Abstract

Although previous morphological studies have demonstrated abnormalities in prefrontal cortical thickness in children with attention deficit/hyperactivity disorder (ADHD), studies investigating cortical surface area are lacking. As the development of cortical surface is closely linked to the establishment of thalam-ocortical connections, any abnormalities in the structure of the thalamus are likely to relate to altered cortical surface area. Using a clinically well-defined sample of children with ADHD (n=25, 1 female) and typically developing controls (n=24, 1 female), we studied surface area across the cortex to determine whether children with ADHD had reduced thalamic volume that related to prefrontal cortical surface area. Relative to controls, children with ADHD had a significant reduction in thalamic volume and dorsolateral prefrontal cortical area in both hemispheres. Furthermore, children with ADHD with smaller thalamic volumes were found to have greater reductions in surface area, a pattern not evident in the control children. Our results are further evidence of reduced lateral prefrontal cortical area in ADHD. Moreover, for the first time, we have also shown a direct association between thalamic anatomy and frontal anatomy in ADHD, suggesting the pathophysiological process that alters surface area maturation is likely to be linked to the development of the thalamus.

Highlights

  • Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting around 5% of children and young people (Polanczyk et al, 2007)

  • In the whole brain analysis seeking the brain regions showing differential covariance with thalamic volume in the two groups, a significant interaction between thalamic volume and the diagnosis of ADHD was seen in a cluster that included right inferior and midlateral prefrontal cortex (BA 10, Brodmann areas (BA) 45, BA 46, BA 47; Fig. 2)

  • Children with ADHD with a smaller thalamic volume showed a greater reduction in the surface area (r 1⁄40.60, df 1⁄423, p1⁄4 0.001), while controls showed a trend towards a negative association with thalamic volume (r 1⁄4 À 0.34, df 1⁄4 22, p1⁄4 0.1)

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Summary

Introduction

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting around 5% of children and young people (Polanczyk et al, 2007). It is characterised by pervasive and developmentally inappropriate levels of inattention, impulsivity and hyperactivity, and is a risk factor for the development of other disorders. Morphological abnormalities have been found across a number of cortical regions in children and adolescents with ADHD (Seidman et al, 2005) supporting the view that cortico–striato–thalamo-cortical (CSTC) loops (Castellanos et al, 2006) play a key role in the pathogenesis of ADHD

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