Brain Architecture Predicts Development of Depression, ADHD in Children

By Will Boggs MD

December 27, 2019

NEW YORK (Reuters Health) - Brain architecture at age 7 predicts symptoms of depression or attention-deficit/hyperactivity disorder (ADHD) by age 11, according to findings from a longitudinal study.

"We are facing a tremendous epidemic with teenage anxiety/depression," Dr. Susan Whitfield-Gabrieli from Northeastern University, Boston, Massachusetts, told Reuters Health. "Our lab is hoping to find early brain biomarkers that would indicate who is at risk for developing anxiety/depression."

Dr. Whitfield-Gabrieli and colleagues investigated whether resting-state functional MRI (fMRI) connectivity at age 7 predicted changes four years later in scores on the Child Behavior Checklist (CBCL), a questionnaire used to screen children for behavioral problems.

Overall in the study of 94 children, they found minimal average changes in CBCL scores, but there was considerable interparticipant variability across four years. Overall, less positive baseline medial prefrontal cortex and dorsolateral prefrontal cortex (MPFC-DLFPC) connectivity was associated with improvement of attentional problems four years later.

In contrast, weaker left DLPFC-subgenual anterior cingulate cortex (sgACC) connectivity at baseline predicted greater worsening on the subscales of anxiety/depression and withdrawn, but not with changes in somatic complaints, according to the report in JAMA Psychiatry.

Weaker DLPFC-sgACC connectivity at baseline predicted worsening on the anxiety/depression subscale for children at familial risk for major depressive disorder (MDD) as well as for typically developing children.

Collectively, these symptoms (worsening on the internalization subscales of anxiety/depression and withdrawn) are associated with ADHD and MDD.

"These resting-state fMRI metrics are promising biomarkers for the early identification of children at risk of developing MDD or ADHD," the researchers conclude.

"I think that this could have great clinical implications, because identification of these biomarkers at such a young age could promote early interventions (e.g., exercise, mindfulness, etc.) which could mitigate or possibly prevent the progression of psychiatric illness," Dr. Whitfield-Gabrieli said by email.

"Previously, most longitudinal neuroimaging studies that predict worsening of symptoms or conversion to illness have been with individuals who are clinically or genetically at-risk for illness," she added. "We are extending this research here by investigating the brain networks in a community sample which wasn't preselected for being at-risk for mental illness."

SOURCE: JAMA Psychiatry, online December 26, 2019.