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Open Access Highly Accessed Research article

Structural brain change in Attention Deficit Hyperactivity Disorder identified by meta-analysis

Ian Ellison-Wright13*, Zoë Ellison-Wright2 and Ed Bullmore3

Author Affiliations

1 Avon and Wiltshire Mental Health Partnership NHS Trust, Salisbury, UK

2 Child and Adolescent Mental Health Service, Dorset County Hospital NHS Foundation Trust, Dorchester, UK

3 Brain Mapping Unit, University of Cambridge, Cambridge, UK

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BMC Psychiatry 2008, 8:51  doi:10.1186/1471-244X-8-51

Published: 30 June 2008

Abstract

Background

The authors sought to map gray matter changes in Attention Deficit Hyperactivity Disorder (ADHD) using a novel technique incorporating neuro-imaging and genetic meta-analysis methods.

Methods

A systematic search was conducted for voxel-based structural magnetic resonance imaging studies of patients with ADHD (or with related disorders) in relation to comparison groups. The authors carried out meta-analyses of the co-ordinates of gray matter differences. For the meta-analyses they hybridised the standard method of Activation Likelihood Estimation (ALE) with the rank approach used in Genome Scan Meta-Analysis (GSMA). This system detects three-dimensional conjunctions of co-ordinates from multiple studies and permits the weighting of studies in relation to sample size.

Results

For gray matter decreases, there were 7 studies including a total of 114 patients with ADHD (or related disorders) and 143 comparison subjects. Meta-analysis of these studies identified a significant regional gray matter reduction in ADHD in the right putamen/globus pallidus region. Four studies reported gray matter increases in ADHD but no regional increase was identified by meta-analysis.

Conclusion

In ADHD there is gray matter reduction in the right putamen/globus pallidus region. This may be an anatomical marker for dysfunction in frontostriatal circuits mediating cognitive control. Right putamen lesions have been specifically associated with ADHD symptoms after closed head injuries in children.