Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

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J Psychiatry Neurosci 2010;35(1):55-8

Marcel Romanos,* MD; David Weise,* MD; Mira Schliesser; Martin Schecklmann, PhD; Julia Löffler; Andreas Warnke, MD, PhD; Manfred Gerlach, PhD; Joseph Classen, MD; Claudia Mehler-Wex, MD

Romanos, Löffler, Warnke, Gerlach — Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Weise, Schliesser, Classen — Department of Neurology, University Hospital of Wuerzburg, Wuerzburg; Weise, Classen — Department of Neurology, University Hospital of Leipzig, Leipzig; Schecklmann — Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg; Löffler — Leopoldina Hospital, Department of Child and Adolescent Psychiatry and Psychotherapy; Mehler-Wex — Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany

*These authors contributed equally to this article.

Abstract

Background: Structural abnormality of the substantia nigra can be detected by transcranial sonography in neuropsychiatric disorders such as Parkinson disease and restless legs syndrome. We investigated echogenicity of the substantia nigra as a potential structural marker for dysfunction of the nigrostriatal dopamine system in children with attention-deficit hyperactivity disorder (ADHD).

Methods: We used a blinded design and determined echogenicity of the substantia nigra by use of transcranial sonography in 22 children with ADHD and 22 healthy controls matched for age and sex.

Results: The echogenic substantia nigra area was significantly larger in ADHD patients than in healthy controls (F1,42= 9.298, p = 0.004, effect size = 0.92). We found no effects of age or sex.

Limitations: Owing to a lack of dimensional assessment, we could not analyze the correlation between echogenicity and clinical symptoms.

Conclusion: Our results support the hypothesis that the nigrostriatal dopaminergic system is abnormal in children with ADHD.


Acknowledgments: The authors thank all families for their participation and support. This study was performed within the framework of the Clinical Research Program ADHD (KFO 125/1-1 & 1-2) supported by the Deutsche Forschungsgesellschaft. The research of the authors is also supported by a grant from the Münchner Medizinische Wochenschrift and the “Verein zur Durchführung neurowissenschaftlicher Kongresse e.V.”

Competing interests: None declared.

Contributors: Drs. Romanos, Weise, Warnke, Gerlach, Classen and Mehler-Wex designed the study. Drs. Romanos and Weise and Mrs. Schliesser and Mrs. Löffler acquired the data, which Drs. Romanos, Weise, Schecklmann, Warnke, Gerlach, Classen and Mehler-Wex analyzed. Drs. Romanos, Weise and Schecklmann wrote the article. All authors reviewed the article and approved its publication.

Submitted Apr. 11, 2009; Revised Aug. 21, 2009; Accepted Sep. 2, 2009.

Correspondence to: Dr. Marcel Romanos, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hopital of Wuerzburg, Fuechsleinstr. 15, 97080 Wuerzburg, Germany; fax 49 (0)931 201 78 620;