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Functional deficits in basal ganglia of children with attention-deficit/hyperactivity disorder shown with functional magnetic resonance imaging relaxometry


Attention-deficit/hyperactivity disorder is a highly heritable and prevalent neuropsychiatric disorder estimated to affect 6% of school-age children1,2,3. Its clinical hallmarks are inattention, hyperactivity and impulsivity4,5, which often respond substantially to treatment with methylphenidate or dextroamphetamine. Etiological theories suggest a deficit in corticostriatal circuits, particularly those components modulated by dopamine. We developed a new functional magnetic resonance imaging procedure (T2 relaxometry) to indirectly assess blood volume in the striatum (caudate and putamen) of boys 6–12 years of age in steady-state conditions. Boys with attention-deficit/hyperactivity disorder had higher T2 relaxation time measures in the putamen bilaterally than healthy control subjects. Relaxation times strongly correlated with the child's capacity to sit still and his accuracy in accomplishing a computerized attention task. Daily treatment with methylphenidate significantly changed the T2 relaxation times in the putamen of children with attention-deficit/hyperactivity disorder, although the magnitude and direction of the effect was strongly dependent on the child's unmedicated activity state. There was a similar but nonsignificant trend in the right caudate. T2 relaxation time measures in thalamus did not differ significantly between groups, and were not affected by methylphenidate. Attention-deficit/hyperactivity disorder symptoms may be closely tied to functional abnormalities in the putamen, which is mainly involved in the regulation of motor behavior.

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Figure 1: Differences between ADHD and control subjects in T2-RT evaluated in specific regions of interest
Figure 2: Association between T2-RT and attention and influence of basal activity on T2-RT drug response.


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We thank A. Smith and E. Connolly for collecting the fMRI data, and R. Feldman for help with technical writing. Support for this project was provided in part by National Institutes of Mental Health grant MH-48343 (M.H.T.) and National Institute on Drug Abuse grant DA-09448 (P.F.R.). C.M.A. was supported by special supplement to National Institutes of Mental Health grant MH-53636 (M.H.T.).

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Teicher, M., Anderson, C., Polcari, A. et al. Functional deficits in basal ganglia of children with attention-deficit/hyperactivity disorder shown with functional magnetic resonance imaging relaxometry. Nat Med 6, 470–473 (2000).

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