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Affected brain regions in ADHD


Affected brain regions in ADHD

1. Affected brain regions in ADHD

ADHD is associated with changes in different brain regions:

  • PFC
    • DlPFC
    • MPFC
    • OlPFC
  • Basal Ganglia1
    • Striatum
      • Nucleus caudates
      • Thalamus
  • Cerebellum1
  • Corpus Callosum1
  • Largest reductions in gray matter in:2
  • Frontal-parietal brain regions
  • Corpus callosum
  • Limbic system
    This includes:3
    • Corpus mamillare
      • Memory formation, in the context of the Papez neuron circuit
      • Sexual functions
    • Cingulate gyrus
      • Vegetative functions
      • Psycho- and locomotor drive
    • Parahippocampal gyrus
      • Primarily transmits information from the limbic system to the hippocampus
      • Memory formation
    • Hippocampus
      • Memory formation
      • Vegetative and emotional functions
    • Amygdala
      • Storage of emotionally moving memory content
      • Vegetative and sexual functions
  • Significant hypoactivation in2
    • Several frontal-temporal brain regions
    • Right postcentral gyrus
    • Left insula
    • Corpus callosum.

2. Volume changes in brain regions in ADHD

In ADHD, the volume of different brain regions is altered.

In children with ADHD, MRI studies found, compared with unaffected individuals

  • Total brain volume reduced
    • (by 4 %)4
  • Caudates reduced45
  • Anterior PFC reduced in size4
  • Orbital PFC reduced, predominantly on right side6
  • Inferior dorsolateral frontal region6
  • Basal Ganglia
    • Striatum reduced6
    • Globus pallidus reduced4 6
  • Cerebellum reduced 5
    • Central vermis area, predominantly reduced on right side46
  • ACC
    • Reduced, mostly underactivated6
  • Corpus callosum
    • Splenium (beam bulge) reduced6
  • Putamen changed5
  • Thalamus changed5 or hypoactive7

The effects were stronger in boys than in girls, he said, correlating with the Polygenic Risk Score.5

Children with ADHD showed microstructural changes and alterations in the long-range white matter connections. Learning problems and hyperactivity/impulsivity correlated negatively with mean FA levels in the right forceps major, left IFOF, and left genu internal capsule.8

German Interestingly, the reductions in size of certain brain regions that are usually observed from the age of 60 seem to be less pronounced in ADHD. This is discussed as a neuroprotective factor of ADHD. It is open whether this is a consequence of ADHD itself or of stimulant treatment.
This was particularly significant in brain regions where a strong loss of volume correlates with cognitive impairment and Alzheimer’s disease, such as the hippocampus and amygdala.

  1. Biederman, Faraone (2005): Attention-deficit hyperactivity disorder. Lancet. 2005 Jul 16-22;366(9481):237-48. doi: 10.1016/S0140-6736(05)66915-2. Erratum in: Lancet. 2006 Jan 21;367(9506):210. PMID: 16023516. REVIEW

  2. Yu M, Gao X, Niu X, Zhang M, Yang Z, Han S, Cheng J, Zhang Y (2023): Meta-analysis of structural and functional alterations of brain in patients with attention-deficit/hyperactivity disorder. Front Psychiatry. 2023 Jan 6;13:1070142. doi: 10.3389/fpsyt.2022.1070142. PMID: 36683981; PMCID: PMC9853532. METASTUDY

  3. DocCheck Flexikon: Limbisches System

  4. Castellanos (2001): Neuroimaging studies of ADHD. In Solanto, Arnsten, Castellanos (Herausgeber): Stimulant drugs and ADHD: Basic and clinical neuroscience (p. 243–258). zitiert nach Solanto (2002): Dopamine dysfunction in AD/HD: integrating clinical and basic neuroscience research. Behav Brain Res. 2002 Mar 10;130(1-2):65-71.

  5. Mooney, Bhatt, Hermosillo, Ryabinin, Nikolas, Faraone, Fair, Wilmot, Nigg (2020): Smaller total brain volume but not subcortical structure volume related to common genetic risk for ADHD. Psychol Med. 2020 Jan 24;1-10. doi: 10.1017/S0033291719004148. PMID: 31973781.

  6. Barkley (2014): The Importance of Emotion in ADHD; unter Verweis auf Cortese, Kelly, Chabernaud, Proal, Di Martino, Milham, Castellanos (2012): Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am J Psychiatry. 2012 Oct;169(10):1038-55. doi: 10.1176/appi.ajp.2012.11101521. PMID: 22983386; PMCID: PMC3879048.

  7. Källstrand J, Niklasson K, Lindvall M, Claesdotter-Knutsson E (2022): Reduced thalamic activity in ADHD under ABR forward masking conditions. Appl Neuropsychol Child. 2022 Dec 16:1-7. doi: 10.1080/21622965.2022.2155520. PMID: 36524942.

  8. Zhou R, Dong P, Chen S, Qian A, Tao J, Zheng X, Cheng J, Yang C, Huang X, Wang M (2022): The long-range white matter microstructural alterations in drug-naive children with ADHD: A tract-based spatial statistics study. Psychiatry Res Neuroimaging. 2022 Oct 7;327:111548. doi: 10.1016/j.pscychresns.2022.111548. PMID: 36279811. n = 98

  9. Dutta CN, Christov-Moore L, Ombao H, Douglas PK (2022): Neuroprotection in late life attention-deficit/hyperactivity disorder: A review of pharmacotherapy and phenotype across the lifespan. Front Hum Neurosci. 2022 Sep 26;16:938501. doi: 10.3389/fnhum.2022.938501. PMID: 36226261; PMCID: PMC9548548.

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