Putamen Lesions and the Development of Attention-Deficit/Hyperactivity Symptomatology

Jeffrey E. Max, Peter T. Fox, Jack L. Lancaster, Peter Kochunov, Katherine Mathews, Facundo F. Manes, Brigitte A.M. Robertson, Stephan Arndt, Donald A. Robin, Amy E. Lansing

Research output: Contribution to journalArticle

83 Scopus citations

Abstract

Objective: To investigate the association between focal stroke lesions of the putamen and either attention-deficit/hyperactivity disorder or traits of the disorder (ADHD/Traits). Method: Twenty-five children with focal stroke lesions were studied with standardized psychiatric assessments and anatomic brain magnetic resonance imaging. The pattern of lesion overlap in subjects with ADHD/Traits was determined. Results: Fifteen of 25 subjects had ADHD/Traits. The densest area of overlapping lesions (n=7) in subjects with ADHD/Traits included the posterior ventral putamen. The median lesion volume was 9.7 cm3, and the distribution was highly skewed. Lesion volume was not associated with ADHD/Traits. Therefore the following analyses focused on the 13 subjects with lesions < 10 cm3: ADHD/Traits were exhibited in 6/7 subjects with putamen lesions versus 2/6 with no putamen lesions (Fisher exact test p=.1). Half (4/8) of the subjects with ADHD/Traits had overlapping lesions encompassing the posterior ventral putamen. None of the 5 subjects without ADHD/Traits had lesions in this empirically derived region of interest (Fisher exact test p=.1). Conclusions: Lesions within the dopamine-rich ventral putamen, which is part of the ventral or limbic striatum, tended to increase the risk of ADHD/Traits. ADHD/Traits may therefore be a disinhibition syndrome associated with dysfunction in this cortical-striato-thalamocortical loop.

Original languageEnglish (US)
Pages (from-to)563-571
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume41
Issue number5
DOIs
StatePublished - May 2002

Keywords

  • Attention-deficit/hyperactivity disorder
  • Childhood stroke
  • Putamen

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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