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  • MRI Shows Brain Differences Among ADHD Patients

    Imaging-based parameters may assist psychiatric evaluation for diagnosing and subtyping ADHD.

    November 22, 2017

    Information from brain MRIs can help identify people with attention deficit hyperactivity disorder (ADHD) and distinguish among subtypes of the condition, according to new Radiology research.

    ADHD affects 5 to 7 percent of children and adolescents worldwide, according to the ADHD Institute. The three primary subtypes of ADHD are predominantly inattentive, predominantly hyperactive/impulsive and a combination of inattentive and hyperactive.

    While clinical diagnosis and subtyping of ADHD is currently based on reported symptoms, psychoradiology has emerged in recent years as a promising tool for helping to clarify diagnoses, said study author Qiyong Gong, MD, PhD, at West China Hospital of Sichuan University in Chengdu, China.

    “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,” Dr. Gong said. “The 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.”

    The authors studied 83 children, ranging in age from of 7 to 14, with newly diagnosed and never-treated ADHD. The group included children with the inattentive ADHD subtype and the combined subtype. The authors used anatomic and diffusion-tensor MRI and compared the results with those of a control group of 87 healthy, similarly aged children. Then, they performed a random forest-based feature selection algorithm that allowed them to screen relevant radiomics signatures from more than 3,100 quantitative features extracted from the gray and white matter.

    While no overall difference was found between ADHD and controls in total brain volume or total gray and white matter volumes, differences emerged in specific regions within the brain.

    There was altered distribution of the curvature of vertices within the left precentral and postcentral regions of the temporal regions of the brain. The authors also found increased cortical thickness throughout the bilateral cuneus. These differences, plus alterations in the cortical shape regions areas around the left central sulcus, contributed significantly to distinguishing ADHD from typically developing controls.

    Overall, the radiomics signatures allowed discrimination of ADHD patients and healthy control children with 74 percent accuracy and discrimination of ADHD inattentive and ADHD combined subtypes with 80 percent accuracy.

    The findings indicate that a moderately successful diagnostic classification efficiency can be achieved between patients with ADHD and those without as well as between the two most common ADHD subtypes, said the authors. In addition, MRI has the potential to assist with classification strategies for the diagnosis of ADHD and provide new insights into the specific neurologic/anatomic features related to the condition and its subtypes.

    The authors plan to recruit more newly diagnosed ADHD patients to validate the results and learn more about imaging-based classification.


    Gong Figure 3
    Graphs show distribution of significant features that discriminated ADHD and healthy control subjects. FA = fractional anisotropy.

    Gong Figure 4
    Distribution of significant features that discriminated ADHD-I and ADHD-C.

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