MRI Sheds Light on Brain Differences in ADHD

— Frontal, occipital lobe and central cortex vary from matched controls


Children with attention deficit hyperactivity disorder (ADHD) showed alterations in different regions of the brain versus children without ADHD when both were examined via MRI, a small study found.

There were differences in the cortical shape of the frontal lobe, and areas in the occipital lobe and central cortex in the brains of children who had ADHD and age and sex-matched controls, reported Huaiqiang Sun, PhD, of West China Hospital in Chengdu, and colleagues.

However, there was no difference found in total brain volume or gray and white matter volumes, the authors wrote in Radiology.

Prior research suggested that individuals with ADHD have alterations in brain volume, various cortical features and differences in white matter, but the authors said that these studies can lack diagnostic value, since studies "typically report group-level differences" between patients and controls.

They discussed the developing field of psychoradiology, which examines imaging data through pattern recognition algorithms to "develop classifiers that can be used to predict disorders in individuals." Radiomics, which converts radiographic images into a data set with a series of algorithms, has been applied in clinical oncology to examine imaging features of solid tumors, the authors said. But they added that brain MRI can be analyzed using radiomics "by precisely segmenting the brain into anatomic structures and then extracting quantitative features from segmented structures to form the mineable data set."

"The main aim of the current study was to establish classification models that can assist the psychiatrist or clinical psychologist in diagnosing and subtyping of ADHD based on relevant radiomics signatures," co-author Qiyong Gong, MD, PhD also of West China Hospital, said in a statement. "This imaging-based classification model could be an objective adjunct to facilitate better clinical decision making."

Researchers examined 83 age and sex-matched children with newly diagnosed and never-treated ADHD, who were a mean age of around 10 years, and 71 of which were boys. Among these, 40 were ADHD-inattentive and 43 were ADHD-combined, or inattentive and hyperactive -- the two most common ADHD subtypes. There were 87 controls who were a mean age of 11 years, and 72 were boys. They underwent anatomic and diffusion-tensor MRI to help build the model.

Overall, mean classification accuracy in separating patients from healthy controls was 73.7%, and about 80% in distinguishing between subtypes of ADHD. Patients with ADHD had alteration in the cortical shape of the left temporal lobe, bilateral ceneus, which is part of the occipital lobe, and regions around the left central sulcus, or a groove in the central cortex.

Examining the difference between ADHD subtypes, Sun's group found "discriminating features" in the default mode network, or a large scale brain network of interacting brain regions, which is generally activated when a person is not thinking about a task. Differences were also observed in the insular cortex, a portion of the cerebral cortex.

"The present study adds to the developing field of psychoradiology, which seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with psychiatric disorders," Gong said in a statement.

Sun's group added that this proposed analysis framework is "fully automatic" and can be "deployed readily in clinical environments" to help in the psychiatric behavioral evaluation of ADHD.


The study was supported by the National Natural Science Foundation of China, the Ministry of Education of the People's Republic of China, and the Ministry of Science and Technology of the People's Republic of China.

Gong disclosed a scholarship from the Institute of International Education. One co-author disclosed support from Takeda.