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F. Xavier Castellanos, MD; Jay N. Giedd, MD; Patrick C. Berquin, MD; James M. Walter, MA; Wendy Sharp, MSW; Thanhlan Tran, BS; A. Catherine Vaituzis; Jonathan D. Blumenthal, MA; Jean Nelson, MHS; Theresa M. Bastain, BA; Alex Zijdenbos, PhD; Alan C. Evans, PhD; Judith L. Rapoport, MD

Arch Gen Psychiatry. 2001;58:289-295.

Background  Anatomic studies of boys with attention-deficit/hyperactivity disorder (ADHD) have detected decreased volumes in total and frontal brain, basal ganglia, and cerebellar vermis. We tested these findings in a sample of girls with ADHD.

Methods  Anatomic brain magnetic resonance images from 50 girls with ADHD, of severity comparable with that in previously studied boys, and 50 healthy female control subjects, aged 5 to 15 years, were obtained with a 1.5-T scanner with contiguous 2-mm coronal slices and 1.5-mm axial slices. We measured volumes of total cerebrum, frontal lobes, caudate nucleus, globus pallidus, cerebellum, and cerebellar vermis. Behavioral measures included structured psychiatric interviews, parent and teacher ratings, and the Wechsler vocabulary and block design subtests.

Results  Total brain volume was smaller in girls with ADHD than in control subjects (effect size, 0.40; P = .05). As in our previous study in boys with ADHD, girls with ADHD had significantly smaller volumes in the posterior-inferior cerebellar vermis (lobules VIII-X; effect size, 0.54; P = .04), even when adjusted for total cerebral volume and vocabulary score. Patients and controls did not differ in asymmetry in any region. Morphometric differences correlated significantly with several ratings of ADHD severity and were not predicted by past or present stimulant drug exposure.

Conclusions  These results confirm previous findings for boys in the posterior-inferior lobules of the cerebellar vermis. The influence of the cerebellar vermis on prefrontal and striatal circuitry should be explored.

From the Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Md (Drs Castellanos, Giedd, and Rapoport, Messrs Walter and Blumenthal, and Mss Sharp, Tran, Vaituzis, Nelson, and Bastain); Service de Pédiatrie 1, CHU Hôpital Nord, Amiens, France (Dr Berquin); and Montreal Neurological Institute, McGill University, Montreal, Quebec (Drs Zijdenbos and Evans).

Corresponding author and reprints: F. Xavier Castellanos, MD, Child Psychiatry Branch, National Institute of Mental Health, Bldg 10, Room 3N-202, 10 Center Dr—MSC 1600, Bethesda, MD 20892-1600.

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