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Caudate nucleus volume asymmetry predicts attention-deficit hyperactivity disorder (ADHD) symptomatology in children
Gregory W Schrimsher1, Rebecca L Billingsley, Edward F Jackson
1Department of Psychology, University of Houston, Houston, TX, USA.
Insights
Caudate asymmetry in the brain predicts inattentive behaviors in children. This suggests attention-deficit hyperactivity disorder (ADHD) may exist on a spectrum within the general population.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) relies on behavioral assessments of inattention, hyperactivity, and impulsivity.
- Neuroanatomic models highlight the role of caudate and frontal lobe function in attention.
- Previous studies indicate differences in caudate nucleus size and symmetry between children with and without ADHD.
Purpose of the Study:
- To investigate whether caudate volume symmetry in nonreferred children predicts the severity of ADHD-related behaviors.
- To determine if caudate asymmetry accounts for variance in inattentive and hyperactive/impulsive symptoms beyond demographic factors and internalizing problems.
Main Methods:
- Magnetic resonance imaging (MRI) was used to measure caudate volume symmetry in a sample of nonreferred children (ages 7.0–16.6).
- Multiple regression analysis assessed the predictive power of caudate asymmetry on parent-reported ADHD behaviors.
- Child Behavior Checklist data were used to control for internalizing problems.
Main Results:
- Caudate asymmetry significantly predicted the severity of inattentive behaviors (P = .015), explaining 17.1% of the variance.
- Caudate asymmetry accounted for 4.3% of the variance in hyperactive/impulsive symptoms.
- Greater right-to-left caudate volume asymmetry correlated with subclinical inattentive behaviors.
Conclusions:
- Caudate volume asymmetry is a significant predictor of subclinical inattentive behaviors in children.
- Findings support neuroanatomic models implicating lateralized alterations in prefrontal/striatal systems in attention.
- The study suggests that ADHD exists on a behavioral continuum extending into the general population.
Abstract:
Clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on evaluation of behavioral functioning in three domains: inattentiveness, hyperactivity, and impulsivity. Caudate and frontal lobe function figures prominently in several neuroanatomic models of attentional functioning. Studies comparing children with and without ADHD have found differences in the size and symmetry of the caudate nuclei. Using multiple regression, we tested the hypothesis that caudate volume symmetry (log left minus log right caudate volume) measured from serial sagittal magnetic resonance images in a sample of nonreferred children (12 girls/15 boys, 7.0 to 16.6 years, 81 to 129 IQ) would predict the cumulative severity of parent-reported ADHD diagnostic behaviors beyond variance predicted by age, sex, and level of internalizing problems as measured by the Child Behavior Checklist. No child had been previously diagnosed with ADHD, although one child was found to meet diagnostic criteria based on the rating scale used for the study. The degree of caudate asymmetry significantly predicted cumulative severity ratings of inattentive behaviors (P = .015), uniquely accounting for 17.1% of the variance in inattention symptomatology over demographic variables and internalizing problems, which collectively predicted 28.9% of the variance. Caudate asymmetry uniquely accounted for only 4.3% of the variance in cumulative severity ratings of hyperactive/impulsive symptomatology over demographic variables and internalizing problems that collectively predicted 21.2% of the variance. A greater degree of right to left caudate volume asymmetry predicted subclinical inattentive behaviors in a sample of nonreferred children. This finding is congruent with neuroanatomic models of attention emphasizing lateralized alteration in prefrontal/striatal systems. The results support the view that clinical ADHD is the extreme of a behavioral continuum that extends into the normal population.
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