ADHD breakthrough could be on horizon

By Mark Waghorn via SWNS

A screening program for attention deficit hyperactivity disorder (ADHD) could be on the horizon.

Scientists at Yale have identified brain differences that identify young patients.

It could lead to earlier diagnosis, treatment planning and surveillance of the condition.

Co-author of the study Dr. Huang Lin, of the Yale School of Medicine in New Haven, Connecticut, said: "There’s a need for a more objective methodology for a more efficient and reliable diagnosis.

"ADHD symptoms are often undiagnosed or misdiagnosed because the evaluation is subjective."

The findings are based on MRI (magnetic resonance imaging) scans of almost 8,000 nine and ten-year-olds in the US.

Participants included 1,798 who had been diagnosed with ADHD. A statistical analysis was carried out of brain volume, surface area, white matter integrity and functional connectivity.

Dr. Lin said: "We found changes in almost all the regions of the brain we investigated. The pervasiveness throughout the whole brain was surprising since many prior studies have identified changes in selective regions of the brain."

The team observed abnormal connectivity in neurons involved in memory and auditory processing, thinner brain cortex and alterations in white matter - especially in the frontal lobe.

Dr. Lin said: "The frontal lobe is the area of the brain involved in governing impulsivity and attention or lack thereof - two of the leading symptoms of ADHD."
 
Data was significant enough that it could be used as input for machine learning models to predict an ADHD diagnosis. Artificial intelligence (AI) can analyze large amounts of MRI data.

Dr. Lin said: "Our study underscores that ADHD is a neurological disorder with neuro-structural and functional manifestations in the brain, not just a purely externalized behavior syndrome."

The data also offers reassurance that the MRI biomarkers give a solid picture of the brain.

She explained: "At times when a clinical diagnosis is in doubt, objective brain MRI scans can help to clearly identify affected children.

"Objective MRI biomarkers can be used for decision making in ADHD diagnosis, treatment planning and treatment monitoring."

According to the Centers for Disease Control and Prevention, ADHD is one of the most common neurodevelopmental disorders in childhood.

It affects approximately six million American children between the ages of three and 17 years.

Children with the disorder may have trouble paying attention and controlling impulsive behaviors, or they may be overly active.

Diagnosis relies on a checklist completed by the child’s caregiver to rate the presence of ADHD symptoms.

Dr. Lin said: "The demographics of our group mirror the US population, making our results clinically applicable to the general population."

Recent trials have reported microstructural changes in response to therapy among ADHD children.

Senior author Dr. Sam Payabvash, from the same lab, said: "Our study provides novel and multimodal neuroimaging biomarkers as potential therapeutic targets in these children."

The study was presented at a meeting of the Radiological Society of North America in Chicago.