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Abstract

Objective:

Attention deficit hyperactivity disorder (ADHD) is a multifactorial disorder with diverse associated risk factors and comorbidities. In this study, the authors sought to understand ADHD from a dimensional perspective and to identify neuroanatomical correlates of traits and behaviors that span diagnostic criteria.

Methods:

Multimodal neuroimaging data and multi-informant cognitive and clinical data were collected in a densely phenotyped pediatric cohort (N=160; 70 with ADHD; age range, 9–12 years). Multivariate analysis identified associations between clinical and cognitive factors and multimodal neuroimaging markers (across tissue volume, cortical thickness, cortical area, and white matter microstructure). The resulting imaging markers were validated in an independent cohort (N=231; 132 with ADHD; age range, 7–18 years).

Results:

Four novel patterns of neuroanatomical variation that related to phenotypic variation were identified. The first imaging pattern captured association of head size with sex, socioeconomic status, and mathematics and reading performance. The second pattern captured variation associated with development and showed that individuals with delayed development were more likely to be receiving ADHD medication. The third pattern was associated with hyperactivity, greater comorbidities, poorer cognition, lower parental education, and lower quality of life. The fourth pattern was associated with a particular profile of poorer cognition and irritability independent of ADHD. The authors further demonstrated that these imaging patterns could predict variation in age and ADHD symptoms in an independent cohort.

Conclusions:

The findings suggest that ADHD presentation may arise from a summation of several clinical, developmental, or cognitive factors, each with a distinct neuroanatomical foundation. This informs the neurobiological foundations of ADHD and highlights the value of detailed phenotypic data in understanding the neurobiology underlying neurodevelopmental disorders.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 57 - 66
PubMed: 30220220

History

Received: 10 January 2018
Revision received: 24 April 2018
Revision received: 25 May 2018
Revision received: 1 June 2018
Accepted: 11 June 2018
Published online: 17 September 2018
Published in print: January 01, 2019

Keywords

  1. Attention Deficit Hyperactivity Disorder
  2. Brain Imaging Techniques

Authors

Details

Gareth Ball, Ph.D. [email protected]
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Charles B. Malpas, Ph.D.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Sila Genc, M.Sc.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Daryl Efron, M.D., F.R.A.C.P.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Emma Sciberras, D.Psych.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Vicki Anderson, Ph.D.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
Jan M. Nicholson, Ph.D.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.
[email protected]Timothy J. Silk, Ph.D.
From Developmental Imaging, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia; Population Health, Murdoch Children’s Research Institute, Melbourne; the Royal Children’s Hospital, Melbourne; the Department of Paediatrics, University of Melbourne, Melbourne; the Judith Lumley Centre, La Trobe University, Melbourne; the School of Psychology, Deakin University, Geelong, Australia; and the Melbourne School of Psychological Sciences, University of Melbourne, Melbourne.

Notes

Address correspondence to Dr. Ball ([email protected]) and Dr. Silk ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

National Health and Medical Research Council10.13039/501100000925: 1008522, 1065895

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