Inferior Frontal Gyrus Volume Loss Distinguishes Between Autism and (Comorbid) Attention-Deficit/Hyperactivity Disorder-A FreeSurfer Analysis in Children.

Kathrin Nickel,Jacek Manko,Christoph P Kaller,Christoph Klein,Josef Unterrainer,Irina Mader,Monica Biscaldi,Ludger Tebartz Van Elst,Andreas Riedel,Simon Maier,Reinhold Rauh,Dominique Endres

doi:10.3389/fpsyt.2018.00521

Kathrin Nickel, Jacek Manko + Show 10 more

Open Access

https://doi.org/10.3389/fpsyt.2018.00521

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Abstract

Objective: Autism spectrum (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with a high rate of comorbidity. To date, diagnosis is based on clinical presentation and distinct reliable biomarkers have been identified neither for ASD nor ADHD. Most previous neuroimaging studies investigated ASD and ADHD separately.Method: To address the question of structural brain differences between ASD and ADHD, we performed FreeSurfer analysis in a sample of children with ADHD (n = 30), with high-functioning ASD (n = 14), with comorbid high-functioning ASD and ADHD (n = 15), and of typically developed controls (TD; n = 36). With FreeSurfer, an automated brain imaging processing and analyzing suite, we reconstructed the cerebral cortex and calculated gray matter volumes as well as cortical surface parameters in terms of cortical thickness and mean curvature.Results: A significant main effect of the factor ADHD was detected for the left inferior frontal gyrus (Pars orbitalis) volume, with the ADHD group exhibiting smaller Pars orbitalis volumes. Dimensional measures of autism (SRS total raw score) and ADHD (DISYPS-II FBB-ADHD score) had no significant influence on the left Pars orbitalis volume. Both, ASD and ADHD tended to have an effect on cortical thickness or mean curvature, which did not survive correction for multiple comparisons.Conclusion: Our results underline that ADHD rather than ASD is associated with volume loss in the left inferior frontal gyrus (Pars orbitalis). This area might play a relevant role in modulating symptoms of inattention and/or impulsivity in ADHD. The effect of comorbid ADHD in ASD samples and vice versa, on cortical thickness and mean curvature, requires further investigation in larger samples.

Highlights

Previous studies mainly investigated autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in isolation
An interaction of the factors ADHD and ASD could be detected for the right isthmus cingulate cortex
These findings suggest that ADHD rather than ASD is related to left Pars orbitalis volume loss

Summary

Introduction

Previous studies mainly investigated autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in isolation. To identify endophenotypes across diagnostic categories, it is important to further investigate the overlap between ADHD and ASD on a behavioral, neurocognitive, and neurobiological level [3, 4]. ASD is characterized by impairment in social communication and interaction as well as by a range of stereotypic behaviors whereas deficits in attention, hyperactivity, impulsiveness, disorganization and affective instability represent the core symptoms of ADHD [5]. As ASD is a frequent comorbid condition in ADHD and vice versa [1], there is the possibility of dual diagnosis according to DSM-5 [5]. The interpretation of studies prior to 2013 is limited by DSM-IV guidelines not permitting the dual diagnosis of ASD and ADHD [6]

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