Researchers at Children’s Hospital Los Angeles Discover a Potential Structural Basis for ADHD in Brain of Preterm Newborns 

Published on 
July 3, 2013

Early detection of behavioral disorders on the horizon

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In the first study of its kind, Natasha Leporé, PhD, and colleagues have pinpointed structural anomalies in the developing brain that may increase the risk of cognitive disabilities, such as frontal executive dysfunction (FED) and attention deficit hyperactivity disorder (ADHD), in premature newborns.  This study will be published by the Public Library of Science in PLOS ONE.

“Dr. Leporé’s innovative research is an important step toward developing non-subjective criteria for the diagnosis of ADHD, one of the most common neurobehavioral disorders of childhood.  Her work also provides a potential therapeutic target for more specific pharmacological intervention to help children reach their fullest potential,” said Brent Polk, MD, director of The Saban Research Institute of Children’s Hospital Los Angeles.

Often regarded as the most advanced area of the brain, the frontal lobe gives humans the ability to plan, problem-solve, memorize, remain attentive and suppress socially unacceptable behaviors. In order to carry out these executive functions, extensive connections throughout the cerebral cortex must properly develop in utero. Miscommunications between the frontal lobe and other areas of the brain can be broadly categorized as FED and include cognitive and behavioral disorders such as ADHD.

ADHD is a condition characterized by extreme inattention, hyperactivity or impulsiveness, and is often diagnosed when children reach school-age. While previous studies have shown strong correlations between premature birth and behavioral problems later in life, no potential mechanism has been discovered until now.

By using magnetic resonance imaging (MRI) scans and surface-generation technologies, researchers were able to reconstruct three-dimensional images of internal structures in the brains of preterm and healthy full-term infants. When comparing these two groups, significant structural differences were found in a centrally-located area, the putamen, which is part of an intricate circuit connecting to the frontal lobe. The same variancesseen in the premature newborns are known to be abnormal in older children diagnosed with ADHD. Discovering this atypical development in infants born pretermprovides a structural explanation for the increased rates of FED, ADHD and other behavioral disorders seen in this population.

“The next step will be to see whether we can find a way to predict which premature children will develop ADHD based on the differences that we see in their putamens compared to babies born full term,” said the study’s senior author, Natasha Leporé, from The Saban Research Institute of Children’s Hospital Los Angeles.

While survival rates of preterm infants have greatly improved due to advancements in neonatal care, these children are still at a high risk of exhibiting cognitive and behavioral problems once they are a few years old. The ability to identify structural signs of FED and ADHD shortly after birth will allow for early interventions, greatly increasing the child’s social and learning behaviors as they age.

The study was a multi-disciplinary collaborative effort involving multiple institutions. Natasha Leporé, PhD, is Assistant Professor of Research Radiology at University of Southern California. Other contributing researchers include: Yalin Wang, MD, Jie Shi, MD, and Xing An, MD, from Arizona State University, Ashok Panigrahy, MD, and Rafael Ceschin, MD, from Children’s Hospital Pittsburgh, Yi Lao, Douglas Vanderbilt, MD, and Marvin D. Nelson, MD, from Children’s Hospital Los Angeles and Paul M. Thompson, MD, from University of California-Los Angeles. This work was partially funded by the NIH.

About Children's Hospital Los Angeles

Children's Hospital Los Angeles has been named the best children’s hospital on the West Coast and among the top five in the nation for clinical excellence with its selection to the prestigious U.S. News & World Report Honor Roll. Children’s Hospital is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the United States. Children’s Hospital is also one of America's premier teaching hospitals through its affiliation since 1932 with the Keck School of Medicine of the University of Southern California.

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