Brain morphology in children with epilepsy and ADHD
Ricardo Saute1, Kevin Dabbs2, Jana E Jones2
1Faculty of Medicine, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Insights
Children with epilepsy and ADHD show widespread brain structure differences, including thinner cortex and smaller brainstem/subcortical volumes. These early changes suggest underlying neurodevelopmental issues.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with childhood epilepsy.
- Neuroanatomical differences associated with ADHD in epilepsy are not fully understood.
Purpose of the Study:
- To investigate the neuroanatomical correlates of ADHD in children with recent-onset epilepsy.
- To compare brain structure in children with epilepsy and ADHD, epilepsy without ADHD, and healthy controls.
Main Methods:
- High-resolution MRI scans were acquired for three groups: epilepsy with ADHD (n=18), epilepsy without ADHD (n=36), and healthy controls (n=46).
- Cortical morphology (thickness, area, volume, curvature) and subcortical/cerebellar volumes were analyzed using FreeSurfer 5.1.
Main Results:
- Children with epilepsy and ADHD demonstrated diffuse bilateral cortical thinning in frontal, parietal, and temporal lobes compared to controls.
- Reduced volumes were observed in the brainstem and subcortical structures (caudate, thalamus, hippocampus) in the epilepsy with ADHD group.
- Few significant differences were found in cortical volume, area, or curvature between groups.
Conclusions:
- Comorbid ADHD in children with epilepsy is associated with widespread bilateral decreased cortical thickness and reduced brainstem/subcortical volumes.
- These early anatomical abnormalities suggest antecedent neurodevelopmental alterations in this population.
- Further research is needed to determine the long-term course of these neurodevelopmental changes.
Background:
Attention deficit hyperactivity disorder (ADHD) is a common comorbidity of childhood epilepsy, but the neuroanatomical correlates of ADHD in epilepsy have yet to be comprehensively characterized.
Methods:
Children with new and recent-onset epilepsy with (n = 18) and without (n = 36) ADHD, and healthy controls (n = 46) underwent high resolution MRI. Measures of cortical morphology (thickness, area, volume, curvature) and subcortical and cerebellar volumes were compared between the groups using the program FreeSurfer 5.1.
Results:
Compared to the control group, children with epilepsy and ADHD exhibited diffuse bilateral thinning in the frontal, parietal and temporal lobes, with volume reductions in the brainstem and subcortical structures (bilateral caudate, left thalamus, right hippocampus). There were very few group differences across measures of cortical volume, area or curvature.
Conclusions:
Children with epilepsy and comorbid ADHD exhibited a pattern of bilateral and widespread decreased cortical thickness as well as decreased volume of subcortical structures and brainstem. These anatomic abnormalities were evident early in the course of epilepsy suggesting the presence of antecedent neurodevelopmental changes, the course of which remains to be determined.
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:22Epilepsy ll: Types
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...