viewpoints, aimed to find common patterns – across several anatomical scales – associated with particular sets of ADHD symptoms, or cognitive abilities. Its findings suggest that the unique ADHD symptoms experienced by different children may have roots in the specific biological roots of the brain.

In the study, 70 of the children evaluated had ADHD, and 23 were taking medication to manage it. To track symptoms and demographic characteristics, each participant completed a 3.5-hour assessment including a cognitive evaluation, self-reported survey, and parent questionnaire.

Using these assessments, in conjunction with MRI scans and demographic/psychographic data, the researchers found four distinct brain patterns associated with unique behavioral and demographic profiles, and used them to predict ADHD symptoms in a separate group of children:

• Development
  • Less developmentally mature children were more likely to be hyperactive and to receive medication for ADHD.
  • Younger “brain age” is common among children with ADHD, who lag developmentally behind their peers.
• Largely Male Hyperactivity
  • Children in this segment had a clinical profile that included higher hyperactivity, higher parent and teacher ratings of ADHD symptoms, and greater likelihood of social problems and comorbidities.
  • This profile was the most common among pre-pubescent male children.
  • Specifically, the role of the superior longitudinal fasciculus, a fiber tract present in both of the brain’s hemispheres, was implicated in ADHD symptoms like hyperactivity.
  • This profile was also associated with poorer academic performance, lower parental education, and increased experience of stressful life events. These findings suggest possible pathways that may lead to the altered development that occurs in children with ADHD.
• Cognitive Performance
  • This pattern was associated with a poorer cognitive performance, increased irritability not associated with ADHD, and fewer hyperactive symptoms.
  • An environmental component – lower parental education, maternal smoking, and a poorer quality of life – also associated with this profile may underlie the decreased cognitive performance.
• Head size
  • Larger intracranial volume was associated with male sex and better performance in reading and math.
  • This pattern supported a previously documented link between brain size, cognitive ability, and academic achievement.
  • This pattern was not significantly associated with ADHD symptoms, even though some research has posited that people with ADHD have reduced brain volume. A new study has confirmed that ADHD medications do not affect brain size.

The researchers are hopeful this study will eventually lead to objective measures for ADHD diagnosis, and help advance the neurobiological understanding of ADHD.

[¹Gareth Ball, Ph.D., Charles B. Malpas, Ph.D., et al. “Multimodal Structural Neuroimaging Markers of Brain Development and ADHD Symptoms.” American Journal of Psychiatry , 17 September 2018. doi: 10.1176/appi.ajp.2018.18010034