MRI Investigations in Attention Deficit Hyperactivity Disorder (ADHD) and High Potential (HP) Children for a Better Therapeutic Approach (HP)

Impulsivity and/or hyperactivity in children has become one of the main clinical symptom for consultation, among the most frequent, in general or pediatric medicine. Among the different clinical forms of instability, ADHD appears to be an especially disabling condition for the development of the child, both in psychomotor, cognitive, emotional and relational aspects. Further, a significant link between ADHD children and some children with High Potential (HP) is observed. HP children show overall ahead cognitive developments compared to children with the same age. In these children, as well as in children with ADHD, an attention vulnerability, psychomotor deficits are noted, as well as emotional and relational deficits that significantly contrasted with some of their cognitive skills. Regarding the HP, the hypothesis is that children with significantly heterogeneous results (Complex) to the Wechsler IV scales are affected by this shift, and hence, by the difficulty of a differential diagnosis with ADHD, unlike those whose intelligence quotient (IQ) results that are more homogeneous (Laminar).

The goal of this work was to study a population of 80 children aged from 8 to 12 years (20 subjects per group) to evaluate the functional and structural brain development by:

• Functional magnetic resonance imaging (fMRI) acquisitions with cognitive stimulations, involving attention, working memory and semantic processing, and emotional stimulations,
• fMRI acquisitions at rest (without activation),
• diffusion tensor magnetic resonance imaging (DTI) acquisitions,
• 3D anatomic acquisitions. Identification of developmental differences in certain cortical brain areas (eg, prefrontal vs parietal), white matter fiber bundles or functional networks preferentially used by one or other of these groups, will help to better understand this disease, and to improve the differential diagnosis in order to implement a more appropriate and personalized management of the patients via new therapeutic strategies.

Study Overview

• Status: Completed
• Conditions: ADHD
• Intervention / Treatment: Other: MRI; Other: neuropsychological assessment

• Study Type: Interventional
• Enrollment (Actual): 74
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Bron, France, 69500
    • Service de psychiatrie infantile, Hôpital Pierre Wertheimer, 59 Boulevard Pinel

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 years to 8 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Right-hand 4 groups :
• Laminar HP : IQ > 130 and difference between Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) < 9
• Complex HP : IQ > 130 and difference between VCI and PRI >15
• ADHD : 90 < IQ <110
• Controls : 90 < IQ <110

Exclusion Criteria:

• Subjects with any psychiatric disorders except ADHD,
• Subjects with known learning deficits (dyslexia, dysphasia…), attention deficits except for ADHD group
• Subjects with claustrophobia or magnetic devices
• Children with out both parental agreements

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Laminar HP; Structural and functional MRI markers	Other: MRI; MRI and neuropsychological assessment planned for the study for patient and volunteers; Other: neuropsychological assessment
Experimental: Complex HP; Structural and functional MRI markers	Other: MRI; MRI and neuropsychological assessment planned for the study for patient and volunteers; Other: neuropsychological assessment
Experimental: ADHD; Structural and functional MRI markers	Other: MRI; MRI and neuropsychological assessment planned for the study for patient and volunteers; Other: neuropsychological assessment
Other: Control; Structural and functional MRI markers	Other: MRI; MRI and neuropsychological assessment planned for the study for patient and volunteers; Other: neuropsychological assessment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cortical gray matter (GM) volumes	using the software VBM (Voxel Based Morphometry)	Day 1
Microstructural connectivity of white matter (WM) fiber bundles	measured by diffusion tensor imaging. Diffusion metrics maps are compared using the software TBSS (Track Based Spatial Statistics),	Day 1
Functional MRI activity during cognitive tests	using the software SPM (Statistical Parametric Mapping)	Day 1
Functional connectivity in resting-state fMRI	using the CONN toolbox (functional connectivity toolbox) of SPM (Statistical Parametric Mapping)	Day 1
Subcortical gray matter (GM) volumes	using the software VBM (Voxel Based Morphometry)	Day 1
Functional MRI activity during emotional tests	using the software SPM (Statistical Parametric Mapping)	Day 1
Functional connectivity in resting-state fMRI	using the graph-theory methods	Day 1

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon
• Investigators: Principal Investigator: Olivier REVOL, MD, HCL

Study record dates

Study Major Dates

• Study Start: May 1, 2013
• Primary Completion (Actual): February 1, 2015
• Study Completion (Actual): February 1, 2015

Study Registration Dates

• First Submitted: June 9, 2016
• First Submitted That Met QC Criteria: June 30, 2016
• First Posted (Estimate): July 6, 2016

Study Record Updates

• Last Update Posted (Estimate): July 6, 2016
• Last Update Submitted That Met QC Criteria: June 30, 2016
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Keywords: Laminar HP; Complex HP
• Additional Relevant MeSH Terms: Mental Disorders; Attention Deficit and Disruptive Behavior Disorders; Neurodevelopmental Disorders; Attention Deficit Disorder with Hyperactivity
• Other Study ID Numbers: 2013-805