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Review
. 2019 May:100:1-8.
doi: 10.1016/j.neubiorev.2019.02.011. Epub 2019 Feb 18.

Brain alterations in children/adolescents with ADHD revisited: A neuroimaging meta-analysis of 96 structural and functional studies

Fateme Samea  1 , Solmaz Soluki  1 , Vahid Nejati  2 , Mojtaba Zarei  3 , Samuele Cortese  4 , Simon B Eickhoff  5 , Masoud Tahmasian  6 , Claudia R Eickhoff  7
Affiliations
Review

Brain alterations in children/adolescents with ADHD revisited: A neuroimaging meta-analysis of 96 structural and functional studies

Fateme Samea et al. Neurosci Biobehav Rev. 2019 May.

Abstract

The findings of neuroimaging studies in children/adolescents with ADHD, and even those of previous meta-analyses, are divergent. Here, Activation Likelihood Estimation meta-analysis, following the current best-practice guidelines, was conducted. We searched multiple databases and traced the references up to June 2018. Then, we extracted the reported coordinates reflecting group comparison between ADHD and healthy subjects from 96 eligible studies, containing 1914 unique participants. The analysis of pooled structural and functional, sub-analyses restricted to modality, and in-/decreased contrast did not yield any significant findings. However, further sub-analyses in the task-fMRI experiments (neutral stimuli only) led to aberrant activity in the left pallidum/putamen and decreased activity (male subjects only) in the left inferior frontal gyrus. The overall findings indicate a lack of regional convergence in children/adolescents with ADHD, which might be due to heterogeneous clinical populations, various experimental design, preprocessing, statistical procedures in individual publications. Our results highlight the need for further high-powered investigations, but may also indicate ADHD pathophysiology might rest in network interactions rather than just regional abnormality.

Keywords: ADHD; Activation likelihood estimation; Coordinate-based meta-analysis; VBM; fMRI.

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Conflict of interest statement

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1.
Fig. 1.
Study selection strategy flow chart. ROI: region of Interest, task-fMRI: task-based functional magnetic resonance imaging, rs-fMRI: resting-state functional magnetic resonance imaging, VBM: voxel-based morphometry, ADHD: attention-deficit/hyperactivity disorder.
Fig. 2.
Fig. 2.
Distribution of the included coordinates in the current study. Included coordinates reflecting structural/functional alterations in children/adolescents with ADHD compared to healthy subjects. Rs-fMRI: resting-state functional magnetic resonance imaging; task-fMRI: task-based functional magnetic resonance imaging; VBM: voxel-based morphometry.
Fig. 3.
Fig. 3.
Convergent findings of sub-analyses. A. Aberrant activity (green) in the left pallidum/putamen (−18, 4, −4 MNI, 109 voxels, p = 0.036), based on task-based fMRI experiments (using neutral stimuli only); B. Decreased activity (blue) in the left inferior frontal gyrus (−38, 26, −16 MNI, 93 voxels, p = 0.049 based on fMRI (task-fMRI & rs-fMRI) experiments (using male patients only).
See this image and copyright information in PMC

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