BRAIN METABOLISM IN TEENAGERS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER

Objectives: We sought to obtain and compare values of cerebral glucose metabolism in normal minors and minors with Attention Deficit Hyperac tivity Disorder (ADHD). We also sought to confirm our earlier findings of reduced brain metabolism in adults with ADHD, and to examine wheth er these results might be diagnostically useful. Design: Case-control study. Setting: Adolescents were recruited to National Institutes of H ealth Clinical Center/Research Facility through advertisement at local high schools and ADHD organizations. Patients: Subjects were 10 norma l adolescents and 10 adolescents with ADHD diagnosed with structured i nterviews using DSM-III-R criteria. Main Outcome Measures: Positron em ission tomography and fludeoxyglucose F18 were used to study cerebral glucose metabolism in minors while they performed an auditory-attentio n task. Results: Global or absolute measures of metabolism did not sta tistically differ between groups, although hyperactive girls had a 17. 6% lower absolute brain metabolism than normal girls. As compared with the values for the controls, normalized glucose metabolism was signif icantly reduced in six of 60 specific regions of the brain, including an area of the left anterior frontal lobe (P<.05). Lower metabolism in that specific region of the left anterior frontal lobe was significan tly inversely correlated with measures of symptom severity (P<.001-.00 9, r=-.56 to -.67). Conclusions: Global or absolute measures of metabo lism using positron emission tomography and fludeoxyglucose F18 did no t statistically differentiate between normal adolescents with ADHD. Po sitron emission tomography scans can be performed and are well tolerat ed by normal teenagers and teenagers with ADHD. The feasibility of nor mal minors participating in research involving radiation was establish ed.