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Regional cerebral perfusion abnormalities in attention deficit/hyperactivity disorder. Statistical parametric mapping
Boong-Nyun Kim1, Jae-Sung Lee, Min-Sup Shin
1Division of Child & Adolescent Psychiatry, Department of Neuropsychiatry, Clinical Research Institute, Seoul National University Hospital, 28 Yungundong, Chongrogu, Seoul, Korea. kbn1@snu.ac.kr
Insights
Children with Attention Deficit Hyperactivity Disorder (ADHD) exhibit distinct cerebral blood flow patterns, with reduced flow in prefrontal and cerebellar regions and increased flow in posterior brain areas during rest.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Radiology
Background:
- Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder.
- Understanding the neurobiological underpinnings of ADHD is crucial for effective interventions.
Purpose of the Study:
- To investigate differences in resting-state cerebral blood flow (CBF) between children with ADHD and neurotypical controls.
- To identify specific brain regions associated with functional alterations in ADHD.
Main Methods:
- Voxel-based analysis of (99m)Tc-HMPAO brain SPECT imaging.
- Comparison of 40 children with pure ADHD (DSM-IV criteria) and 17 age, sex, and IQ-matched controls.
- Statistical Parametric Mapping (SPM) used for voxel-wise comparison with a p-value threshold of <0.01.
Main Results:
- Children with ADHD showed significantly decreased CBF in the right lateral prefrontal cortex, right middle temporal cortex, orbital prefrontal cortex, and cerebellar cortices compared to controls.
- The ADHD group exhibited increased CBF in certain parietal and occipital lobe regions (posterior brain areas).
Conclusions:
- This study confirms functional deficits in the prefrontal cortex in children with ADHD.
- Novel findings indicate alterations in the limbic area, somatosensory areas, and cerebellum during the resting state in ADHD brains.
Objective:
A voxel based investigation of cerebral blood flow was conducted to identify brain function differences in the resting state between children with Attention Deficit Hyperactivity Disorder (ADHD) and normal controls.
Method:
Using DSM-IV criteria, we selected 40 children with pure ADHD by various assessment scales, psychometric tools and a neuropsychological battery. All patients were examined by (99m)Tc-HMPAO brain SPECT. Seventeen normal controls were recruited from age, sex, and IQ-matched children whose previous SPECT, MRI, EEG and psychometric and neuropsychological findings had been normal. Using SPM methods, we compared SPECT images of ADHD patients and those of 17 control subjects on a voxel by voxel basis using t-statistics. Voxels with a p-value of less than 0.01 were considered to be significantly different.
Result:
Decreased cerebral blood flow in right lateral prefrontal cortex, right middle temporal cortex, both orbital prefrontal cortex and both cerebellar cortices were found in children with ADHD compared to the controls. In addition, the ADHD group showed increased blood flow in some parietal and occipital lobes (posterior brain regions) compared to the control group.
Conclusion:
Although the results should be interpreted cautiously, this study confirms the presence of functional defects in the prefrontal cortex and reports new problems in the limbic area, somatosensory areas and in the cerebellum during the resting state of brains of ADHD children.
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