The diagnosis of Attention Deficit/Hyperactivity Disorder is a controversial one. Rates of children being diagnosed with it have increased every year, and no one can agree on whether that increase is a result of better diagnostics or if parents and health care providers are too quick to slap a medical label on what might simply be a behavioral issue. Indeed, there are still some who believe the disorder is not physical, but merely bad behavior that could be the result of anything from diet to parenting to environment.
It’s been thought that as children grow, the disorder recedes and that kids can actually “outgrow” the disorder. New research from scientists from the University of Cambridge in the UK and the University of Oulu in Finland suggests this is likely not the case.
The findings of a study that followed 49 young adults diagnosed with AD/HD into adulthood were published in the Journal European Child Adolescent Psychiatry and researchers pointed to brain structure and memory to illustrate that even into their mid-twenties, patients with AD/HD still suffered with attentional issues, memory problems and restlessness.
Most of the research up until now has concentrated on interviewing adults that had been diagnosed with AD/HD as children. When these patients were interviewed and asked to self-evaluate their symptoms, anywhere from 10-50% of them said that yes, they still did have AD/HD. The new study is the first to use MRI studies to document brain structure and function. Individuals aged 20-24 with a diagnosis of AD/HD that had been made in their teens were asked to complete memory tests while inside an MRI scanner that measured their brain activity as it functioned. The tests showed differences in the size and activity of the caudate nucleus, a region of the brain that is responsible for handing some cognitive functions and processing memory. In the scans, those with an AD/HD diagnosis had differences in this area.
Dr. Graham Murray from the Department of Psychiatry, University of Cambridge, who led the study described it this way in a press release "In the controls, when the test got harder, the caudate nucleus went up a gear in its activity, and this is likely to have helped solve the memory problems. But in the group with adolescent AD/HD, this region of the brain is smaller and doesn't seem to be able to respond to increasing memory demands, with the result that memory performance suffers.”
The study was able to actually track the activity of the caudate nucleus as the tests were being administered. In the control group of subjects who did not have AD/HD, when the memory questions increased in difficulty, the activity in that region of the brain could be seen on the scans. In the group of subjects with AD/HD, there was no increase in activity. This lead researchers to surmise that without this uptick in brain activity, patients with AD/HD were at a disadvantage compared to those without AD/HD, and this deficit did not go away as they grew older.
The researchers involved in the study stressed that the results should show that simply meeting a certain number of symptoms on a checklist should not be the deciding factor on whether or not an adult still has AD/HD. Brain function and structure are much more reliable in terms of diagnosing and measuring the deficits a patient may have, regardless of their age.
In an email to the Huffington post for their article on the study, Murray wrote ‘"Should we continue to rely on symptom checklists, or should we consider doing laboratory tests? I’m not suggesting routine MRI scans, but computerised tests of memory function might be important in future, as part of a more holistic assessment."
See the video below to learn more about the progression of AD/HD.
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