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Quantitative susceptibility mapping reveals brain iron deficiency in children with attention-deficit/hyperactivity disorder: a whole-brain analysis

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Abstract

Objectives

To quantitatively measure and compare the whole-brain iron deposition between attention-deficit/hyperactivity disorder (ADHD) patients and typically developing (TD) children using the quantitative susceptibility mapping (QSM) technique.

Methods

This study was approved by the institutional review board of our institution (No. [2019]328). Fifty-one patients between 6 and 14 years with clinical diagnosis of ADHD and 51 age- and gender-paired TD children were enrolled. For each participant, the 3D T1 and multi-echo GRE sequence were performed to acquire the whole-brain data with 3.0-T MRI. The QSM maps were calculated using STISuite toolbox. After normalizing the QSM images to MNI space, the voxel-based analysis was used to compare the iron content between the two groups. Pearson’s correlation test was used to assess the associations between the iron content and the score of the tablet-PC-based cancellation test, which was done to evaluate the attention concentration level.

Results

Iron deficiency was observed in several brain regions in children with ADHD, including bilateral striatums, anterior cingulum, olfactory gyrus, and right lingual gyri. In further correlation analysis, the left anterior cingulum was found to show positive correlation with the symptom severity (r = 0.326, p < 0.05).

Conclusions

Our study demonstrated that the iron deficiency in several brain regions might be related with ADHD, which might be valuable for further studies. And QSM might have the potential efficacy in the auxiliary diagnosis of ADHD.

Key Points

• Iron deficiency was observed in several brain regions in children with ADHD, which include bilateral striatums, the critical regions in the dopaminergic transmitter system.

• The iron content in the left ACG may have association with the symptom severity of ADHD.

• QSM might have the potential efficacy in the auxiliary diagnosis of ADHD.

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Abbreviations

AAL:

Automated Anatomical Labeling

ACG:

Anterior cingulate and paracingulate gyri

ADHD:

Attention-deficit/hyperactivity disorder

ESWAN:

Enhanced susceptibility-weighted angiography

MNI:

Montreal Neurological Institute

QSM:

Quantitative susceptibility mapping

SPM:

Statistical Parametric Mapping

TD:

Typically developing

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Acknowledgements

We would like to thank the participants and their families as well as the staff at the MRI in the First Affiliated Hospital of Sun Yat-sen University for making this study possible.

Funding

This study has received the National Natural Science Foundation of China (grant number 82001439) and the Medical Scientific Research Foundation of Guangdong Province (grant number A2020327).

Author information

Author notes

  1. Yingqian Chen and Shu Su contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, China

    Yingqian Chen, Shu Su, Yan Dai, Mengsha Zou, Liping Lin, Qin Zhou, Jing Zhao & Zhiyun Yang

  2. MR Research, GE Healthcare, Beijing, China

    Long Qian

  3. Department of Pediatric, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, China

    Hongyu Zhang & Meina Liu

Authors
  1. Yingqian Chen
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  2. Shu Su
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  3. Yan Dai
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  10. Jing Zhao
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Corresponding authors

Correspondence to Jing Zhao or Zhiyun Yang.

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Guarantor

The scientific guarantor of this publication is Zhiyun Yang.

Conflict of interest

The authors declare no competing interests.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects’ parents in this study.

Ethical approval

This study was approved by the institutional review board of the First Affiliated Hospital of Sun Yat-sen University (No. [2019]328).

Methodology

• prospective

• cross-sectional study

• performed at one institution

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Chen, Y., Su, S., Dai, Y. et al. Quantitative susceptibility mapping reveals brain iron deficiency in children with attention-deficit/hyperactivity disorder: a whole-brain analysis. Eur Radiol 32, 3726–3733 (2022). https://doi.org/10.1007/s00330-021-08516-2

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  • DOI: https://doi.org/10.1007/s00330-021-08516-2

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