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Brain development is delayed in attention-deficit/hyperactivity disorder

July 30, 2012

Philadelphia, PA, July 30, 2012 - Is attention-deficit/hyperactivity disorder (ADHD) due to a delay in brain development or the result of complete deviation from typical development? In the current issue of Biological Psychiatry, Dr. Philip Shaw and colleagues present evidence for delay based on a study by the National Institutes of Health.

The cerebral cortex is the folded gray tissue that makes up the outermost portion of the brain, covering the brain's inner structures. This tissue has left and right hemispheres and is divided into lobes. Each lobe performs specific and vitally important functions, including attention, thought, language, and sensory processing.

Two dimensions of this structure are cortical thickness and cortical surface area, both of which mature during childhood as part of the normal developmental process. This group of scientists had previously found that the thickening process is delayed in children diagnosed with ADHD. So in this study, they set out to measure whether surface area development is similarly delayed.

They recruited 234 children with ADHD and 231 typically developing children and scanned each up to 4 times. The first scan was taken at about age 10, and the final scan was around age 17. Using advanced neuroimaging technology, they were able to map the trajectories of surface area development at over 80,000 points across the brain.

They found that the development of the cortical surface is delayed in frontal brain regions in children with ADHD. For example, the typically developing children attained 50% peak area in the right prefrontal cortex at a mean age of 12.7 years, whereas the ADHD children didn't reach this peak until 14.6 years of age.

"As other components of cortical development are also delayed, this suggests there is a global delay in ADHD in brain regions important for the control of action and attention," said Dr. Shaw, a clinician studying ADHD at the National Institute of Mental Health and first author of this study.

"These data highlight the importance of longitudinal approaches to brain structure," commented Dr. John Krystal, Editor of Biological Psychiatry. "Seeing a lag in brain development, we now need to try to understand the causes of this developmental delay in ADHD."

Dr Shaw agrees, adding that this finding "guides us to search for genes that control the timing of brain development in the disorder, opening up new targets for treatment."

Additional work expanding these measures into adulthood will also be important. Such data would help determine whether or when a degree of normalization occurs, or if these delays translate into long-lasting cortical deficits.

-end-

The article is "Development of Cortical Surface Area and Gyrification in Attention-Deficit/Hyperactivity Disorder" by Philip Shaw, Meaghan Malek, Bethany Watson, Wendy Sharp, Alan Evans, and Deanna Greenstein (doi: 10.1016/j.biopsych.2012.01.031). The article appears in Biological Psychiatry, Volume 72, Issue 3 (August 1, 2012), published by Elsevier.

Notes for editors

Full text of the article is available to credentialed journalists upon request; contact Rhiannon Bugno at +1 214 648 0880 or Biol.Psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact Raymond MacDougall at +1 301 443 3523 or macdougallr@mail.nih.gov.

The authors' affiliations, and disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.

About Biological Psychiatry

Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.

The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.

Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric neuroscience. It is ranked 5th out of 129 Psychiatry titles and 16th out of 243 Neurosciences titles in the Journal Citations Reports® published by Thomson Reuters. The 2011 Impact Factor score for Biological Psychiatry is 8.283.

About Elsevier

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include ScienceDirect, Scopus, Reaxys, ClinicalKey and Mosby's Nursing Suite, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact

Rhiannon Bugno
Editorial Office, Biological Psychiatry
+1 214 648 0880
biol.psych@utsouthwestern.edu

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