Long-Range White Matter Microstructural Alterations in Drug-Naive Children with Attention Deficit Hyperactivity Disorder: A Tract-Based Spatial Statistics Study
Abstract Background Microstructural changes might underlie white matter (WM) pathology in attention deficit hyperactivity disorder (ADHD). To investigate WM alterations, particularly the changes in long-range fibers, in drug-naive children with ADHD, we conducted tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) data. Materials and Methods In this study, 57 children with ADHD and 41 healthy controls (HCs) were enrolled. None of the enrolled ADHD children received any medication before data collection. The difference in fractional anisotropy (FA), and in mean (MD), axial (AD), and radial diffusivity (RD) between both groups were calculated using TBSS. WM changes were then correlated with clinical symptoms, including the hyperactivity index score and the impulsivity score. Results Whole-skeleton analysis identified several long-range fibers of decreased FA and increased RD in the ADHD group as compared to the HC group. ADHD children demonstrated decreased FA in the right corpus callosum (CC) splenium, left inferior fronto-occipital fasciculus, and intersection of the anterior and posterior internal capsule. Moreover, higher RD was observed in the right CC splenium, superior longitudinal fasciculus, and posterior corona radiata. No regions of increased FA or reduced RD were observed, and no differences in MD or AD were noted. Conclusion Our results demonstrate that microstructural WM alterations and changes in the long-range WM connections are present in children with ADHD. We speculate that these changes may relate to the symptoms of hyperactivity and impulsivity.