Unique Brain Patterns Spotted in Children with Comorbid ADHD and Epilepsy

A recent study published in PLOS ONE has discovered that children with both ADHD and recent-onset epilepsy display a unique brain morphology compared to healthy patients.

Kevin Dabbs and colleagues at the University of Wisconsin School of Medicine and Public Health conducted high-resolution magnetic resonance imaging (MRI) in 18 children recently diagnosed with epilepsy and ADHD, 36 children with epilepsy but no ADHD, and 46 children with neither condition. The subjects’ cortical thickness, area, volume, and curvature were examined, in addition to their volumes of subcortical and brain stem structures.

Unlike healthy patients, children with both ADHD and epilepsy had “a pattern of bilateral and widespread decreased cortical thickness as well as decreased volume of subcortical structures and brainstem,” the researchers discovered in their study. However, there was no difference in cortical thickness among patients with epilepsy but no ADHD compared to healthy controls.

Still, the investigators disclosed several study limitations that involved the applicant pool. Because the number of children with epilepsy and ADHD was small, an ADHD group with no epilepsy was absent from the study. In addition, the researchers were unable to delve into the mechanisms behind an ADHD and epilepsy comorbidity. Nevertheless, they pointed out that their study’s protocol concretely defined ADHD.

“The strengths of the paper include that fact that ADHD is an important complication of childhood epilepsy, the diagnosis of which was defined rigorously based on DSM-IV diagnosis from the K-SADS-PL, rather than a parent report questionnaire, which thereby improved diagnostic reliability,” the study authors wrote.

The investigators also looked at participants’ morphology outside of cortical thickness, and they plan to follow up with the subjects at year 2, as well as 5-6 years later.

“This comorbidity of epilepsy has anatomical correlates that are detectable early in the course of the epilepsy, suggesting that the altered neuroanatomy is not due to epilepsy chronicity or treatment,” the researchers penned. “The etiology of this anatomical signature and its prospective course remain to be characterized, as does the life course of children with epilepsy with ADHD compared to children with epilepsy without ADHD.”