Brain abnormalities in adults with Attention Deficit Hyperactivity Disorder revealed by voxel-based morphometry

• Anatomical MRI images are obtained using VBM from a large sample of ADHD-Combined adults and a matched group of healthy volunteers.
• ADHD adults show structural abnormalities in key regions of cognitive control.
• Long-term stimulant medication may act to normalize brain structural deficits in patients with ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) commonly affects children, although the symptoms persist into adulthood in approximately 50% of cases. Structural imaging studies in children have documented both cortical and subcortical changes in the brain. However, there have been only a few studies in adults and the results are inconclusive.MethodVoxel-based morphometry (VBM) was applied to 44 adults with ADHD, Combined subtype, aged 18–54 years and 44 healthy controls matched for age, sex and IQ.ResultsADHD patients showed reduced gray matter (GM) volume in the right supplementary motor area (SMA). Using more lenient thresholds we also observed reductions in the subgenual anterior cingulate (ACC) and right dorsolateral prefrontal (DLPFC) cortices and increases in the basal ganglia, specifically in the left caudate nucleus and putamen. There was a positive correlation between the cumulative stimulant dose and volume in the right SMA and DLPFC clusters.ConclusionsThe findings suggest that adults with ADHD show brain structural changes in regions belonging to the so-called cool executive function network. Long-term stimulant medication may act to normalize these GM alterations.