Elsevier

Biological Psychiatry

Volume 61, Issue 12, 15 June 2007, Pages 1361-1369
Biological Psychiatry

Original Article
Meta-Analysis of Structural Imaging Findings in Attention-Deficit/Hyperactivity Disorder

https://doi.org/10.1016/j.biopsych.2006.06.011Get rights and content

Background

Although there are many structural neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) in children, there are inconsistencies across studies and no consensus regarding which brain regions show the most robust area or volumetric reductions relative to control subjects. Our goal was to statistically analyze structural imaging data via a meta-analysis to help resolve these issues.

Methods

We searched the MEDLINE and PsycINFO databases through January 2005. Studies must have been written in English, used magnetic resonance imaging, and presented the means and standard deviations of regions assessed. Data were extracted by one of the authors and verified independently by another author.

Results

Analyses were performed using STATA with metan, metabias, and metainf programs. A meta-analysis including all regions across all studies indicated global reductions for ADHD subjects compared with control subjects, standardized mean difference = .408, p < .001. Regions most frequently assessed and showing the largest differences included cerebellar regions, the splenium of the corpus callosum, total and right cerebral volume, and right caudate. Several frontal regions assessed in only two studies also showed large significant differences.

Conclusions

This meta-analysis provides a quantitative analysis of neuroanatomical abnormalities in ADHD and information that can be used to guide future studies.

Section snippets

Methods and Materials

We searched the MEDLINE (PubMed) and PsycINFO databases, using the key words ADHD, attention-deficit/hyperactivity disorder, attention deficit disorder, hyperkinetic disorder, neuroimaging, structural imaging, imaging, magnetic resonance imaging, and MRI. Citations from identified articles were also searched for relevant studies. We placed no limit on year of publication and the search was completed in January of 2005. To be included, studies must have been written in English, used magnetic

Results

A meta-analysis including all brain regions measured across all studies indicated global reductions for the ADHD subjects compared with control subjects, SMD = .408, Z = 17.21, p < .001, 95% confidence interval (.361–.454). Not surprisingly, there was also significant heterogeneity across regions and studies, χ2 = 437.09, p < .001. Regions of interest that were assessed in at least three studies are shown in Table 2, Table 3. Table 2 presents ROIs that yielded significant SMDs between ADHD and

Discussion

This meta-analysis provides a quantitative analysis of the structural imaging findings for ADHD youth. By conducting meta-analyses for each ROI, we demonstrated that the brain regions most frequently assessed and showing the largest and most significant area or volumetric reductions relative to control subjects include cerebellar ROIs, in particular the posterior inferior vermis, as well as the splenium of the CC, total and right cerebral volume, and right caudate. Regions of interest assessed

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