Many investigators have hypothesized that attention-deficit/hyperactivity disorder
(ADHD) involves structural and functional brain abnormalities in frontal-striatal
circuitry. Although our review suggests that there is substantial support for this
hypothesis, a growing literature demonstrates widespread abnormalities affecting other
cortical regions and the cerebellum. Because there is only one report studying adults
with ADHD, this summary is based on children. A key limitation of the literature is
that most of the studies until recently have been underpowered, using samples of fewer
than 20 subjects per group. Nevertheless, these studies are largely consistent with
the most comprehensive and definitive study(
Castellanos et al 2002
). Moreover, studies differ in the degree to which they address the influence of medications,
comorbidities, or gender, and most have not addressed potentially important sources
of heterogeneity such as family history of ADHD, subtype, or perinatal complications.
Despite these limitations, a relatively consistent picture has emerged. The most replicated
alterations in ADHD in childhood include significantly smaller volumes in the dorsolateral
prefrontal cortex, caudate, pallidum, corpus callosum, and cerebellum. These results
suggest that the brain is altered in a more widespread manner than has been previously
hypothesized. Developmental studies are needed to address the evolution of this brain
disorder into adulthood.Key Words
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Article info
Publication history
Published online: January 25, 2005
Accepted:
November 6,
2004
Received in revised form:
October 28,
2004
Received:
June 2,
2004
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
