Conducting the largest imaging study of attention-deficit hyperactivity disorder to date, researchers have identified differences in five brain regions, suggesting that the condition should be treated like a brain disorder. That gives researchers more confidence that the changes they found are reliable and worth investigating further. Researchers knew that this brain area is involved in recognizing emotional stimuli and regulating emotions.
With funding from the National Institutes of Health, researchers from the worldwide ENIGMA ADHD Working Group embarked on what they said is the largest study performed on brain differences in people with and without ADHD. While the results point to possible places where doctors can look to diagnose ADHD, "unfortunately we don't have objective measures yet for many conditions in psychiatry, and that includes ADHD".
"These differences are very small.so the unprecedented size of our study was crucial to help identify these", said Hoogman, the study's lead author. But now, thanks to this study, scientists believe they have conclusive evidence that brain differences and ADHD are not related to medication or other psychiatric disorders people with ADHD may also have.
The finding that children with ADHD had smaller brain structures fits with a "delayed peak volume" theory that ADHD is associated with an "altered velocity of cortical development", the authors said.
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"Many people doubt not only the existence of the disorder, but also its biological basis", he says.
They measured overall brain volume as well as the size of seven regions thought to be linked to the disorder. The findings on the accumbens, amygdala and hippocampus were new.
Martine Hoogman, a geneticist at Radboud University in the Netherlands and also the first author of the study, claimed that the amygdala is a brain structure which was not known to be involved in the evolution of ADHD. The hippocampus constitutes the area where our memories form, while the nucleus accumbens is the area responsible for processing motivation and reward.
Despite the large numbers of participants of all ages, the study was not created to investigate how ADHD might develop over a person's lifetime.
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However, researchers found no differences between individuals who were taking or had taken ADHD drugs and who were not, recommending that the brain changes were not brought by psychostimulants. "We hope that this will help to reduce stigma that ADHD is "just a label" for hard children or caused by poor parenting".
The research was praised by Columbia University's Jonathan Posner as "an important contribution" to the study of the condition.
"Having less brain in several regions sounds bad but it's not as simple as that", he said, pointing out that decreased brain matter can sometimes be beneficial - like in teenagers, when the outer cortex of their developing brains becomes thinner as their intellectual capacity grows.
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