Comprehensive Examination of Frontal Regions in Boys and Girls with Attention-Deficit/Hyperactivity Disorder

Abstract

The current study examined regional frontal lobe volumes based on functionally relevant subdivisions in contemporaneously recruited samples of boys and girls with and without attention-deficit/hyperactivity disorder (ADHD). Forty-four boys (21 ADHD, 23 control) and 42 girls (21 ADHD, 21 control), ages 8–13 years, participated. Sulcal–gyral landmarks were used to manually delimit functionally relevant regions within the frontal lobe: primary motor cortex, anterior cingulate, deep white matter, premotor regions [supplementary motor complex (SMC), frontal eye field, lateral premotor cortex (LPM)], and prefrontal cortex (PFC) regions [medial PFC, dorsolateral PFC (DLPFC), inferior PFC, lateral orbitofrontal cortex (OFC), and medial OFC]. Compared to sex-matched controls, boys and girls with ADHD showed reduced volumes (gray and white matter) in the left SMC. Conversely, girls (but not boys) with ADHD showed reduced gray matter volume in left LPM; while boys (but not girls) with ADHD showed reduced white matter volume in left medial PFC. Reduced left SMC gray matter volumes predicted increased go/no–go commission rate in children with ADHD. Reduced left LPM gray matter volumes predicted increased go/no–go variability, but only among girls with ADHD. Results highlight different patterns of anomalous frontal lobe development among boys and girls with ADHD beyond that detected by measuring whole lobar volumes.

Grey matter volume differences associated with gender in children with attention-deficit/hyperactivity disorder: A voxel-based morphometry study

“…In the only previous VBM study considering potential gender effects, no interaction between gender and diagnosis of ADHD were found, possibly due to the large age range (7-17 years) of the participants included, spanning different brain maturational stages (Yang et al, 2008). Our results are, however, consistent with previous evidence of gender-by-diagnosis interaction in structural brain imaging (Mahone et al, 2011;Dirlikov et al, 2014), electroencephalography (Clarke et al, 2001;Hermens et al, 2004) and functional brain imaging studies of children with ADHD (Ernst et al, 1994;Valera et al, 2010). Thus, our data adds to an increasing number of neuroimaging studies by documenting opposite alterations in brain structure in boys and girls with ADHD, possibly underlying gender-related differences in symptomatology (Hinshaw et al, 2006;Skogli et al, 2013).…”

“…Authors reported no interaction between diagnosis and gender, but several potential confounding factors were present: the study sample was characterized by a large age range (7-17 years), participants presented with various comorbidities, and most patients were receiving medication treatment. Three previous ROI structural studies also examined gender-by-diagnosis interactions in childhood ADHD (Mahone et al, 2011;Qiu et al, 2009;Dirlikov et al, 2014). Two of these studies were restricted to the frontal lobe, manually or automatically delimiting functionally relevant sub regions such as the primary motor cortex, the anterior cingulate cortex, the premotor region, the orbitofrontal cortex or the inferior prefrontal cortex (Mahone et al, 2011;Dirlikov et al, 2014).…”

“…Three previous ROI structural studies also examined gender-by-diagnosis interactions in childhood ADHD (Mahone et al, 2011;Qiu et al, 2009;Dirlikov et al, 2014). Two of these studies were restricted to the frontal lobe, manually or automatically delimiting functionally relevant sub regions such as the primary motor cortex, the anterior cingulate cortex, the premotor region, the orbitofrontal cortex or the inferior prefrontal cortex (Mahone et al, 2011;Dirlikov et al, 2014). Mahone et al (2011) reported significantly smaller left lateral premotor cortices in girls (but not boys) with ADHD when compared with TD participants (Mahone et al, 2011).…”

“…Two of these studies were restricted to the frontal lobe, manually or automatically delimiting functionally relevant sub regions such as the primary motor cortex, the anterior cingulate cortex, the premotor region, the orbitofrontal cortex or the inferior prefrontal cortex (Mahone et al, 2011;Dirlikov et al, 2014). Mahone et al (2011) reported significantly smaller left lateral premotor cortices in girls (but not boys) with ADHD when compared with TD participants (Mahone et al, 2011). Dirlikov et al (2014) found widely distributed reductions of surface area in girls with ADHD in the bilateral dorsolateral prefrontal cortex, the left inferior lateral prefrontal cortex, the right medial prefrontal cortex and the right orbitofrontal cortex, while boys with ADHD showed reduced surface area in the right anterior cingulate cortex and in the left medial prefrontal cortex, when compared with TD children (Dirlikov et al, 2014).…”

Neuroanatomical deficits correlate with executive dysfunction in boys with attention deficit hyperactivity disorder

“…Functional studies have revealed anomalous activations within motor areas in patients with ADHD at a resting state or when performing tasks that require response inhibition or motor control [33,34]. Previous structural study has also found reduced volume of motor areas in ADHD patients [35]. The results of our study are consistent with these previous findings; gray matter volume reductions in the primary motor/premotor cortex of patients with ADHD may demonstrate a critical role of motor structure deficits in the pathophysiology of ADHD.…”