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Grainne M. McAlonan, Vinci Cheung, Siew E. Chua, Jaap Oosterlaan, Se-fong Hung, Chun-pan Tang, Chi-chiu Lee, Shi-leung Kwong, Ting-pong Ho, Charlton Cheung, John Suckling, and Patrick W. L. Leung
Age-related grey matter volume correlates of response inhibition and shifting in attention-deficit hyperactivity disorder
The British Journal of Psychiatry 2009; 194: 123-129 [Abstract] [Full text] [PDF]
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[Read eLetter] Putamen involvement in ADHD
Ian C Ellison-Wright, Zoë Ellison-Wright, Ed Bullmore   (25 February 2009)

Putamen involvement in ADHD 25 February 2009
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Ian C Ellison-Wright,
Consultant Psychiatrist
Avon & Wiltshire Mental Health Partnership NHS Trust,
Zoë Ellison-Wright, Ed Bullmore

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Re: Putamen involvement in ADHD

ian.ellison-wright{at}awp.nhs.uk Ian C Ellison-Wright, et al.

We read with interest the study by McAlonan et al. (1) which found that in children with ADHD, slower reaction times in tests of attention were correlated with reduced gray matter in the right putamen. Evidence from several other sources implicates the putamen as having a central role in the brain circuit mediating ADHD symptoms.

A study of ADHD symptoms in twenty-five children with focal stroke lesions found that the symptoms were most commonly associated with lesions of the posterior putamen (2). Our meta-analysis of voxel-based MRI studies located the gray matter deficit in ADHD subjects in the right putamen/globus pallidus region (3). More recently, a study of basal ganglia shape found volume loss in parts of the putamen (bilaterally) in boys with ADHD (4).

The connectivity of the putamen can now be investigated by diffusion tensor imaging (5) and this may permit the identification of specific white matter tract changes in children with ADHD, providing a potential investigation to assist in earlier diagnosis.

References

1. McAlonan GM, Cheung V, Chua SE, Oosterlaan J, Hung SF, Tang CP, Lee CC, Kwong SL, Ho TP, Cheung C, Suckling J, Leung PW. Age-related grey matter volume correlates of response inhibition and shifting in attention- deficit hyperactivity disorder. Br J Psychiatry 2009;194:123-9.

2. Max JE, Fox PT, Lancaster JL, Kochunov P, Mathews K, Manes FF, Robertson BA, Arndt S, Robin DA, Lansing AE. Putamen lesions and the development of attention-deficit/hyperactivity symptomatology. J Am Acad Child Adolesc Psychiatry 2002; 41:563-71.

3. Ellison-Wright I, Ellison-Wright Z, Bullmore E. Structural brain change in Attention Deficit Hyperactivity Disorder identified by meta- analysis. BMC Psychiatry. 2008; 8:51.

4. Qiu A, Crocetti D, Adler M, Mahone EM, Denckla MB, Miller MI, Mostofsky SH. Basal ganglia volume and shape in children with attention deficit hyperactivity disorder. Am J Psychiatry 2009; 166:74-82.

5. Leh SE, Ptito A, Chakravarty MM, Strafella AP. Fronto-striatal connections in the human brain: a probabilistic diffusion tractography study. Neurosci Lett 2007; 419:113-8.