Cerebellar development and clinical outcome in attention deficit hyperactivity disorder
Susan Mackie1, Philip Shaw, Rhoshel Lenroot
1Columbia University School of Medicine, New York, NY, USA.
The American Journal of Psychiatry
|April 4, 2007
Summary
Children with attention deficit hyperactivity disorder (ADHD) show fixed volume loss in the superior cerebellar vermis. Cerebellar hemispheres may be a target for interventions, as their volume changes with ADHD severity.
Area of Science:
- Neuroscience
- Developmental Psychology
- Radiology
Background:
- Previous MRI studies indicate smaller cerebellar volumes in children with Attention Deficit Hyperactivity Disorder (ADHD).
- The regional specificity and longitudinal development of these cerebellar volume differences in ADHD are not well understood.
Purpose of the Study:
- To compare cerebellar lobe volumes in children with ADHD and healthy controls.
- To characterize the developmental trajectory of regional cerebellar volume differences in ADHD using a novel measurement technique.
Main Methods:
- Longitudinal case-control study involving 36 children with ADHD (divided by outcome) and 36 matched healthy controls.
- MR imaging used to measure volumes of cerebellar hemispheres, vermis subdivisions, and white matter at baseline and follow-up scans (2-year intervals).
- Clinical outcome defined by global measures and DSM-IV criteria.
Main Results:
- A nonprogressive volume loss in the superior cerebellar vermis was observed in ADHD groups, irrespective of clinical outcome.
- Children with worse ADHD outcomes showed a progressive decrease in inferior-posterior cerebellar lobe volumes during adolescence compared to controls and those with better outcomes.
- These findings suggest distinct developmental trajectories for different cerebellar regions in ADHD.
Conclusions:
- Reduced superior cerebellar vermis volume represents a fixed, nonprogressive anatomical characteristic of ADHD.
- Cerebellar hemispheres may serve as a more plastic, state-dependent marker for ADHD, potentially indicating targets for therapeutic intervention.
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