Shawn Kohler, Post-Baccalaureate IRTA Fellow; Phillip Nelson, Head
Imaging normal and abnormal brain development: new perspectives for child psychiatry
Article first published online: 12 AUG 2003
Australian and New Zealand Journal of Psychiatry
Volume 35, Issue 3, pages 272–281, June 2001
How to Cite
Rapoport, J. L., Castellanos, F. X., Gogate, N., Janson, K., Kohler, S. and Nelson, P. (2001), Imaging normal and abnormal brain development: new perspectives for child psychiatry. Australian and New Zealand Journal of Psychiatry, 35: 272–281. doi: 10.1046/j.1440-1614.2001.00900.x
Section on Neurobiology, Laboratory of Developmental Neurobiology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland
- Issue published online: 12 AUG 2003
- Article first published online: 12 AUG 2003
- brain development;
- childhood schizophrenia
Objective: The availability of non-invasive brain imaging permits the study of normal and abnormal brain development in childhood and adolescence. This paper summarizes current knowledge of brain abnormalities of two conditions, attention deficit hyperactivity disorder (ADHD) and childhood onset schizophrenia (COS), and illustrates how such findings are bringing clinical and preclinical perspectives closer together.
Method: A selected review is presented of the pattern and temporal characteristics of anatomic brain magnetic resonance imaging (MRI) studies in ADHD and COS. These results are discussed in terms of candidate mechanisms suggested by studies in developmental neuroscience.
Results: There are consistent, diagnostically specific patterns of brain abnormality for ADHD and COS. Attention deficit hyperactivity disorder is characterized by a slightly smaller (4%) total brain volume (both white and grey matter), less-consistent abnormalities of the basal ganglia and a striking (15%) decrease in posterior inferior cerebellar vermal volume. These changes do not progress with age. In contrast, patients with COS have smaller brain volume due to a 10% decrease in cortical grey volume. Moreover, in COS there is a progressive loss of regional grey volume particularly in frontal and temporal regions during adolescence.
Conclusions: In ADHD, the developmental pattern suggests an early non-progressive ‘lesion’ involving neurotrophic factors controlling overall brain growth and selected dopamine circuits. In contrast, in COS, which shows progressive grey matter loss, various candidate processes influencing later synaptic and dendritic pruning are suggested by human post-mortem and developmental animal studies.