Attention-deficit hyperactivity disorder other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Haleigh Williams, B.S., Dima Nimri, M.D. [2]

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The diagnosis of ADHD is mostly clinical, based on a thorough history and physical exam. Imaging studies should not be routinely done, but rather be guided by pertinent findings in the history and physical exam.[1]

Imaging Findings


High resolution MRI in ADHD shows:

  • Decreased overall brain volume
  • Decreased gray matter volume
  • Decreased cortical thickness
  • Increased white matter volume

These effects are most pronounced in the areas of the prefrontal cortex, caudate and cerebellum.[2][3][4]


  • SPECT scans in patients with ADHD may reveal orbito-frontal and cerebellar hypoperfusion.[5]


  • PET scan shows decreased activity in the front-straito-cerebellar and limbic networks.[6]


  1. Taylor E, Döpfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Rothenberger A, Sonuga-Barke E, Steinhausen HC, Zuddas A (2004). "European clinical guidelines for hyperkinetic disorder -- first upgrade". Eur Child Adolesc Psychiatry. 13 Suppl 1: I7–30. doi:10.1007/s00787-004-1002-x. PMID 15322953.
  2. Narr KL, Woods RP, Lin J, Kim J, Phillips OR, Del'Homme M, Caplan R, Toga AW, McCracken JT, Levitt JG (2009). "Widespread cortical thinning is a robust anatomical marker for attention-deficit/hyperactivity disorder". J Am Acad Child Adolesc Psychiatry. 48 (10): 1014–22. doi:10.1097/CHI.0b013e3181b395c0. PMC 2891193. PMID 19730275.
  3. Seidman LJ, Valera EM, Makris N (2005). "Structural brain imaging of attention-deficit/hyperactivity disorder". Biol. Psychiatry. 57 (11): 1263–72. doi:10.1016/j.biopsych.2004.11.019. PMID 15949998.
  4. Makris N, Liang L, Biederman J, Valera EM, Brown AB, Petty C, Spencer TJ, Faraone SV, Seidman LJ (2015). "Toward Defining the Neural Substrates of ADHD: A Controlled Structural MRI Study in Medication-Naïve Adults". J Atten Disord. 19 (11): 944–53. doi:10.1177/1087054713506041. PMID 24189200.
  5. Schneider H, Thornton JF, Freeman MA, McLean MK, van Lierop MJ, Schneider J (2014). "Conventional SPECT Versus 3D Thresholded SPECT Imaging in the Diagnosis of ADHD: A Retrospective Study". J Neuropsychiatry Clin Neurosci. 26 (4): 335–43. doi:10.1176/appi.neuropsych.12110280. PMID 26037855.
  6. del Campo N, Fryer TD, Hong YT, Smith R, Brichard L, Acosta-Cabronero J, Chamberlain SR, Tait R, Izquierdo D, Regenthal R, Dowson J, Suckling J, Baron JC, Aigbirhio FI, Robbins TW, Sahakian BJ, Müller U (2013). "A positron emission tomography study of nigro-striatal dopaminergic mechanisms underlying attention: implications for ADHD and its treatment". Brain. 136 (Pt 11): 3252–70. doi:10.1093/brain/awt263. PMC 4125626. PMID 24163364.

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