27 Neither of the anatomic

MRI studies that reported putamen volumes detected significant diagnostic group differences.22,32 However, studies of secondary ADHD suggest that the putamen lesions can contribute to ADHD symptomatology. In a study of 76 Natural Product high throughput screening children with severe closed head injury, those who developed secondary ADHD were significantly more likely to demonstrate lesions in the right putamen.33 likewise, children Inhibitors,research,lifescience,medical with focal strokes and ADHD symptoms were significantly more likely to have involvement of right ventral putamen.34 The caudate, putamen, and nucleus accumbens receive efferents from the entire cerebral cortex. This impressive convergence of information is then processed and emerges from the output, nuclei of the basal ganglia, which, in primates, are the internal segment, of the globus pallidus and the substantia nigra pars reticulata. However, the volume of the latter

cannot be reliably measured with current MRI Inhibitors,research,lifescience,medical parameters, and the size of the globus pallidus can only be measured as a unit (internal and external segments together), Inhibitors,research,lifescience,medical and then only with difficulty. Still, this region was found to be significantly reduced in size in boys with ADHD,22,32 although these two studies differed in side of the larger difference (left or right). Globus pallidus volume differences in girls with ADHD did not survive Inhibitors,research,lifescience,medical covariance for total cerebral volume and IQ.31 A report of two cases of severe iatrogenic ADHD presumed to have been caused

by traumatic amniocentesis at 17 weeks’ gestation found complete ablation of right caudate, putamen, and globus pallidus in both.35 Cerebellum An early Inhibitors,research,lifescience,medical computed tomography study found a trend toward greater cerebellar atrophy in adults with a prior history of hyperkinetic minimal brain dysfunction.36 In a quantitative MRI study of 112 subjects, the volumes of the cerebellar hemispheres were found to be significantly smaller in ADHD boys.22 In a follow-up study within the same sample, the cerebellar vermis as a whole, and particularly the posterior-inferior lobules (lobules VIII to X) were found to be significantly smaller in ADHD.37 Smaller lobules VIII-X were independently replicated in boys with ADHD,38 and in girls with ADHD31 secondly where the posteriorinferior cerebellar vermis was the only structure that was rigorously replicated, with a comparable standardized effect size (d=0.66 in boys, d=0.63 in girls). Recently completed automated analyses of brain anatomy in 152 children and adolescents with ADHD and 139 age- and sexmatched controls revealed highly significant global decreases in overall cerebral volume in patients, which were statistically comparable in all four lobes, and which were statistically more prominent only in cerebellum.