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Putamen Lesions and the development of attention-deficit/hyperactivity symptomatology
Journal article   Peer reviewed

Putamen Lesions and the development of attention-deficit/hyperactivity symptomatology

Jeffrey E MAX, Peter T FOX, Jack L LANCASTER, Peter KOCHUNOV, Katherine MATHEWS, Facundo F MANES, Brigitte A. M ROBERTSON, Stephan ARNDT, Donald A ROBIN and Amy E LANSING
Journal of the American Academy of Child and Adolescent Psychiatry, Vol.41(5), pp.563-571
2002
DOI: 10.1097/00004583-200205000-00014
PMID: 12014789

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Abstract

Objective: To investigate the association between focal stroke lesions of the putamen and either attention-deficit/hyperactivity disorder or traits of the disorder (ADHD/Traits). Method: Twenty-five children with focal stroke lesions were studied with standardized psychiatric assessments and anatomic brain magnetic resonance imaging. The pattern of lesion overlap in subjects with ADHD/Traits was determined. Results: Fifteen of 25 subjects had ADHD/Traits. The densest area of overlapping lesions (n = 7) in subjects with ADHD/Traits included the posterior ventral putamen. The median lesion volume was 9.7 cm3, and the distribution was highly skewed. Lesion volume was not associated with ADHD/Traits. Therefore the following analyses focused on the 13 subjects with lesions < 10 cm3: ADHD/Traits were exhibited in 6/7 subjects with putamen lesionsversus 2/6 with no putamen lesions (Fisherexacttestp= .1). Half (4/8) of the subjects with ADHD/Traits had overlapping lesions encompassing the posterior ventral putamen. None of the 5 subjects without ADHD/Traits had lesions in this empirically derived region of interest (Fisher exact test p = .1). Conclusions: Lesions within the dopamine-rich ventral putamen, which is part of the ventral or limbic striatum, tended to increase the risk of ADHD/Traits. ADHD/Traits may therefore be a disinhibition syndrome associated with dysfunction in this cortical-striato-thalamocortical loop.
Biological and medical sciences Psychology. Psychoanalysis. Psychiatry Medical sciences Attention deficit disorders. Hyperactivity Child clinical studies Psychopathology. Psychiatry

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