Living with ADHD is a crazy adventure, and the crazy part starts right away when you're just trying to make sense of what's happening inside your head.
Usually, before getting you an ADHD diagnosis and figuring out how much treatment you need, doctors will have you undergo a series of psychological and physical evaluations and tests. But still, misdiagnoses are not a rarity. So, medical professionals are looking for other methods to help diagnose ADHD accurately.
Because of the neurodevelopmental nature of ADHD, in recent decades, researchers have delved into various brain scanning techniques to explore the peculiarities of the brains of folks with ADHD.
We all love talking about how the ADHD brain works differently from the normal brain, but how exactly?
Let's take the plunge into the fascinating world of brain scans and see how they are shaking things up!
Today, we are going to learn all the things, like:
- What is brain scanning anyway?
- Does ADHD manifest in tangible ways on MRI or other scans?
- Can brain scans tell us anything meaningful about ADHD?
Aight, let's dig in!
What is brain scanning, and what can it show us?
In the dynamic world of neuroscience, various brain scanning methods have become instrumental in research and diagnostics for diverse neurological conditions. Each method offers a unique lens through which the brain's intricacies are unveiled. Some of these methods effectively locate tumors and brain abnormalities, areas of swelling or bleeding, and others - in tracking brain activity.
So, it's no wonder some methods are more frequently used in ADHD-related research. Among the key players are these three:
Computed Tomography Scan (CT);Functional Magnetic Resonance Imaging (fMRI);Positron Emission Tomography Scan (PET).
CT combines a series of X-ray images taken from different angles of your brain. It gives much more detailed information about your brain than a conventional X-ray scan. CT scans can reveal some structural changes in the brain, which can be helpful for researchers who study the effects of ADHD medication.
fMRI is the most widely used imaging method in current psychiatric research(1). This method detects the change in blood flow and oxygen levels in the brain to visualize brain activity. It is a safe and highly prospective brain imaging method, and it enables medical scientists to understand the neurobiological mechanisms behind ADHD.
Like fMRI, PET scans can also detect the areas of higher brain activity. But instead of tracking the oxygen levels, PET uses a radioactive tracer that attaches to glucose in your blood. More glucose goes to some part of the brain - more activity is happening there. So, like with fMRI, the researchers can compare the brain function of people with and without ADHD using this method.
Beyond these well-known methods, there exist additional techniques such as near-infrared spectroscopy (NIRS) that monitors your brain’s oxygen saturation, magnetoencephalography (MEG) that measures the magnetic field from neuron electrical activity, single-photon emission computed tomography (SPECT), voxel-based morphometry (VBM) and many other complicated abbreviations we won’t dive into in this article. These collectively represent the sophisticated toolbox researchers employ in unraveling the mysteries of the human brain.
Can you tell the person has ADHD by looking at their brain scan?
Considering the variety of different brain imaging methods, some can offer a firm diagnosis. But alas, that's not the case—at least not yet. I know it’s a bit of a downer.
Using brain scanning to analyze the brains of folks with ADHD and other neurodevelopmental disorders is a relatively new practice. And it’s rarely used for making clinical diagnoses. But it’s not only because of the method’s novelty and the lack of research.
The deal is that the brain imaging methods have their limitations - they are not sensitive enough to be accurate in individual cases, and they can’t really help to differentiate ADHD from other conditions. These scans haven't yet been standardized and approved for widespread clinical use in ADHD diagnostics.
But it doesn’t mean that brain imaging has no hope of becoming one of the primary methods of diagnosing neurodevelopmental conditions like ADHD. Many scientists believe involving brain scanning in analyzing mental health has much potential. They've even coined a term for this clinical practice - psychopathology. It's not officially recognized yet, but it has a cool ring.
Now, circling back to those brain scans of folks with ADHD - can they be useful in some way? Let's dig into that, shall we?
What can brain scans tell us about ADHD?
So, there's some intriguing research suggesting that ADHD might be linked to structural differences in the brain, and this difference can be spotted in brain scans.
The researchers who studied the brains of teens with ADHD with the help of VBM have found that several brain regions are abnormally smaller in adolescents with ADHD compared to those who don’t have it. It turns out that folks with ADHD have a bit less gray matter volume in the anterior cingulate cortex (2).
Now, you might be thinking, "Great! Soon, doctors can just glance at my gray matter and diagnose ADHD." Well, not so fast. It's not that straightforward.
Another study examined the differences between the brains of kids with newly diagnosed and never-treated ADHD and healthy kids of the same age by analyzing their brain MRI scans through a curveball. No significant gray or white matter volume deviations were found.
This study is worth mentioning because of its other discovery. It showed that children with ADHD had alterations in the shape of three brain regions - the left temporal lobe, the bilateral cuneus, and areas around the left central sulcus (3). Moreover, the scans also showed the differences between different subtypes of ADHD. This is a very promising finding, as it differentiated kids with ADHD from healthy control children with 74 percent accuracy and ADHD inattentive from ADHD combined subtypes with 80 percent accuracy.
Such research shows how the involvement of brain scanning methods in evaluating patients who may have ADHD can improve diagnosis accuracy. Also, it can help diagnose ADHD earlier so psychiatrists can start adequate treatment sooner.
But that's not all these scans are good for. The brain scans can help us understand how ADHD medication can affect our brains and improve the existing ADHD treatments. It has already happened. Researchers discovered that methylphenidate, a common stimulant prescribed for ADHD, can trigger changes in brain white matter in children (4). Just four months of methylphenidate treatment caused alterations in the distribution of white matter, so the researchers shared their concerns about the possible long-term effects of the methylphenidate treatment and urged doctors not to over-prescribe it unless absolutely necessary.
The bottom line? Scientists are only scratching the surface of the many possibilities of using brain scanning in diagnosing and treating ADHD, and more research will come.
Even though various brain scan techniques and methods have been around for ages, their use in diagnosing ADHD is still relatively new and riddled with challenges and constraints. Yet, as the imaging systems advance, get more sophisticated, sensitive, and sharper over time, and researchers complete more studies - there's a chance for a major shift. We might witness a transformative moment where MRI and other brain scan methods become the primary tools for diagnosing ADHD in the not-so-distant future.
But if you’re thinking that you may have ADHD, there’s no use waiting decades for scientists to develop a super cool and accurate brain scan that will confirm or deny your suspicions. Fear not, my friend! You can start by completing our fun little adaptation of a test originally crafted by the brains at Harvard Medical School, New York University Medical School, and the World Health Organization and check if your symptoms match up with ADHD. It might not be as flashy as an MRI and won't hand you a concrete diagnosis, but it's a solid first step. Consider it your entry ticket to unraveling the marvelous quirks of your unique and beautiful brain. Let the adventure begin!
Europe PMC Founders. Functional magnetic resonance imaging in attention deficit hyperactivity disorder (ADHD): a systematic literature review
Journal of Attention Disorders. Regional Gray Matter Volume Differences Between Adolescents With ADHD and Typically Developing Controls: Further Evidence for Anterior Cingulate Involvement
Journal of Radiology. Psychoradiologic Utility of MR Imaging for Diagnosis of Attention Deficit Hyperactivity Disorder: A Radiomics Analysis