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Quantitative Brain Magnetic Resonance Imaging in Girls With Attention-Deficit/Hyperactivity Disorder
F. Xavier Castellanos, MD;
Jay N. Giedd, MD;
Patrick C. Berquin, MD;
James M. Walter, MA;
Wendy Sharp, MSW;
Thanhlan Tran, BS;
A. Catherine Vaituzis;
Jonathan D. Blumenthal, MA;
Jean Nelson, MHS;
Theresa M. Bastain, BA;
Alex Zijdenbos, PhD;
Alan C. Evans, PhD;
Judith L. Rapoport, MD
Arch Gen Psychiatry. 2001;58:289-295.
Background Anatomic studies of boys with attention-deficit/hyperactivity disorder
(ADHD) have detected decreased volumes in total and frontal brain, basal ganglia,
and cerebellar vermis. We tested these findings in a sample of girls with
ADHD.
Methods Anatomic brain magnetic resonance images from 50 girls with ADHD, of
severity comparable with that in previously studied boys, and 50 healthy female
control subjects, aged 5 to 15 years, were obtained with a 1.5-T scanner with
contiguous 2-mm coronal slices and 1.5-mm axial slices. We measured volumes
of total cerebrum, frontal lobes, caudate nucleus, globus pallidus, cerebellum,
and cerebellar vermis. Behavioral measures included structured psychiatric
interviews, parent and teacher ratings, and the Wechsler vocabulary and block
design subtests.
Results Total brain volume was smaller in girls with ADHD than in control subjects
(effect size, 0.40; P = .05). As in our previous
study in boys with ADHD, girls with ADHD had significantly smaller volumes
in the posterior-inferior cerebellar vermis (lobules VIII-X; effect size,
0.54; P = .04), even when adjusted for total cerebral
volume and vocabulary score. Patients and controls did not differ in asymmetry
in any region. Morphometric differences correlated significantly with several
ratings of ADHD severity and were not predicted by past or present stimulant
drug exposure.
Conclusions These results confirm previous findings for boys in the posterior-inferior
lobules of the cerebellar vermis. The influence of the cerebellar vermis on
prefrontal and striatal circuitry should be explored.
From the Child Psychiatry Branch, National Institute of Mental Health,
Bethesda, Md (Drs Castellanos, Giedd, and Rapoport, Messrs Walter and Blumenthal,
and Mss Sharp, Tran, Vaituzis, Nelson, and Bastain); Service de Pédiatrie
1, CHU Hôpital Nord, Amiens, France (Dr Berquin); and Montreal Neurological
Institute, McGill University, Montreal, Quebec (Drs Zijdenbos and Evans).
Corresponding author and reprints: F. Xavier Castellanos, MD, Child
Psychiatry Branch, National Institute of Mental Health, Bldg 10, Room 3N-202,
10 Center Dr—MSC 1600, Bethesda, MD 20892-1600.
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