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Quantitative MR analysis of caudate abnormalities in pediatric ADHD: proposal for a diagnostic test
Joan Carles Soliva1, Jordi Fauquet, Anna Bielsa
1Unitat de Recerca en Neurociència Cognitiva (URNC), Department of Psychiatry, Universitat Autònoma de Barcelona (UAB), Spain. 24744jsv@comb.es
Insights
Pediatric attention-deficit/hyperactivity disorder (ADHD) may be diagnosed using a novel imaging technique. The right caudate body volume (rCBV) to bilateral caudate body volume (bCBV) ratio shows promise as a diagnostic biomarker for ADHD in children.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Psychiatry
Background:
- Pediatric attention-deficit/hyperactivity disorder (ADHD) is frequently associated with reduced right caudate nucleus volume.
- Our previous research identified diminished right caudate body volume (rCBV) as the primary contributor to this reduction.
Purpose of the Study:
- To investigate the utility of rCBV/total bilateral caudate volume (tbCV) and rCBV/bilateral caudate body volume (bCBV) ratios as potential imaging diagnostic markers for ADHD.
- To establish a reliable imaging diagnostic test for pediatric ADHD.
Main Methods:
- A case-control morphometric MRI study was conducted with 39 ADHD subjects and 39 matched controls.
- A novel semi-automated caudate segmentation procedure was employed for volumetric analysis.
- Student t-tests and receiver operating characteristic (ROC) analysis were used to evaluate diagnostic performance.
Main Results:
- The rCBV/bCBV ratio was found to be statistically different between ADHD subjects and controls.
- An optimal cut-off value for the rCBV/bCBV ratio was determined using ROC analysis.
- A ratio equal to or less than 0.48 demonstrated 95.00% specificity for ADHD diagnosis.
Conclusions:
- The rCBV/bCBV ratio is a promising imaging biomarker for assisting in the diagnosis of ADHD in children.
- This ratio offers a potential non-invasive tool to aid clinicians in ADHD diagnosis.
Abstract:
Most morphometric magnetic resonance imaging (MRI) studies of pediatric attention-deficit/hyperactivity disorder (ADHD) with appropriate sample sizes reveal a decreased right caudate nucleus volume. Recently, our group reported that this decrease is mainly due to a diminished right caudate body volume (rCBV). Here, we hypothesize that, employing either the total bilateral caudate volume (tbCV) or the bilateral caudate body volume (bCBV) as scaling variables, the rCBV/tbCV and rCBV/bCBV ratios could be found diminished and used as a basis of an imaging diagnostic test. Volumetric caudate nucleus data were obtained from a case-control morphometric MRI study with 39 ADHD subjects and 39 handedness- and IQ-matched controls, using a novel semi-automated caudate segmentation procedure. Student t-tests comparing each relevant ratio were conducted between the two samples. After splitting the samples into two groups, a receiving operator characteristic (ROC) analysis was conducted on the training group to determine the optimal cut-off. Its performance was then examined on the test group. The rCBV/bCBV ratio was found to be statistically different. For a value equal or inferior to 0.48, the specificity was 95.00%. We propose using the rCBV/bCBV ratio to assist in the diagnosis of ADHD in children.
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