Pilar Dies-Suarez MD, Presenter: Nothing to Disclose

Silvia Hidalgo MBBS, PhD, Abstract Co-Author: Nothing to Disclose

Benito De Celis, Abstract Co-Author: Nothing to Disclose

Eduardo Barragan, Abstract Co-Author: Nothing to Disclose

Porfirio Ibanez, Abstract Co-Author: Nothing to Disclose

Manuel Obregon, Abstract Co-Author: Nothing to Disclose

Attention deficit hyperactivity disorder (ADHD) is the most common neurological disorder in children and adolescents (prevalence of 7% worldwide).Diffusion tensor imaging (DTI) is an MR imaging modality that provides information about the direction and integrity of neural fiber tracks in the brain in-vivo.Here we performed DTIstudies on inattentive children,who hadreceived clinical treatment for a whole year and compared the results to previous studies in which the same subjects had been imaged before the start of medication. 

Eleven children with ADHD (inattentive subtype, ages 7-12 years old), after one year of treatment were examined. Imagingperformed on a 1.5T imager (Philips Intera-Achieva). Diffusion Tensor Imaging (DTI) data was acquired using a SE-EPI sequence with: TR/TE = 9491/75 ms, FOV=230x230x140 mm3, voxel size=1.60x1.60x2mm3, slice number= 70, fat suppressed. Diffusion weighted gradients were applied along 15 non-collinear directions with a bvalue of 800 s/mm2. High-resolution anatomical images were acquired using 3D-T1 Gradient Sequence with the following parameters: TR/TE=25/3.88ms, slice thickness 2mm, and NEX=1. Tractography:  preprocessing steps correcting for head movements and eddy currents.The diffusion tensor (DT) was then fitted toa linear least-square, and using MedINRI, diffusion tensors were analyzed to obtain Mean Diffusivity values as well as the Fractional Anisotropy (FA) with an FA threshold of 0.2 and smoothness factor of 20 out of 100. Segmentation of the cerebellum was manually performed drawing on the anatomical midline sagittal 3D-T1 images.

Results of white matter connectivity (tracts) connecting the cerebellum to prefrontal areas are presented. One year after treatmentwe found great recovery of these fronto-cerebellar tracts in patients with ADHD,was also reflected on FA values which were similar to those of healthy controls.

With this follow-up study it was possible to distinguish between children with true ADHD and other pathologies(i.e. bipolar disorder). It was expected that with the results of this protocol, we have more tools to diagnose and follow-up a precise type of ADHD patients.  It could be argued that MRI generated a quantitative value (FA, tract number) to give precise diagnosis

This work will allow MDs to provide an appropriate treatment and follow up and dismiss any other disorder with similar symptoms to ADHD

Dies-Suarez, P, Hidalgo, S, De Celis, B, Barragan, E, Ibanez, P, Obregon, M, "Diffusion Tensor Imaging of the Cerebellum-prefrontal Area in ADHD Children". The Follow Up and the Conclusions.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006613.html