Developmental brain trajectories in children with ADHD and controls: a longitudinal neuroimaging study.

Timothy J Silk,Sila Genc,Jan M Nicholson,Charles B Malpas,Michael Kean,Emma Sciberras,Vicki Anderson,Daryl Efron,Philip Hazell

doi:10.1186/s12888-016-0770-4

Abstract

BackgroundThe symptom profile and neuropsychological functioning of individuals with Attention Deficit/Hyperactivity Disorder (ADHD), change as they enter adolescence. It is unclear whether variation in brain structure and function parallels these changes, and also whether deviations from typical brain development trajectories are associated with differential outcomes. This paper describes the Neuroimaging of the Children’s Attention Project (NICAP), a comprehensive longitudinal multimodal neuroimaging study. Primary aims are to determine how brain structure and function change with age in ADHD, and whether different trajectories of brain development are associated with variations in outcomes including diagnostic persistence, and academic, cognitive, social and mental health outcomes.Methods/DesignNICAP is a multimodal neuroimaging study in a community-based cohort of children with and without ADHD. Approximately 100 children with ADHD and 100 typically developing controls will be scanned at a mean age of 10 years (range; 9–11years) and will be re-scanned at two 18-month intervals (ages 11.5 and 13 years respectively). Assessments include a structured diagnostic interview, parent and teacher questionnaires, direct child cognitive/executive functioning assessment and magnetic resonance imaging (MRI). MRI acquisition techniques, collected at a single site, have been selected to provide optimized information concerning structural and functional brain development.DiscussionThis study will allow us to address the primary aims by describing the neurobiological development of ADHD and elucidating brain features associated with differential clinical/behavioral outcomes. NICAP data will also be explored to assess the impact of sex, ADHD presentation, ADHD severity, comorbidities and medication use on brain development trajectories. Establishing which brain regions are associated with differential clinical outcomes, may allow us to improve predictions about the course of ADHD.

Highlights

The symptom profile and neuropsychological functioning of individuals with Attention Deficit/ Hyperactivity Disorder (ADHD), change as they enter adolescence
This study will allow us to address the primary aims by describing the neurobiological development of ADHD and elucidating brain features associated with differential clinical/behavioral outcomes
Neuroimaging of the Children’s Attention Project (NICAP) data will be explored to assess the impact of sex, ADHD presentation, ADHD severity, comorbidities and medication use on brain development trajectories

Summary

Discussion

This research will provide the ability to map trajectories of brain structure and function onto a comprehensive set of functional outcome domains encompassing academic, cognitive, social, and mental health functioning. Developing a large database of multimodal MRI sequences with ongoing clinical and cognitive/behavioral measures in a demographically diverse sample will enable the detection of subtle, yet important, differences in brain developmental trajectories in children with ADHD compared to non-ADHD peers. Identifying objective neural markers of outcomes in ADHD, and potential modifiable predictors of outcomes will be an important innovation and will contribute substantially to improving the prognosis of children with ADHD. Establishing which brain regions are associated with positive clinical outcomes will help improve predictions about the course of ADHD. A better understanding of the developmental links between brain changes and outcomes has important implications for children with developmental and mental health problems broader than ADHD. The identification of neurodevelopmental changes associated with functional outcomes will open the possibility for future studies to test targeted interventions leading to improved long-term outcomes.

Background