- Image via Wikipedia
Attention Deficit Hyperactivity Disorder is one of the most widespread psychiatric diagnoses in children. Parents who are faced with the decision to medicate or not medicate their children may wonder if their child – given a bit more time – won’t just “grow out of it”, as many children seem to do. With this in mind, it would obviously be helpful to have biomarkers that could predict whether certain children are more likely to simply acquire better attentional control on their own, and those children that might not. In their paper, “Polymorphisms of the Dopamine D4 Receptor, Clinical Outcome, and Cortical Structure in Attention-Deficit/Hyperactivity Disorder” (Arch Gen Psychiatry Vol 64 (no. 8), Aug 2007) a veritable dream team of child developmental neuroscientists working across several medical institutions report on two such biomarkers. One biomarker is the thickness of the orbitofrontal cortex and posterior parietal cortex. MRI-based measurments of these parts of the brain (just about 5mm thick!) show that children who carry a diagnosis of ADHD have a thinner cortical sheet in these regions. Another biomarker is genetic variation in an intracytoplasmic loop of the G-protein coupled dopamine D4 receptor (DRD4). Children with ADHD are more likely to carry a longer 7-repeat version of this VNTR polymorphism than the more common 4-repeat. Interestingly, the research team found that healthy children who carry the 7-repeat genetic variant also have slightly thinner cortex in the orbitofrontal and posterior parietal cortex, suggesting that this genetic variant may influence the risk of ADHD by way of an effect on cortical development. Additionally, the research team found that the cortex of ADHD children who carry this 7-repeat genetic variant “catches up” from age 8 and eventually falls within the range of healthy children by age 15. Lastly, the team reports that ADHD children who carry the 7-repeat had better clinical outcomes (albeit, many of the ADHD children in this study were treated with medication). Nevertheless, it appears that some progress has been made in identifying biomarkers that might predict favorable developmental trajectories.