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Brain abnormalities may persist into young adulthood among adolescents with ADHD

Young adults diagnosed with attention deficit/hyperactivity disorder in adolescence exhibited structural and functional deficits associated with abnormal working memory function, suggesting changes in the brain may persist into adulthood despite clinical improvement.

“[ADHD] was initially thought to abate in adolescence but increasing evidence indicates that ADHD frequently persists through to adulthood. Of those diagnosed during childhood, about 30–60% show symptoms during adulthood. It is because of its associated morbidity and disability across the lifespan that ADHD has come to be a major clinical and public health concern,” Andres Roman‑Urrestarazu, PhD, of the University of Cambridge, and colleagues wrote.

To determine if individuals diagnosed with ADHD in adolescence had residual brain abnormalities in adulthood, researchers assessed brain scans from 49 young adults diagnosed with ADHD in adolescence and 34 controls in a voxel-based analysis. Study participants were aged 20 to 24 years. One patient had received medication for ADHD. A sub-sample of 21 individuals with ADHD and 23 controls performed a working memory task while acquiring functional MRI data.

Researchers found that individuals with adolescent ADHD had lower grey matter volume in the caudate (P < .05) and poorer working memory, associated with failure to exhibit normal load-dependent caudate activation.

“Although people diagnosed with ADHD in adolescence may recover clinically sufficiently to no longer meet diagnostic criteria, they may continue to manifest abnormalities in caudate structure and function and working memory performance in early adulthood,” Roman-Urrestarazu and colleagues wrote. “The results emphasize the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time.” – by Amanda Oldt

Disclosure: Roman‑Urrestarazu reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.