Table 3:
Summary of neuroimaging studies included. The final three columns indicate the degree to which each model of ADHD outcome is supported by the study. Some of the major strengths and limitations are noted in the final columns.
| Referenc e |
Participants (N) |
Age (year) M(SD) |
Outcomes | Models | Comments | Association with hyperactivity- impulsivity and inattention |
|||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Task based imaging | |||||||||||
| Schulz et al 2017 |
11/16/28 | 7–11 | 24 (2) | fMRI: stimulus and response conflict task |
+++ Fronto- parietal activation during high cognitive demand |
- | - | Strengths: Tested core ADHD cognitive deficit Limitations: Modest N of remitters |
Not reported | ||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Szekely et al 2017 |
fMRI:24/40/84 MEG-25/26/46 |
9 (1) | 24(4) | MEG and f RI: response inhibition |
+++ Prefrontal inhibitory processing |
- | +++ Striatal activity |
Strengths: Multimodal Large sample size Limitations: Adult endpoint imaging only |
Hyperactivity- impulsivity (not inattention) associated with atypical inferior frontal activity in fMRI and MEG |
||
| Schneider et al 2010 |
11/8/17 | N/A | 32(10 ) |
fMRI: NoGo in continuous performance task |
++ More typical activation in fronto- parietal regions in remitters |
- | - | Strengths: medication naive Limitations: First clinical assessment in adulthood Small N of remitters |
Inattention, hyperactivity, impulsivity scores all correlated with decreased fronto- striato-parietal hypoactivation, and with increased insula activity |
||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Clerkin et al 2013 |
16/19/32 | 9(1) | 24(2) | fMRI: cued response preparation (‘bottom-up’) |
- | + Thalamo- cortical connectivit y during response preparation |
++ Thalamic activation |
Strengths: Direct test of an influential model of ADHD remission Limitations: ROI (thalamus) connectivity analyses only |
Not reported | ||
| Michelini et al 2016 |
87/23/169 | 13 | 19 (3) | EEG: Eriksen Flanker task |
+++ Error related negativity (bottom- up) |
- | + Conflict monitoring - N2 signal (top- down) |
Strengths: First use of electrophysiology in adult remitters. Limitations: Modest N of remitters |
Not reported | ||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Cheung et al 2016 |
87/23/169 | 13 | 19 (3) | EEG: cued flanker continuous performance task |
+++ Preparation -vigilance: contingent negative variation (bottom- up) |
+ Executive, ‘top-down’ processes (NoGo P3 amplitude) |
As above | Not reported | |||
| Wetterlin g et al 2015 |
17/15/22 | Not give n |
21(4) | fMRI: reward, punishment processing |
+++ Fronto- striatal connectivit y |
++ Pre-frontal processing of punishmen t |
- | Strengths: Only examination of reward processing in remitters Limitations: Modest N of remitters |
Not reported | ||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Resting state | |||||||||||
| Mattfield et al 2014 |
13/22/17 | 10 (3) |
28 (5) | fMRI : default mode and its interconnectio ns |
++ DMN internal connectivit y |
- | ++ DMN connection to other regions |
Strengths: First rsFMRI study of adult outcome Clinical FU from childhood into adulthood Limitations: Seed based analyses only |
Not reported | ||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Francx et al 2015 |
74 (persistent symptoms)/55 (improving symptoms; 19 reached remission)/10 0 |
12 | 18 (3) | fMRI: cognitive control network only |
- | +++ Higher connectivit y between cognitive and other brain networks in remitters vs controls |
- | Strengths: Large overall sample size FU over adolescence Limitations: Examined only cognitive network Few syndromic remitters |
Hyperactivity- impulsivity (not inattention) associated with higher connectivity between cognitive control and other networks |
||
| Sudre et al 2017 |
fMRI-41/fMRI- 35/fMRI-71 |
9 (1) | 24(4) | MEG and fMRI: default mode and its interconnectio ns |
+++ DMN internal and external connectivit y |
- | - | Strengths: Multimodal Large sample size Limitations: Adult endpoint only |
Anomalies associated with inattentive symptoms |
||
| MEG-32/MEG- 35/MEG-58 | |||||||||||
| White matter microstructure | |||||||||||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Cortese et al 2013 |
15/25/47 | 8 (2) | 41 (3) | DTI - analyzed at voxel level |
+ | - | ++ | Strengths: Clinical FU from childhood into middle age with low attrition rate Limitations: Males only Low N of directions in DTI |
Not reported | ||
| Bode et al 2015 |
0/30/30 | 15 (1) |
23(1) | DTI - analyzed at voxel level |
? | ? | ? | Strengths Based on population birth cohort Medication naive Limitations: No persisters in study for contrast 1.5T scanner |
Not reported | ||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Francx et al 2015 |
59 (persistent symptoms)/42 (improving symptoms)/40 |
12 | 18 (3) | DTI - analyzed at voxel level |
+++ | - | - | Strengths: Large overall sample size Symptom level analyses Limitations: Low N of directions Few syndromic remitters |
Persistent hyperactive- impulsive (but not inattentive) symptoms correlated with white matter microstructural anomalies |
||
| Shaw et al 2015 |
32/43/74 | 10(3 ) |
23(4) | DTI - analyzed at tract level |
+++ | - | - | Strengths: Clinical FU from childhood to adulthood Large N of DTI directions Limitations: Tract based analyses only |
Persistent inattention correlated with anomalies |
||
| Neuroanatomic | |||||||||||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Shaw et al 2013 |
37/55/184 | 10 (3) |
24(3) | Cortical thickness |
+++ Cortical attention, cognitive control regions converged to typical dimensions in remitters |
- | - | Strengths: Combined prospective clinical FU and imaging from childhood into adulthood Limitations: 1.5T scanner |
Persistent inattention correlated with degree of cortical convergence |
||
| Mackie et al 2007 |
16/16/32 | 10 (3) |
14(4) | Cerebellar subregional volumes |
++ Trajectory of hemisphere s |
- | ++ Trajectory of vermis |
As above | Combined presentation showed most atypical trajectories |
||
| Persistent ADHD /Remitted /Never Affected |
Entr y |
Follo w-up |
Converge/ ‘Normalize’ |
Compensat e |
Fixed trait | ||||||
| Proal et al 2013 |
17/26/57 | 8 (2) | 41 (3) | Cortical thickness/ VBM |
++ Volumes of thalamus/ cerebellum |
- | ++ Thickness of posterior cortex |
Strengths: Clinical FU from childhood into middle age Limitations: Males only Two scanners used |
Not reported | ||