A large multinational imaging study published last month in The Lancet provides additional evidence confirming what smaller studies have already shown: the brains of children with ADHD look different from those without ADHD. In this recent study, MRI brain scans were analyzed from 1,713 people with ADHD and 1,529 people without ADHD from 9 countries in North America, Europe, South America, and Asia. Participants ranged in age from 4-63 years old. For children with ADHD, five brain regions showed smaller volume: the amygdala (emotion regulation), the hippocampus (memory), the putamen and caudate nucleus (both involved in motor skills and learning), and the nucleus accumbens (sensitivity to rewards). For adults with ADHD however, there were no differences in brain volume in these regions.
From a scientific standpoint, studies like these help advance our understanding of ADHD and will hopefully one day lead to more targeted treatments and more specific diagnoses. For example, previous studies hadn’t identified the amygdala, which helps us regulate our emotions, as a region of the brain that is smaller in kids with ADHD. Now, with this new information, ADHD researchers will likely invest more time and money into developing behavioral treatments and medications that target emotion regulation. From an everyday, real-world standpoint, these results also serve another purpose - one that may be equally as important. For parents and teachers who too often hear that ADHD is caused by poor parenting or poor teaching, and for children with ADHD who are too often told that they should just “try harder” and “apply themselves,” these results provide reassurance that ADHD is a real brain-based problem and that no one should be blamed for the fact that the symptoms exist.
While parents very often find this research helpful when it comes to understanding ADHD overall, it also brings up important questions about what this research means for their children specifically:
Can I ask our pediatrician to order a brain scan so I can confirm that my child has ADHD?
Currently there is no brain scan methodology available to doctors that will help them diagnose ADHD. In research studies the reported differences in brain volume are actually very small. So small in fact that these differences are only observable and meaningful when you are able to combine brain scan data from multiple people into a single study. With the limited technology and information that we have available today, we can’t reliably identify these differences in a single child with ADHD. Hopefully one day in the future this will be possible!
If the differences were not found in adults, then does this mean that my child’s brain will eventually catch up and they won’t have ADHD anymore?
Remember that this study compared brain regions in people with ADHD and people without ADHD. To qualify for the “ADHD” group, adults were required to have a current ADHD diagnosis. So, even without smaller brain volume, adults in this study were experiencing ADHD symptoms. This means that it’s not just differences in brain volume that causes ADHD symptoms, its other aspects of brain functioning as well. However, these study results do show us how the brain changes over time, and they may help explain why many ADHD symptoms look different in adults than they do in kids.
If my child’s brain is different, is there anything we can really do to help him get over his ADHD?
Knowing that ADHD is a brain-based disorder doesn’t change the fact that there are many effective behavioral, educational, and medication-based treatments that work for kids with ADHD. These treatments all help compensate for the brain differences that we see in these research studies. On top of this, many factors that have been shown to improve “brain health” and promote brain growth and development may help kids with ADHD if they are used long-term. This includes things like regular physical activity, healthy food and nutrition, getting enough sleep, close family relationships and friendships, and participating in a wide-range of academically and mentally challenging activities.
Scientists are just starting to learn about differences in the ADHD brain, and their findings will eventually lead to new treatment options. In the meantime, we can use this information to help ourselves improve our understanding of ADHD and expand our thinking about ADHD treatments to include healthy lifestyle choices that promote long term brain growth and development.
Read the full study here: http://www.sciencedirect.com/science/article/pii/S2215036617300494
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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