MRI technique may help prevent ADHD misdiagnosis

June 17, 2014, Radiological Society of North America
This shows subgroup averages of parametric maps of MRI brain iron indices: magnetic field correlation (MFC: top row) and relaxation rates R2 (second row), R2*(third row), and R2' (bottom row). Parametric maps, masked for regions of interests (green): caudate nucleus (CN), putamen (PUT), globus pallidus (GP) and thalamus (THL), are shown for controls (n = 27), medication-naïve ADHD patients (ADHD-non-medicated; n = 12) and ADHD patients with a history of psychostimulant treatment (ADHD-medicated; n = 10). The ADHD-non-medicated subgroup displayed significantly reduced striatal (CN, PUT) and thalamic MFC compared to both controls and the ADHD-medicated subgroup. No significant differences were detected between the latter two groups. Credit: Radiological Society of North America

Brain iron levels offer a potential biomarker in the diagnosis of attention deficit hyperactivity disorder (ADHD) and may help physicians and parents make better informed treatment decisions, according to new research published online in the journal Radiology.

ADHD is a common disorder in children and adolescents that can continue into adulthood. Symptoms include hyperactivity and difficulty staying focused, paying attention and controlling behavior. The American Psychiatric Association reports that ADHD affects 3 to 7 percent of school-age children.

Psychostimulant medications such as Ritalin are among the drugs commonly used to reduce ADHD symptoms. Psychostimulants affect levels of dopamine, a neurotransmitter in the brain associated with addiction.

"Much debate and concern has emerged regarding the continual rise of ADHD diagnosis in the U.S. given that two-thirds of those diagnosed receive psychostimulant medications," said Vitria Adisetiyo, Ph.D., postdoctoral research fellow at the Medical University of South Carolina in Charleston, S.C. "We wanted to see if we could identify brain iron as a potential noninvasive biomarker for medication-naïve ADHD to prevent misdiagnosis."

For the study, the research team measured brain iron levels in 22 children and adolescents with ADHD, 12 of whom had never been on medication for their condition (medication naïve), and 27 healthy control children and adolescents using a magnetic resonance imaging (MRI) technique called magnetic field correlation imaging. The technique was introduced in 2006 by study co-authors and faculty members Joseph A. Helpern, Ph.D., and Jens H. Jensen, Ph.D. No contrast agents were used, and blood iron levels in the body were measured using a blood draw.

The results showed that the 12 ADHD medication-naïve patients had significantly lower brain iron levels than the 10 ADHD patients who had been on psychostimulant medication and the 27 children and adolescents in the control group. In contrast, ADHD patients with a history of psychostimulant medication treatment had brain iron levels comparable to controls, suggesting that brain iron may increase to normal levels with psychostimulant treatment.

"Our research suggests that iron absorption into the brain may be abnormal in ADHD given that atypical brain iron levels are found even when blood iron levels in the body are normal," Dr. Adisetiyo said. "We found no differences in blood iron measures between controls, medication-naïve ADHD patients or pscyhostimulant-medicated ADHD patients."

Magnetic field correlation imaging's ability to noninvasively detect the low iron levels may help improve ADHD diagnosis and guide optimal treatment. Currently, ADHD diagnosis is based only on subjective clinical interviews and questionnaires. Having a biological biomarker may help inform clinical diagnosis, particularly in borderline cases, Dr. Adisetiyo noted.

If the results can be replicated in larger studies, magnetic field correlation might have a future role in determining which patients would benefit from psychostimulants—an important consideration because the drugs can become addictive if taken inappropriately and lead to abuse of other drugs like cocaine.

"We want the public to know that progress is being made in identifying potential noninvasive biological biomarkers of ADHD which may help to prevent misdiagnosis," Dr. Adisetiyo said. "We are currently testing our findings in a larger cohort to confirm that measuring levels in ADHD is indeed a reliable and clinically feasible biomarker."

Explore further: MRI technique reveals low brain iron in ADHD patients

More information: "Multimodal MR Imaging of Brain Iron in Attention Deficit Hyperactivity Disorder: A Non-invasive Biomarker that Responds to Psychostimulant Treatment?" Radiology, 2014.

Related Stories

MRI technique reveals low brain iron in ADHD patients

December 2, 2013
Magnetic resonance imaging (MRI) provides a noninvasive way to measure iron levels in the brains of people with attention deficit hyperactivity disorder (ADHD), according to a study being presented today at the annual meeting ...

CDC: More than one in 10 kids diagnosed with ADHD

November 26, 2013
(HealthDay)—More than one in 10 children and adolescents are diagnosed with attention-deficit/hyperactivity disorder (ADHD), an increase of 42 percent in less than a decade, according to a study published online Nov. 25 ...

MRI shows disrupted connections in the brains of young people with ADHD

April 30, 2014
A new study has found that children and adolescents with attention deficit hyperactivity disorder (ADHD) have disrupted connections between different areas of the brain that are evident on resting-state functional magnetic ...

Gyroscopes can help diagnose ADHD

June 10, 2014
The latest miniaturised movement sensors, incorporating both accelerometers and gyroscopes, can be used to provide an objective diagnosis of attention-deficit/hyperactivity disorder (ADHD), according to new research in the ...

Long-term ADHD treatment increases brain dopamine transporter levels, may affect drug efficacy

May 15, 2013
Long-term treatment of attention deficit/hyperactivity disorder (ADHD) with certain stimulant medications may alter the density of the dopamine transporter, according to research published May 15 in the open access journal ...

ADHD treatment associated with lower smoking rates

May 12, 2014
Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when medication is taken consistently, according to an analysis led by researchers at Duke Medicine.

Recommended for you

For children with ADHD, a brief, school-based program can help dramatically with homework problems, study finds

December 6, 2017
Children with attention deficit hyperactivity disorder who took part in a brief, school-based program displayed significant improvements in their homework, organization and planning skills, according to a new study led by ...

What can twitter reveal about people with ADHD?

November 9, 2017
What can Twitter reveal about people with attention-deficit/hyperactivity disorder, or ADHD? Quite a bit about what life is like for someone with the condition, according to findings published by University of Pennsylvania ...

Brain imaging reveals ADHD as a collection of different disorders

November 8, 2017
Researchers have found that patients with different types of attention-deficit/hyperactivity disorder (ADHD) have impairments in unique brain systems, indicating that there may not be a one-size-fits-all explanation for the ...

Can adults develop ADHD? New research says probably not

October 20, 2017
Adults likely do not develop ADHD, according to new research by FIU clinical psychologist Margaret Sibley.

Nearly a third of college kids think ADHD meds boost grades

October 16, 2017
(HealthDay)—Many college students who abuse ADHD drugs mistakenly believe that doing so will lead to better grades, a new survey suggests.

School year 'relative age' causing bias in ADHD diagnosis, says research

October 9, 2017
Younger primary school children are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older peers within the same school year, new research has shown.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.