Attention-deficit/hyperactivity disorder (ADHD) is presumed to be heterogeneous, but the best way to characterize this heterogeneity remains unclear. Although considerable evidence suggests that the 2 different types of ADHD, inattention and combined, have different cognitive and behavioral profiles, and underlying neurobiologies, we currently lack information on whether these subtypes reflect separated brain structure changes. Structural magnetic resonance imaging scans (N = 234), diagnostic, and demographic information were obtained from the ADHD-200 database. Of this sample, 138 were Typically Developing people, 37 were ADHD-Combined, and 59 were ADHD-Inattentive patients. Freesurfer segmentation methods were used to measure cortical thickness, area, and volume, subcortical volume and hipposubfield volume. ADHD-Inattentive patients showed milder clinical symptoms but more serious cognitive injury than ADHD-Combined patients. In addition, dissociable structural brain changes were found in different subtypes of ADHD, particularly in terms of decreased subcortical volume in ADHD-Combined patients compared with Typically Developing people. Clinical symptoms were predominantly related to smaller rh_caudalanteriorcingulate thickness and left-Pallidum volume, whereas verbal IQ injury was correlated strongly with smaller rh_insula area. These findings indicate that there are significant differences in clinical symptoms and gray matter damage between ADHD-Combined and -Inattentive patients. This supports the growing evidence of heterogeneity in the ADHD-Inattentive subtype and the evidence of brain structure differences.

中文翻译：

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儿童多动症亚型的结构性脑变化及相关症状

注意缺陷/多动障碍 (ADHD) 被认为是异质性的，但表征这种异质性的最佳方法仍不清楚。尽管大量证据表明，注意力不集中和合并的两种不同类型的 ADHD 具有不同的认知和行为特征以及潜在的神经生物学，但我们目前缺乏关于这些亚型是否反映分离的大脑结构变化的信息。从 ADHD-200 数据库获得结构磁共振成像扫描 (N = 234)、诊断和人口统计信息。在这个样本中，138 人是典型发育人群，37 人是多动症合并症患者，59 人是注意力不集中的多动症患者。Freesurfer分割方法用于测量皮质厚度、面积和体积、皮质下体积和海马亚区体积。ADHD-注意力不集中的患者比ADHD-Combined患者表现出更轻微的临床症状但更严重的认知损伤。此外，在 ADHD 的不同亚型中发现了可分离的大脑结构变化，特别是与典型发育人群相比，ADHD 合并患者的皮质下体积减少。临床症状主要与较小的 rh_caudalanteriorcingulate 厚度和左侧苍白球体积有关，而言语 IQ 损伤与较小的 rh_insula 面积密切相关。这些发现表明，ADHD 合并和注意力不集中的患者在临床症状和灰质损伤方面存在显着差异。这支持了 ADHD-注意力不集中亚型异质性的不断增长的证据和大脑结构差异的证据。