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. 2021 Sep;62(9):1140-1149.
doi: 10.1111/jcpp.13384. Epub 2021 Mar 30.

Characterizing neuroanatomic heterogeneity in people with and without ADHD based on subcortical brain volumes

Ting Li  1 , Daan van Rooij  2 , Nina Roth Mota  1   3 , Jan K Buitelaar  2 ; ENIGMA ADHD Working Group; Martine Hoogman  1 , Alejandro Arias Vasquez  1   2   3 , Barbara Franke  1   3
Collaborators, Affiliations

Characterizing neuroanatomic heterogeneity in people with and without ADHD based on subcortical brain volumes

Ting Li et al. J Child Psychol Psychiatry. 2021 Sep.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Neuroanatomic heterogeneity limits our understanding of ADHD's etiology. This study aimed to parse heterogeneity of ADHD and to determine whether patient subgroups could be discerned based on subcortical brain volumes.

Methods: Using the large ENIGMA-ADHD Working Group dataset, four subsamples of 993 boys with and without ADHD and to subsamples of 653 adult men, 400 girls, and 447 women were included in analyses. We applied exploratory factor analysis (EFA) to seven subcortical volumes in order to constrain the complexity of the input variables and ensure more stable clustering results. Factor scores derived from the EFA were used to build networks. A community detection (CD) algorithm clustered participants into subgroups based on the networks.

Results: Exploratory factor analysis revealed three factors (basal ganglia, limbic system, and thalamus) in boys and men with and without ADHD. Factor structures for girls and women differed from those in males. Given sample size considerations, we concentrated subsequent analyses on males. Male participants could be separated into four communities, of which one was absent in healthy men. Significant case-control differences of subcortical volumes were observed within communities in boys, often with stronger effect sizes compared to the entire sample. As in the entire sample, none were observed in men. Affected men in two of the communities presented comorbidities more frequently than those in other communities. There were no significant differences in ADHD symptom severity, IQ, and medication use between communities in either boys or men.

Conclusions: Our results indicate that neuroanatomic heterogeneity in subcortical volumes exists, irrespective of ADHD diagnosis. Effect sizes of case-control differences appear more pronounced at least in some of the subgroups.

Keywords: ADHD; community detection; effect sizes; neuroanatomic heterogeneity; subcortical volume.

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Figures

Figure 1
Figure 1
The three‐factor model that was generated by EFA in the boys with estimated factor loadings of the latent factors. Note: Similar factor models were generated in boys with and without ADHD separately
Figure 2
Figure 2
Communities generated by CD. A: Communities in boys; B: Communities in men. Note: Lines represent participants in each community from CD. Y‐axis indicates the mean factor scores for each factor. Error bars: standard error of the mean. * indicates the difference of factor scores between patients and controls are significant
See this image and copyright information in PMC

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