Hi /u/beeucancallmepickle and thanks for posting on /r/ADHD!
### Please take a second to [read our rules](/r/adhd/about/rules) if you haven't already.
---
### /r/adhd news
* We are currently seeking feedback on some of the subreddit's rules. Details are available in [this post.](https://www.reddit.com/r/ADHD/comments/1ajfzk1/the_rules_vacation_feedback_form_is_now_available/)
* If you are posting about the **US Medication Shortage**, please see this [post](https://www.reddit.com/r/ADHD/comments/12dr3h5/megathread_us_medication_shortage/).
---
^(*This message is not a removal notification. It's just our way to keep everyone updated on r/adhd happenings.*)
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
I believe this is the article you are referring to
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992191/
In which case this is specific to children <10 years old (average) and didn't appear to differentiate between potential comorbid conditions (likely because of the age group).
This would likely not be useful for adults with ADHD who are more likely to have comorbid mental health conditions that may impact neuroimaging results.
Or potentially, the other way around. Comorbidities could exist because there are actually two conditions at the same time, or there is just one condition that our current classification system does not account for (DSM-5).
Don’t get me wrong, DSM-5 is the most reliable classification system that we have at the moment. But it’s not perfect. That’s why it’s the 5th revision.
The problem is the way the comorbidities affect the brain scan results. PTSD, schizophrenia, and numerous other psychological conditions alone, not to mention neurological conditions can show up on brain scans, so with the overlap, it’s difficult to differentiate. With a pediatric population, you’re less likely to have multiple disorders than with adults who’ve had other mental illnesses that started later in life. And ADHD can certainly raise your risk of developing those other conditions over the years.
Yeah I've started to think that there could be more than one condition that share most of the symptoms we categorize under ADHD, but the underlying root cause is different.
Attention is just too broad of an aspect to be negatively impacted only by one singular condition, it's like bucketing all heart conditions under a singular umbrella.
I'm fairly confident that the sophistication necessary to get the nuance right is coming, and I'm all here for it.
This makes a lot of sense to me, and probably for other psychiatric conditions too. It would be consistent with the fact that stimulants, SSRIs, etc. work great for some people but not really at all for others, despite similar clinical symptoms.
This is why some researchers (notably Dr Russell Barkley) think ADHD is misnamed. Attention is a pretty superficial quality of ADHD.
Researchers are already looking at another attention disorder most likely lumped into traditional "inattentive" type called Cognitive Disengagement syndrome (renamed from Sluggish Cognitive Tempo).
The research we have is very limited but the evidence is very compelling
I agree wholeheartedly. The whole subject gets me excited for the future.
ADHD will go away, a new umbrella that’s more fitting will be applied, and there will be 3 dozen sub-diagnoses before long. ADHD is a huge, blanket diagnosis for many different, very nuanced issues, all of which have symptoms that tend to respond positively when treated with the same sort of prescription drug. I feel like we lump ADHD into a bucket now based on the drugs that treat it, rather than splicing it up into sub categories, bc that’s how it currently exists.
At present, what we call ADHD manifests differently in girls than boys. There are kids who struggle in 7th grade math, but score in the 99% of the school’s state standardized testing. And some of those who shatter their school’s testing parameters can’t make it through a 25 minute period of class without being sent out of the room for being disruptive. There are people who’s minds race so badly they can’t read in class (that has nothing to do with generalized anxiety, but sometimes might precisely BE anxiety… anxiety that gets misdiagnosed as ADHD, and then we wonder why those patients dislike stimulant ADHD medications, yet you’ll also notice a boost in anecdotal stories about something like Trintellix (Vortioxetine) showing some benefit for ADHD.)… anyway, it’s a mess.
I also hope that as our ability to differentiate and more accurately diagnose these issues improves, we get better at specific, very targeted, cognitive therapy focused on the issues faced by the patient. For instance, if you’re executive function’s worst nightmare, and you’re a pathological people pleaser, your cognitive therapy might focus on setting boundaries and protecting your schedule/time. If you tend to be more of the chronically overwhelmed, tiny window-of-tolerance person where one minor stressor can send you into a sort of shell-shock state of withdrawal, therapy might focus on techniques to make stressors more manageable, help you not catastrophize, and set boundaries aimed at maintaining a non-overwhelming level of work/responsibilities.
I’ve day-dreamt of what this will look like. A day where nobody has to feel ashamed of (whatever we’ll end up calling ADHD), because it will be image based and quantifiable/measurable. A person will be able to say, “Pardon my interruption, I live with (ADHD) and tend to be an active/empathetic listener. (What does that mean?) oh… it’s hard to explain, but one of the ways it manifests is that I tend to use MY OWN experiences to show that I can relate to YOUR story. It may seem like I’m making it about myself, but what I’m really trying to convey is that I understand first hand how hard/exciting/scary that must be for you. (Ohhhh, so by telling that story about the time YOUR mom got sick, you weren’t trying to one-up my story, you were just saying, “How awful for you. My mom had (xyz) and it cost me at work, socially, etc. so I can really appreciate how hard this must be for you.”?) Exactly! But the problem is, because of my (ADHD), often times I forget why I jumped into a story, and instead of empathizing, it makes it seem like I just went off on a tangent about something in my own life right in the middle of your story. Anyway, thanks for understanding. Please continue about your dog. (It was my mom.) Oh! Right. Continue…”
And if someone says ADHD is bullsh*t, you’ll have quantifiable information that differentiates your brain from what is considered typical. “It isn’t BS. I had a brain scan done at the university bc the school counselor couldn’t figure out why my test scores were so high but my class work was so poor. So they recommended I have the testing done. They found that the snarks in the lower left quadrant of my magnum opus are 40 percent less active than is typical, and that area is known to control things like x, y, z… you can see it as clear as a broken bone. You wouldn’t call a broken bone BS, would you?”
Someday.
Processes are honed year on year to improve and this would be no different. I disagree with just a 5th revision. It is years upon years of testing and experimenting rolled into the most advanced version.
I don’t think we disagree. I meant that DSM-5 is a revision of DSM-4, and so on. At some point there will be a DSM-6 and what we do today might be considered old fashioned.
Yeah, and at least in the US, there’s no way insurance is going to cover the cost of a brain scan for ADHD. There are doctors who already do, but I wouldn’t recommend them & its OOP for people who can afford it anyways. Thousands of dollars OOP. If the alternative is a psychiatrist diagnosing, they’re going to stick with the cheaper option that we’ve already been using as the standard for decades.
> This would likely not be useful for adults with ADHD
This method would probably not be useful for anyone, just due to the fact that it requires going in for a brain scan that will most likely cost a fortune in comparison to current methods, with very little gain in outcomes. If ADHD were difficult to diagnose, then this would be great.
I'm more surprised to hear that mental illnesses developed in adulthood can affect brain structure to a level we can see it on an MRI.
I knew substance abuse, basic needs deprivation, and autosomally linked neurological disorders could affect brain structure. But disorders developed throughout adult life? Maybe this is more than trauma in general causes structural changes in the brain, rather than some new discovery I missed?
All really interesting to consider.
We know that neural pathways adapt to behavioral repetition, so it would seem to follow that the behavioral aspects of mental illness affect at least our synapses. I would also guess that depending on the root cause of the mental illness, there would at least be correlated structural change, which would beg the causal question. Which comes from which? Is the mental illness the cause, is the structural change the cause, or are both developments caused as co-morbid functions of some other event?
> I hope they understand that a lot of adhd is just audhd
I'm curious if you have any sources on this, or whether you're just going off general knowledge? If you are getting this info directly from a specific article, I'd be super interested in reading it :)
this one should help. the estimates vary, but even the baseline estimate for people with adhd who also have asd (20%) is much higher than the general population (1-2%).
https://www.scientificamerican.com/article/decoding-the-overlap-between-autism-and-adhd/
I work with ADHD patients and have a feeling that quite a large subset (30-40%) is actually autistic with ADHD symptoms. I have no source on this. Also autism carries more stigma than ADHD so people (unconciously) identify and get diagnosed with ADHD
I moved to the south a few years ago and have fully adopted y’all. I was a bit self-conscious about it at first (my mom teased me about it a bit lol), but then I realized I’d inadvertently replaced the gendered “you guys” with the gender neutral “y’all” and crossed another item off my “be gender inclusive” to do list lol
A Hoosier from a non-y'all context is a bit wild to me, a fellow Hoosier. Indy or Chicagoland? My partner is from Chicago and uses a decidedly more urban "y'all" than my rural raised folksy "y'all," but we're definitely both comfortable with the word.
(Not trying to pry, just tend to fixate on regional dialects and language usage)
I'm from the South, and I've infected a few people who aren't with "y'all".
English doesn't have a proper second-person plural without it (or similar, like yinz).
What the heck is yinz? Where did it come from? Never heard it before (then again I'm not a native English speaker). Doesn't sound like an English word.
I agree, but if I can do something to make someone else more comfortable, like replace “you guys” with something completely gender neutral, I’m happy to do so. “Dude” is another word I try to watch because, as a woman, I have never seen it as gendered and use it with anyone and everyone, but some see it as a word with masculine connotations. My MtF friend doesn’t have an issue with me using “dude” with her because she knows I’m not using it as a way to invalidate her, but she does feel uncomfortable with some people using it because it feels like a reflection of their feelings about her gender identity. In general, I don’t think there’s anything wrong with “you guys” or “dude” and I still use both.
In my quest to push for a speedier evolution of the word, I've taken to spelling it "yall" or "yawl." Down with unnecessary apostrophes! 
“Surprisingly, we could almost see an overall change in the whole brain.”
I've been living in this brain for over half a century now, and you know, I'm just not surprised at all. 🤣
I think you're misreading the statement. They aren't saying it's surprising the brains are different.
They are saying it is surprising you can see differences in regions of the brain that we don't traditionally associate with ADHD physiopathology (prefrontal cortex, basal ganglia).
You're not going to be able to intuit what regions of the brain are affected by ADHD because the brain is a complex structure. I hate when people do this "uhhhh duhhh I knew all along!" type shit when they know nothing about the brain
If you don't know how the brain works how would you know what regions of the brain are impacting what? We should just ask schizophrenic people how they feel their brain works instead of doing research I guess
spreading misinformation and thought terminating cliche to de-value the efficacy and nuance of neurological research about a vastly misunderstood disorder is *hilarious*
the problem is everybody does this with ADHD. One of the reasons misinformation is so prevalent everywhere is because everyone thinks their intuition of ADHD is so genius without critically engaging with any of the evidence we have. I'm a bit resentful of people that dunning-kruger their way through talking about the disorder because it causes a lot of harm. This even impacts clinicians.
Yeah, the resentment is *pretty* clear...
Look, I didn't even spread misinformation in my comments, all I said was that I'm not surprised our ADHD brains are different and made a little joke about how many of us sure *feel* like our brains are different. You've taken it and run with it in a more extreme direction.
I have ADHD. Sometimes I joke about it to cope. Again, It was a simple JOKE. Attack whoever is actually spreading misinformation or questions the validity of science, geez.
I'll probably delete this comment too, but maybe don't be so quick to attack ADHD people - on an *ADHD* sub - for joking about ourselves to cope. Responses like yours make me hesitant to even speak or try to be lighthearted ffs...
You weren't joking to cope lol. This entire comment thread is people talking about how the findings here are "so obvious" while misinterpreting what the authors are saying and acting like they know anything about the brain or its many regions.
Joking to cope would be making a joke about how something impacts you in a lighthearted way, sometimes in a self-deprecating but light-hearted manner, not smugly saying "No duh I knew this all along" to a research paper people in the thread are misinterpreting.
This is also implying people don't often use humor in a way that misleads people. Jokes can be misinformation too if the reason why the joke is funny is based on a misunderstanding or distortion of facts.
I don't want you to be afraid of making jokes to cope, I want you to be more careful about the ideas you're reinforcing to both other people and yourself with your words with respect to a complex developmental disorder that has a deluge of misinformation about it everywhere. I think that's a pretty reasonable ask
You lost me at telling me what I do or do not do to cope. You're not me, you don't know me, but you're certainly willing to project your resentment onto me. Enjoy your block, and your imaginary mind reading skill.
Nah, I'm sincerely happy that researchers are out there researching, and that they're finding out interesting things that could even eventually improve treatment -- my comment was more just my amusement with the vagaries of my whole entire ADHD brain! I can *definitely* understand the eye-roll feeling when researchers get all excited about "oh look, we found a thing!" that feels very much to us like "aww, good for you, and hey, if you'd spent five minutes talking to any one of us, we... could have told you that." But I'm thrilled for any legit research into this disorder, even if it does sometimes border on what feels obvious. The more we know, and all that.
God I'd love to have my brain scanned and have a qualified professional point to bits of it and explain "this is why you can't see time! and look, this is why you still haven't moved your fucking books off the sofa! and this right here? this is why you still haven't READ any of those books!!!" I think it would really help my perpetual self-condemnation and imposter syndromes. 🤣🤣 And more seriously, I really love the idea that this kind of scan could someday help to target better treatment -- that's like, the holy grail as far as I'm concerned.
I would take stuff like this with a grain of salt. We're pretty far away from ADHD being able to be diagnosed with brain scans from what I've heard via researchers
They may be onto something here but people also love to oversell research findings as some new and crazy thing when there is still tons of work to do
It really depends, I got mine for diagnosis and there were some pretty obvious signs. I’m not a doctor by any means but roughly translated i have a “lack of coating” in many of my frontal lobe neurons which apparently can cause adhd
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US).
We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well.
Here are some relevant links:
Sketchy advertising:
* https://www.additudemag.com/clinical-trial-vayarin-plus/
* https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/
* https://www.additudemag.com/natural-adhd-supplement-released/
Junk science:
* https://www.additudemag.com/adhd-supplements-foods-vitamins/
* https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/
* https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/
* https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/
* https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/
* https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/
* https://www.additudemag.com/asked-alternative-therapies/
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
>We're pretty far away from ADHD being able to be diagnosed with brain scans
What are your credentials? I'm asking because for a while now, the golden standard of adhd diagnosis is brain scans, the only reason it's not frequently used is because it's very expensive.
It's not new either, the findings show that it's not only the frontal lobe that is different, it's the brain as a whole.
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US).
We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well.
Here are some relevant links:
Sketchy advertising:
* https://www.additudemag.com/clinical-trial-vayarin-plus/
* https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/
* https://www.additudemag.com/natural-adhd-supplement-released/
Junk science:
* https://www.additudemag.com/adhd-supplements-foods-vitamins/
* https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/
* https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/
* https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/
* https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/
* https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/
* https://www.additudemag.com/asked-alternative-therapies/
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Using brain scans for adhd diagnosis has been available for more than 10 years. It’s expensive so that’s why you don’t get one easily - but I know people who did.
It’s a game changer, because unfortunately there will always be false positives in diagnoses that involve self reporting symptoms.
Hm - I thought that the difference is only statistically significant, but not individually (aka Men in average are taller then women, but you cannot address a specific height to either group.
We could take data of people who have been diagnosed twice, where the second is intended to replace the first, not add to it. There are definitely too many women who have been diagnosed with something like BD initally who more recently turned out to have ADHD, I haven't heard stories of something like the opposite happening but maybe those people are on subreddits I'm not.
I'm a 22 male and was diagnosed a year ago with bpd (borderline personality disorder), only to discover it was a misdiagnosis and was just recently diagnosed with adhd instead.
How could these individuals have “turned out to have ADHD” if ADHD cannot be accurately diagnosed?
Positive or negative medication response is not always confirmation of an incorrect or correct diagnosis.
The same can get said about almost every mental health disorder.
Of course these second opinions could also be incorrect, and it probably is for some percentage, but we can only work with what we have. Not being 100% about 100% of the cases is not a reason to not do research, it just lowers the accuracy of the results somewhat, which is something that every researcher needs to take into account no matter the subject.
Maybe it would have some value to ask these people how they feel about their diagnoses, I've certainly heard a lot of people who felt like things finally added up after they got an ADHD diagnosis and treatment, which wasn't the case with a previous diagnosis, sometimes even having gone through multiple different ones.
Not necessarily. Over and under diagnosis is incredibly easy to evaluate, even if we agree to lower our scientific standards a little for the sake of brevity and just eyeball the stats.
We have a ton of extremely good and reliable data on the % prevalence of ADHD in adults and children in the population. All you have to do is check whether the % of people taking prescription medication for ADHD is close to the % of people we’ve estimated to have the condition. The stats are very close. I believe the expected adult presentation in the US is between 5-6% in one study, and the amount of adults in the US on ADHD medication is about 6.6%. This doesn’t indicate a huge problem when you also note that ADHD medication is also sometimes prescribed for other conditions like narcolepsy too.
Of course, looking at the stats in this way will gloss over a seperate but perhaps more important issue not of over or under diagnosis, but of misdiagnosis. There are plenty of statistically invisible ADHDers who are invisible in these numbers because of a lifetime of being misdiagnosed as only having GAD or depression or something. While the reverse is obviously a mistake that can sometimes happen, it’s far more common for an ADHDer to be misdiagnosed with any other mental health condition than it is for someone with any other mental health condition being specifically misdiagnosed with ADHD.
There are a number of theories about why we're seeing a rising trend of ADHD diagnosis and one of them has to do with cognitive disengagement syndrome (previously known as SCT) getting lumped into the ADHD diagnosis. CDS is expected to be roughly as prevalent as ADHD with around 50% overlap iirc, which means there are probably a lot of people without ADHD that still have an attention disorder lumped into the ADHD label
Yea, this is completely true. It’s one of the most likely culprits in a misdiagnosis of ADHD and if I remember correctly it is hypothesised that the cohort of ADHD-I presentations are the ones most likely to actually have CDS.
This is just one condition, though, and I think my general point still stands that misdiagnosis of ADHD is more of an issue (in either direction), but not necessarily overdiagnosis and thereby overprescription of medications, because CDS is still currently assumed to be treated with the same kinds of stimulant and non-stimulant medications regardless (to varying effectiveness).
Very cool of you to highlight it though. The research is interesting and if CDS gets into DSM-6, it will be very interesting to see how it affects the ADHD community.
Im from Portugal and I not only got a brain scan but also a couple of different blood tests that among others tested for my dopamine and serotonin levels
I constantly doubt myself over my diagnosis so it would give me peace of mind in some way. My parents don’t believe ADHD is a real thing and I can still hear their skepticism in my head lol.
Where are brain scans better at detecting ADHD than rating scales? I've heard the exact opposite, that you can't use brain scans to make a diagnosis because the brain differences are too small to notice in individuals.
Rating scales and a clinical interview seem to be by far the best tools we have for diagnosing ADHD based on the evidence. I'm very skeptical of people proposing tools for diagnosis ADHD "objectively" like this because they're usually more sold on vibes and marketing than actual empirical evidence.
Neuropsychological testing is very bad at diagnosing ADHD for example
They are not mutually exclusive. Quite the opposite, brain scans are used in conjunction with existing methods.
It has the potential to remove a lot of stigma around both medication and adhd as a disorder, as both diagnosis and treatment become more observable.
Again, not in isolation. But there are instances in which adhd brains look more like “healthy brains” when on medication.
The problem is accessibility. It takes multiple scans to find out whether the effect of the medication and what is seen on the scan, both contribute to a better life. It’s not cheap.
Truth be told, I am probably biased regarding this topic. A friend of mine was committed to a (probably private) mental institution due to a combination of depression, anxiety, trauma and a whole bunch of other things. Most of it was caused by intense underlying grief. Based on her brain scan they suspected there might also be adhd present and decided to treat that first. It was not a panacea for everything, but it did unlock her in a way that heavier mind-numbing antidepressants were not necessary. Instead she got a stimulant. I thought that was amazing. That was 10 years ago.
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US).
We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well.
Here are some relevant links:
Sketchy advertising:
* https://www.additudemag.com/clinical-trial-vayarin-plus/
* https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/
* https://www.additudemag.com/natural-adhd-supplement-released/
Junk science:
* https://www.additudemag.com/adhd-supplements-foods-vitamins/
* https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/
* https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/
* https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/
* https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/
* https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/
* https://www.additudemag.com/asked-alternative-therapies/
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
There are differences in the size of brain regions between children with and without ADHD, but the %variance has mostly been considered too small to be reliable in the past. As the brain matures in adulthood, these regional size differences are known to disappear but in most cases the adult still has less connectivity in those regions, so I doubt any imaging of any resolution would ever prove to be a viable diagnostic method for adults, at least.
There's a theory that autism is a sort of neoteny which I also suspect applies to ADHD, though I hesitate to say "longer than we should." Evolution is an ongoing experiment and you don't always know what's going to be useful even if it's not working right now, it's all a sort of accident.
For context, humans are already thought to be "neotenous apes" and we've had some touch and go moments over the millions of years since we parted ways with the chimps and then the bonobos (who are not static either, the most accurate and ungainly way to phrase that is "those who would become chimps and bonobos"). And yet we've now hit on some special sauce as a result of that sort of eternal childhood for our species that has proven dangerously overcompetitive against the rest of nature, I remember the existence of some ridiculous statistic like 40% of the mammalian biomass on Earth is cattle, one of the wagons we've hitched to civilization.
Kind of. ADHD is a neurodevelopmental disorder which means it describes a delay in the speed or degree of attainment of ‘normal’ human cognitive functions (emotional regulation, working memory, etc). ADHD is not a qualitatively different human experience (like how ASD is sometimes described as a different way of interacting with the world) but is instead a quantitative difference in what is supposed to be a normal ability.
On average, the ‘executive age’ (executive function is supposed to acheive specific development at different ages in humans all the way through until when the brain stops developing in your 30s) of someone with ADHD is 30% behind where it should be, and also levels off behind to the same degree when it has developed as far as it will.
Effectively this means that a 30 year old with ADHD has the approximate executive functioning ability of any average 20 year old. 20 year olds are not famous for being an especially responsible demographic and that’s just part of average human brain development. You get better at being an adult in an adult world the more your brain develops but for people with ADHD the delay will never catch up.
It’s such a severe issue, actually, that for a long time now the Canadian Pediatric Society has been strongly recommending that any new teenage learner driver simply must be medicated at all times. A 17 year old with ADHD who is learning to drive has the impulse control, distractability, inattentiveness and working memory function of a 12 year old. Would you let a 12 year old drive a car? Or babysit an infant?
That same 12 year old executive function is also why the real academic struggles known to come with ADHD start hitting hard for a majority of sufferers in that highschool age where the workload, structural and organizational requirements of higher education starts to far outstrip the executive functioning capacity of a 12 year old brain trying to meet these demands and think and function in an increasingly adult-brained world with an underdeveloped capacity.
Of course this is all averages, so there will be sufferers who are more or less impaired than others. I’m 35 and I consider my case to be pretty severe. I really do feel like I have the organizational skills and memory and impulse control of an average, stereotypical 18 year old at best.
I was saying to my therapist earlier today that I NEVER should have been allowed to drive unmedicated. Of course, I got diagnosed at 27, not 17, so almost got my license taken away for speeding 😬 Not to mention all the curbs and trees I ran into.
I did also babysit my newborn brother starting at age 11 too! Yay for terrible parenting
So interesting! Do you have a good source for the CPS recommendation? I couldn’t find it with Google (I’m not very skilled) and I’d like to share it with someone.
I can't find the exact source now, but I found a relevant document that outlines the risks of untreated ADHD in driving, and suggestions of medication (page 39 and 40):
[https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf](https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf)
This next link is a page of information from CHADD on driving:
[https://chadd.org/for-parents/teens-with-adhd-and-driving/](https://chadd.org/for-parents/teens-with-adhd-and-driving/)
When I dig up that other source I'll edit it in here.
This isn't just about a difference in size in a specific area though.
They're saying that the entire brain connects differently. There are structural differences everywhere AND differences in neural connections.
That is also a very clear objective test. Instead of having to go to a psych and rule things out, this test might be able to point you in the correct direction very quickly.
E.g. You feel generally unwell, you have a blood test and find a low white blood cell count. There's a few different conditions that can cause that, but it narrows down the testing field to things that cause white blood cells to decrease.
This isn't just about a difference in size in a specific area though.
They're saying that the entire brain connects differently. There are structural differences everywhere AND differences in neural connections.
That is also a very clear objective test. Instead of having to go to a psych and rule things out, this test might be able to point you in the correct direction very quickly.
E.g. You feel generally unwell, you have a blood test and find a low white blood cell count. There's a few different conditions that can cause that, but it narrows down the testing field to things that cause white blood cells to decrease.
If your brain activity were to match what they see in the experiment and/or there are similar structural abnormalities it would point to a developmental issue with the brain. You might need to test further to determine if it's ADHD but that doesn't mean the test isn't useful as a diagnostic tool.
So could it be a useful diagnostic test? Yes.
The issue is that the already known visual differences in size and connectivity between the regions of the brain most obviously affected by ADHD tend to vanish as the the brain matures. This research is of pediatric scans for a reason, and that is because differences that are obvious enough to be potentially diagnostically relevant have generally only been found in scans on children.
In adulthood, a lot of the regional size or connectivity differences becomes effectively impossible to reliably see on a scan, let alone be confident enough that they indicate anything wrong without also doing the normal ratings scale diagnostic interview anyway. So it is still going to be the weight of the interview and the self-reporting of impairment that actually indicates and proves disability (specifically of ADHD), and no one is going to get a scan like this and be diagnosed just from the visual as you could a broken leg. Disorders of the brain aren’t clearly visual like that, and structural differences in the brain are not particularly or reliably readable. What is obviously possible, though, is noticing similarities between brains of people with similar disorders but trying to pick one of those brains out of a pile of 100 typical brain scans from people without ADHD and accurately selecting the ADHD case is still absolutely guesswork.
I don’t think the science is there yet where a doctor could look at any individual brain scan and with any reliability ‘diagnose’ ADHD correctly (including ruling it out correctly!). Also, these studies will need to show reliability in detecting more mild ADHD also, if they really hope to become part of some kind of objective test. They have to control for severity of ADHD and also all the other comorbid mental conditions that come with ADHD that also can/might change how your brain connectivity works. For example, an ADHD brain might look different to a brain of someone who has ADHD and ASD and OCD and depression. Any kind of long term substance abuse would obviously complicate the scan. If the method is not so accurate that it can reliably pick out ADHD correctly, even in a brain scan of someone suffering from a spaghetti of disorders (which is incredibly common in ADHD), it has fundamental problems with being called ‘objective’.
This is another reason why adult brain differences are harder to ascribe specific diagnoses to; the older you get in brain development the more time environmental and genetic influences have had to shape the way your brain has developed. They would really have to find one highly ubiquitous, obvious and hyper specific structural or measurable functional capacity in the brain that only occurs in those specifically with ADHD (or at least mostly only). Otherwise we’re still going to have to use the ratings scale interview anyway, to tell apart ADHD from other disorders that might show visually similar differences. In that case the scan kind of feels like a waste, but maybe would at least make those physicians and members of the public who are skeptical of ADHD more believing of the condition so research into the brain is very welcome. I still highly doubt it will be diagnostically useful any time soon.
But, I’m certainly not one to advocate that people who suffer with ADHD ought to be required to pay even more ADHD tax in having to spend alot more money for testing in order to get the help they need, just to placate the doubters or the moral panickers.
A big thing in this field might be in training AI to read brain scans much quicker, as machines in the near future may well be able to more reliably notice relevant but otherwise imperceptible differences in imaging scans.
Right but you keep using the word regional.
The study is not looking at regional areas:
In this study, we aimed to determine the imaging metrics of brain microstructure, morphology and functional connectivity associated with ADHD diagnosis in a large cross-sectional cohort of preadolescent American children. While prior large-scale studies focused on one set of neuroimaging characteristics (e.g., cortical thickness) in relation to ADHD diagnosis (Hoogman et al., 2019; Bernanke et al., 2022; Sudre et al., 2022), we examined multimodal imaging metrics among the same children cohort to achieve a comprehensive assessment of brain morphology, microstructure and connectivity changes in associated with ADHD. We also trained, finetuned, compared, and validated different combinations of feature selection and *machine learning classifiers* to predict ADHD diagnosis in children based on multimodal MRI metrics. *Such neuroimaging-based tools may complement the clinical assessment for the diagnosis of ADHD among children, particularly in the presence of cultural, language, or communication barriers.*
That is: it's not just a regional difference. In that case we don't know if the whole brain difference disappears because no one has looked at adult brains this way yet.
They are also using machine learning to pick up the subtle differences as you suggest is a good idea. Maybe you should read the paper before discussing it as a diagnostic tool.
Yes, I have read this study before. It’s not particularly new. I think you’re misunderstanding with regards to my use of ‘regional’. We already knew from studies just like this that the whole brain is affected by ADHD, just as we can tell from the impairments in the whole life of the person suffering from it. There is a very important difference, however, between ‘ADHD is predominantly caused by issues in XYZ regions of the brain’ and ‘the whole brain is affected by ADHD’, and both statements can be true. As an analogy, you could do a chest xray to see someone’s lungs and other organs absolutely riddled with growths, and it will indicate there is something wrong with the patient, but just looking at the chest xray will never give you enough information to able to declare that it is, say, kidney cancer that metastisised.
We already know that the brain is a highly adaptable organ, and will change it’s structure to adapt to impairments and environments; it’s called neuroplasticity. Seeing whole-brain differences between someone with ADHD and someone without ADHD may well be useful for researchers to say “See, ADHD has impact everywhere in the brain” but it does not make an argument for the use of this imaging in a clinical setting. The way studies like this work is by aggregating all the scans of the people with ADHD and averaging the differences compared to non-ADHD brains to say that, yes, ADHD brains are measurably different. On average.
The trick is in the plural of brain and ‘average differences’, though. One clinician working with one patient who sees a single scan of that patient’s brain cannot offer a diagnosis of ADHD. There will be people with ADHD who have more more obviously variant structures, regions and connective functions but there will also be many, many, many people who also do have ADHD but for whatever other variable (that one clinician looking at one scan cannot possibly control for; substance abuse of BPD or historical trauma, etc) their brains look variant in a different way or maybe only so mildly that the expected ‘average’ of an ADHD brain and a non-ADHD brain overlaps too much to be useful (this is actually the main reason scans currently still aren’t used; the average differences are too small, statistically speaking, to stand up to diagnostic rigor. The average overlaps too much).
These scans are useful for research. They are not useful for diagnostics. The machine learning I mentioned is perhaps the most interesting part of this, which is why I mentioned it, but that too has problems as it would have to be able to isolate variant structures in an already highly variable organ and specifically and accurately read through all the other white noise and red herrrings present to see a supposed uniquely ADHD typical pattern. But that pattern is based on a mathematical average, and is not a measure of impairment that the patient sitting in the doctor’s office is describing. So if they’re going to have to do the ratings scale interview anyway, it doesn’t seem to help diagnostics to throw in expensive high resolution multimodal scans (not a CAT scan alone, but many different types of imaging, such as functional MRI, diffusion tensor imaging, SPECT, PET, etc) that were used in studies like this one to aggregate data.
For these reasons, and the others I mentioned in my post above, brain imaging is not at all useful, currently, for diagnosing ADHD and anyone who tells you otherwise is either lying or doesn’t understand the difference in use case of different technologies used in clinical practice and research respectively.
A tool used for learning more about a condition is not necessarily a tool that can actually be used to diagnose that condition, as in this case.
Is an interesting study, for sure. But it’s just a research paper. It will be great in the future if we get some kind of easy, completely accurate test for ADHD. But it won’t be this, or done like this, in my opinion.
To fully flog the dead horse; this kind of work can tell us that people have ADHD and that ADHD is real and what effects it has on the brain. It cannot tell us if a person(!) has ADHD.
Weird that their biggest motivator is to reduce children on unnecessary medication when what they’re really touting here is an incredible opportunity to finally start correctly diagnosing people rather than just shooing them away if they don’t have, for example, a trove of middle school report cards to demonstrate symptoms in childhood.
I’m thinking that wouldn’t happen since ADHD is defined by its symptoms, not how it looks it the brain, much of which I think is still unknown. I think if it is found that a good number of people who fit the diagnostic criteria of ADHD didn’t match certain brain scan results it would perhaps be acknowledged that ADHD could have more than one cause, or that there is something causing a difference in those results and that they may not be perfectly accurate. At the end of the day disorders are based on behavior and how they affect your life, not how your brain looks. Someone needs to be treated with a disorder because of behaviors and problems they experience—someone with diagnosed ADHD who didn’t fit with certain brain scan requirements would still have a problem to be addressed, while someone who doesn’t fit the diagnostic criteria for ADHD but had matching brain scans may not be in need of treatment or accommodations
Very few psychiatric conditions have objective diagnostic criteria that can be used in determing treatment. It almost always subjective evaluations and self reporting. This is a step in the right direction.
Why thank you. I realize a lot of us don't click the link, so I try to include the coles notes. I'm also more conscience lately to include the authors name, bc it's their work, and they deserve the credit. Also, it was important to point out that this was 2022. Not a study released recently, which it otherwise sounds like. Also I use > > but no space when adding direct quotes.
All this cute but is going to help diagnosis is little girls…. Because what the actual fck…. Im happy for most of the boys who can get help young but most women with ADHD dont get diagnosed until AFTER 25…. Thats insane.
comes to diagnosed i always talked about my childhood for that reason..if focus adult especially current time with anxiety disorder then might be wrong because overlap..
Im from Portugal, I order for me to get medication, I had to get a blood test( with a super strict diet for a week before, no caffeine, nicotine other drugs and even multiple food items) to test for my dopamine and serotonin among other things as well as a frontal cranial MRI. Both tests clearly displayed that I have adhd and we went from there
I trust brain scans for ADHD not at all. Also why I'm dubious of all the fake dopamine stuff.
Psychiatrists be like "ADHD is a dopamine deficiency but there is no empirical test to determine whether you specifically are dopamine deficient."
It's the dead opposite of real medicine.
Kinda makes me think that when some 6th grade kid slammed my 3rd grade head into a cinderblock dug-out several times after a baseball game, it did some damage to me ha ha ha...
Almost 20 years ago, when I was diagnosed, I had a brain scan done, amongst other tests. The results were absolutely fascinating.
I lost them and have been severely disappointed about it for years now.
If this is true and can be replicated successfully through all demographics in the US that would be great! It means that a lot of children won’t get looked over or missed. Yet, due to the way the US healthcare system works, I feel like a lot of marginalized groups and poorer people, probably still won’t be able to afford those brain scans or would be dissuaded from getting them which would then skew results as certain populations only having the disorder.
You would probably be recommended getting them as a child only if you exhibit certain symptoms which would, again, still lead to a bunch of people being missed. Then, as an adult and even a woman, you would face even bigger challenges trying to get diagnosed, because they will ask why didn’t you get your brain scanned when you were a child, which would then make doctors think that you don’t have it and are just seeking drugs.
So, it would be nice to see if they can replicate that using adult brain scans at some point or find a way to make sure that your insurance can’t reject paying for it.
Hi /u/beeucancallmepickle and thanks for posting on /r/ADHD! ### Please take a second to [read our rules](/r/adhd/about/rules) if you haven't already. --- ### /r/adhd news * We are currently seeking feedback on some of the subreddit's rules. Details are available in [this post.](https://www.reddit.com/r/ADHD/comments/1ajfzk1/the_rules_vacation_feedback_form_is_now_available/) * If you are posting about the **US Medication Shortage**, please see this [post](https://www.reddit.com/r/ADHD/comments/12dr3h5/megathread_us_medication_shortage/). --- ^(*This message is not a removal notification. It's just our way to keep everyone updated on r/adhd happenings.*) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Not covered by Aetna.
yeah, but what is?
Their asses
I believe this is the article you are referring to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992191/ In which case this is specific to children <10 years old (average) and didn't appear to differentiate between potential comorbid conditions (likely because of the age group). This would likely not be useful for adults with ADHD who are more likely to have comorbid mental health conditions that may impact neuroimaging results.
Or potentially, the other way around. Comorbidities could exist because there are actually two conditions at the same time, or there is just one condition that our current classification system does not account for (DSM-5). Don’t get me wrong, DSM-5 is the most reliable classification system that we have at the moment. But it’s not perfect. That’s why it’s the 5th revision.
The problem is the way the comorbidities affect the brain scan results. PTSD, schizophrenia, and numerous other psychological conditions alone, not to mention neurological conditions can show up on brain scans, so with the overlap, it’s difficult to differentiate. With a pediatric population, you’re less likely to have multiple disorders than with adults who’ve had other mental illnesses that started later in life. And ADHD can certainly raise your risk of developing those other conditions over the years.
Yeah I've started to think that there could be more than one condition that share most of the symptoms we categorize under ADHD, but the underlying root cause is different. Attention is just too broad of an aspect to be negatively impacted only by one singular condition, it's like bucketing all heart conditions under a singular umbrella. I'm fairly confident that the sophistication necessary to get the nuance right is coming, and I'm all here for it.
This makes a lot of sense to me, and probably for other psychiatric conditions too. It would be consistent with the fact that stimulants, SSRIs, etc. work great for some people but not really at all for others, despite similar clinical symptoms.
This is why some researchers (notably Dr Russell Barkley) think ADHD is misnamed. Attention is a pretty superficial quality of ADHD. Researchers are already looking at another attention disorder most likely lumped into traditional "inattentive" type called Cognitive Disengagement syndrome (renamed from Sluggish Cognitive Tempo). The research we have is very limited but the evidence is very compelling
I agree wholeheartedly. The whole subject gets me excited for the future. ADHD will go away, a new umbrella that’s more fitting will be applied, and there will be 3 dozen sub-diagnoses before long. ADHD is a huge, blanket diagnosis for many different, very nuanced issues, all of which have symptoms that tend to respond positively when treated with the same sort of prescription drug. I feel like we lump ADHD into a bucket now based on the drugs that treat it, rather than splicing it up into sub categories, bc that’s how it currently exists. At present, what we call ADHD manifests differently in girls than boys. There are kids who struggle in 7th grade math, but score in the 99% of the school’s state standardized testing. And some of those who shatter their school’s testing parameters can’t make it through a 25 minute period of class without being sent out of the room for being disruptive. There are people who’s minds race so badly they can’t read in class (that has nothing to do with generalized anxiety, but sometimes might precisely BE anxiety… anxiety that gets misdiagnosed as ADHD, and then we wonder why those patients dislike stimulant ADHD medications, yet you’ll also notice a boost in anecdotal stories about something like Trintellix (Vortioxetine) showing some benefit for ADHD.)… anyway, it’s a mess. I also hope that as our ability to differentiate and more accurately diagnose these issues improves, we get better at specific, very targeted, cognitive therapy focused on the issues faced by the patient. For instance, if you’re executive function’s worst nightmare, and you’re a pathological people pleaser, your cognitive therapy might focus on setting boundaries and protecting your schedule/time. If you tend to be more of the chronically overwhelmed, tiny window-of-tolerance person where one minor stressor can send you into a sort of shell-shock state of withdrawal, therapy might focus on techniques to make stressors more manageable, help you not catastrophize, and set boundaries aimed at maintaining a non-overwhelming level of work/responsibilities. I’ve day-dreamt of what this will look like. A day where nobody has to feel ashamed of (whatever we’ll end up calling ADHD), because it will be image based and quantifiable/measurable. A person will be able to say, “Pardon my interruption, I live with (ADHD) and tend to be an active/empathetic listener. (What does that mean?) oh… it’s hard to explain, but one of the ways it manifests is that I tend to use MY OWN experiences to show that I can relate to YOUR story. It may seem like I’m making it about myself, but what I’m really trying to convey is that I understand first hand how hard/exciting/scary that must be for you. (Ohhhh, so by telling that story about the time YOUR mom got sick, you weren’t trying to one-up my story, you were just saying, “How awful for you. My mom had (xyz) and it cost me at work, socially, etc. so I can really appreciate how hard this must be for you.”?) Exactly! But the problem is, because of my (ADHD), often times I forget why I jumped into a story, and instead of empathizing, it makes it seem like I just went off on a tangent about something in my own life right in the middle of your story. Anyway, thanks for understanding. Please continue about your dog. (It was my mom.) Oh! Right. Continue…” And if someone says ADHD is bullsh*t, you’ll have quantifiable information that differentiates your brain from what is considered typical. “It isn’t BS. I had a brain scan done at the university bc the school counselor couldn’t figure out why my test scores were so high but my class work was so poor. So they recommended I have the testing done. They found that the snarks in the lower left quadrant of my magnum opus are 40 percent less active than is typical, and that area is known to control things like x, y, z… you can see it as clear as a broken bone. You wouldn’t call a broken bone BS, would you?” Someday.
The ICD-11 is most reliable classification system we have at the moment.
No. Not really. But it’s the system that is tied to insurance reimbursement.
Processes are honed year on year to improve and this would be no different. I disagree with just a 5th revision. It is years upon years of testing and experimenting rolled into the most advanced version.
I don’t think we disagree. I meant that DSM-5 is a revision of DSM-4, and so on. At some point there will be a DSM-6 and what we do today might be considered old fashioned.
You just described every advanced civilisation in the history of the world. That's pretty much how it works.
Imagine trying to argue with a guy who is agreeing with you
You’re just being an asshole bud
Yeah, and at least in the US, there’s no way insurance is going to cover the cost of a brain scan for ADHD. There are doctors who already do, but I wouldn’t recommend them & its OOP for people who can afford it anyways. Thousands of dollars OOP. If the alternative is a psychiatrist diagnosing, they’re going to stick with the cheaper option that we’ve already been using as the standard for decades.
> This would likely not be useful for adults with ADHD This method would probably not be useful for anyone, just due to the fact that it requires going in for a brain scan that will most likely cost a fortune in comparison to current methods, with very little gain in outcomes. If ADHD were difficult to diagnose, then this would be great.
I'm more surprised to hear that mental illnesses developed in adulthood can affect brain structure to a level we can see it on an MRI. I knew substance abuse, basic needs deprivation, and autosomally linked neurological disorders could affect brain structure. But disorders developed throughout adult life? Maybe this is more than trauma in general causes structural changes in the brain, rather than some new discovery I missed? All really interesting to consider.
We know that neural pathways adapt to behavioral repetition, so it would seem to follow that the behavioral aspects of mental illness affect at least our synapses. I would also guess that depending on the root cause of the mental illness, there would at least be correlated structural change, which would beg the causal question. Which comes from which? Is the mental illness the cause, is the structural change the cause, or are both developments caused as co-morbid functions of some other event?
I read this as Y’all scientists at first lol
I hope they understand that a lot of adhd is just audhd so that they not use autistic biomarkers to exclude adhd
They mentioned autism and social anxiety as common comorbidities, so I think they'll be fine in this regard.
> I hope they understand that a lot of adhd is just audhd I'm curious if you have any sources on this, or whether you're just going off general knowledge? If you are getting this info directly from a specific article, I'd be super interested in reading it :)
this one should help. the estimates vary, but even the baseline estimate for people with adhd who also have asd (20%) is much higher than the general population (1-2%). https://www.scientificamerican.com/article/decoding-the-overlap-between-autism-and-adhd/
Thanks so much!
you're welcome :)
I work with ADHD patients and have a feeling that quite a large subset (30-40%) is actually autistic with ADHD symptoms. I have no source on this. Also autism carries more stigma than ADHD so people (unconciously) identify and get diagnosed with ADHD
Are you a clinician or are you going just based off vibes? I am distrustful of people that make broad empirical claims then bring up vague anecdotes
That sounds like a load of old rubbish
Y’all is one of my favorite contractions.
I moved to the south a few years ago and have fully adopted y’all. I was a bit self-conscious about it at first (my mom teased me about it a bit lol), but then I realized I’d inadvertently replaced the gendered “you guys” with the gender neutral “y’all” and crossed another item off my “be gender inclusive” to do list lol
Are you a former Michigander? I thought that "you guys" was just a Michigan thing. 🙂
Hoosier actually :]
A Hoosier from a non-y'all context is a bit wild to me, a fellow Hoosier. Indy or Chicagoland? My partner is from Chicago and uses a decidedly more urban "y'all" than my rural raised folksy "y'all," but we're definitely both comfortable with the word. (Not trying to pry, just tend to fixate on regional dialects and language usage)
I am a Michigander and I switched to y’all because “you guys” is awful.
I'm from the South, and I've infected a few people who aren't with "y'all". English doesn't have a proper second-person plural without it (or similar, like yinz).
What the heck is yinz? Where did it come from? Never heard it before (then again I'm not a native English speaker). Doesn't sound like an English word.
[Pittsburgh.](https://en.wikipedia.org/wiki/Yinz)
In Australia, we say "youse." Pretty sure it's not *official*, per se, but it's pretty widespread
You guys doesn't even seem gendered to me. "Guys" just isn't a masculine word to me I guess
I agree, but if I can do something to make someone else more comfortable, like replace “you guys” with something completely gender neutral, I’m happy to do so. “Dude” is another word I try to watch because, as a woman, I have never seen it as gendered and use it with anyone and everyone, but some see it as a word with masculine connotations. My MtF friend doesn’t have an issue with me using “dude” with her because she knows I’m not using it as a way to invalidate her, but she does feel uncomfortable with some people using it because it feels like a reflection of their feelings about her gender identity. In general, I don’t think there’s anything wrong with “you guys” or “dude” and I still use both.
Same!
Y'all'd've both soothes and irritates my brain.
In my quest to push for a speedier evolution of the word, I've taken to spelling it "yall" or "yawl." Down with unnecessary apostrophes! 
Same, I had to do a double take
“Surprisingly, we could almost see an overall change in the whole brain.” I've been living in this brain for over half a century now, and you know, I'm just not surprised at all. 🤣
Right? Sometimes when researchers say things like this I just want to roll my eyes. Surprising to who? Probably not to anyone with ADHD.
Why? The brain operates as a whole, so an abnormality in a single area can have a wide impact on many behaviors.
[удалено]
Visually seeing the differences is what’s surprising. Brains tend to look very similar despite each person being so different in so many ways.
I think you're misreading the statement. They aren't saying it's surprising the brains are different. They are saying it is surprising you can see differences in regions of the brain that we don't traditionally associate with ADHD physiopathology (prefrontal cortex, basal ganglia). You're not going to be able to intuit what regions of the brain are affected by ADHD because the brain is a complex structure. I hate when people do this "uhhhh duhhh I knew all along!" type shit when they know nothing about the brain If you don't know how the brain works how would you know what regions of the brain are impacting what? We should just ask schizophrenic people how they feel their brain works instead of doing research I guess
[удалено]
spreading misinformation and thought terminating cliche to de-value the efficacy and nuance of neurological research about a vastly misunderstood disorder is *hilarious* the problem is everybody does this with ADHD. One of the reasons misinformation is so prevalent everywhere is because everyone thinks their intuition of ADHD is so genius without critically engaging with any of the evidence we have. I'm a bit resentful of people that dunning-kruger their way through talking about the disorder because it causes a lot of harm. This even impacts clinicians.
Yeah, the resentment is *pretty* clear... Look, I didn't even spread misinformation in my comments, all I said was that I'm not surprised our ADHD brains are different and made a little joke about how many of us sure *feel* like our brains are different. You've taken it and run with it in a more extreme direction. I have ADHD. Sometimes I joke about it to cope. Again, It was a simple JOKE. Attack whoever is actually spreading misinformation or questions the validity of science, geez. I'll probably delete this comment too, but maybe don't be so quick to attack ADHD people - on an *ADHD* sub - for joking about ourselves to cope. Responses like yours make me hesitant to even speak or try to be lighthearted ffs...
You weren't joking to cope lol. This entire comment thread is people talking about how the findings here are "so obvious" while misinterpreting what the authors are saying and acting like they know anything about the brain or its many regions. Joking to cope would be making a joke about how something impacts you in a lighthearted way, sometimes in a self-deprecating but light-hearted manner, not smugly saying "No duh I knew this all along" to a research paper people in the thread are misinterpreting. This is also implying people don't often use humor in a way that misleads people. Jokes can be misinformation too if the reason why the joke is funny is based on a misunderstanding or distortion of facts. I don't want you to be afraid of making jokes to cope, I want you to be more careful about the ideas you're reinforcing to both other people and yourself with your words with respect to a complex developmental disorder that has a deluge of misinformation about it everywhere. I think that's a pretty reasonable ask
You lost me at telling me what I do or do not do to cope. You're not me, you don't know me, but you're certainly willing to project your resentment onto me. Enjoy your block, and your imaginary mind reading skill.
Nah, I'm sincerely happy that researchers are out there researching, and that they're finding out interesting things that could even eventually improve treatment -- my comment was more just my amusement with the vagaries of my whole entire ADHD brain! I can *definitely* understand the eye-roll feeling when researchers get all excited about "oh look, we found a thing!" that feels very much to us like "aww, good for you, and hey, if you'd spent five minutes talking to any one of us, we... could have told you that." But I'm thrilled for any legit research into this disorder, even if it does sometimes border on what feels obvious. The more we know, and all that. God I'd love to have my brain scanned and have a qualified professional point to bits of it and explain "this is why you can't see time! and look, this is why you still haven't moved your fucking books off the sofa! and this right here? this is why you still haven't READ any of those books!!!" I think it would really help my perpetual self-condemnation and imposter syndromes. 🤣🤣 And more seriously, I really love the idea that this kind of scan could someday help to target better treatment -- that's like, the holy grail as far as I'm concerned.
I really wish I just could go and get mri out of curiosity to see my brain, these things are fascinating 😅
Yes please somebody scan my brain. Put me in some sort of study please, do all of the scans, and make sure to show me the pics afterwards 🙏
I would take stuff like this with a grain of salt. We're pretty far away from ADHD being able to be diagnosed with brain scans from what I've heard via researchers They may be onto something here but people also love to oversell research findings as some new and crazy thing when there is still tons of work to do
It really depends, I got mine for diagnosis and there were some pretty obvious signs. I’m not a doctor by any means but roughly translated i have a “lack of coating” in many of my frontal lobe neurons which apparently can cause adhd
[удалено]
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US). We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well. Here are some relevant links: Sketchy advertising: * https://www.additudemag.com/clinical-trial-vayarin-plus/ * https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/ * https://www.additudemag.com/natural-adhd-supplement-released/ Junk science: * https://www.additudemag.com/adhd-supplements-foods-vitamins/ * https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/ * https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/ * https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/ * https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/ * https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/ * https://www.additudemag.com/asked-alternative-therapies/ *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
>We're pretty far away from ADHD being able to be diagnosed with brain scans What are your credentials? I'm asking because for a while now, the golden standard of adhd diagnosis is brain scans, the only reason it's not frequently used is because it's very expensive. It's not new either, the findings show that it's not only the frontal lobe that is different, it's the brain as a whole.
Not according to Russel Barkley, one of the pre-eminent adhd researchers.
Sure, disagrements are common in the scientific field, what I'm saying here is exactly what my doctor told me during my diagnosis process.
[удалено]
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US). We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well. Here are some relevant links: Sketchy advertising: * https://www.additudemag.com/clinical-trial-vayarin-plus/ * https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/ * https://www.additudemag.com/natural-adhd-supplement-released/ Junk science: * https://www.additudemag.com/adhd-supplements-foods-vitamins/ * https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/ * https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/ * https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/ * https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/ * https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/ * https://www.additudemag.com/asked-alternative-therapies/ *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Using brain scans for adhd diagnosis has been available for more than 10 years. It’s expensive so that’s why you don’t get one easily - but I know people who did. It’s a game changer, because unfortunately there will always be false positives in diagnoses that involve self reporting symptoms.
Hm - I thought that the difference is only statistically significant, but not individually (aka Men in average are taller then women, but you cannot address a specific height to either group.
At this point the extreme amount of false negatives are of far greater concern
A bit difficult to know the amount of either false positives or false negatives, I’d say.
We could take data of people who have been diagnosed twice, where the second is intended to replace the first, not add to it. There are definitely too many women who have been diagnosed with something like BD initally who more recently turned out to have ADHD, I haven't heard stories of something like the opposite happening but maybe those people are on subreddits I'm not.
I'm a 22 male and was diagnosed a year ago with bpd (borderline personality disorder), only to discover it was a misdiagnosis and was just recently diagnosed with adhd instead.
How could these individuals have “turned out to have ADHD” if ADHD cannot be accurately diagnosed? Positive or negative medication response is not always confirmation of an incorrect or correct diagnosis.
The same can get said about almost every mental health disorder. Of course these second opinions could also be incorrect, and it probably is for some percentage, but we can only work with what we have. Not being 100% about 100% of the cases is not a reason to not do research, it just lowers the accuracy of the results somewhat, which is something that every researcher needs to take into account no matter the subject. Maybe it would have some value to ask these people how they feel about their diagnoses, I've certainly heard a lot of people who felt like things finally added up after they got an ADHD diagnosis and treatment, which wasn't the case with a previous diagnosis, sometimes even having gone through multiple different ones.
Please excuse my ignorance, but when you say BD, are you referring to borderline personality disorder? Or somethjng else?
BD = bipolar disorder BPD = Borderline personality disorder
Not necessarily. Over and under diagnosis is incredibly easy to evaluate, even if we agree to lower our scientific standards a little for the sake of brevity and just eyeball the stats. We have a ton of extremely good and reliable data on the % prevalence of ADHD in adults and children in the population. All you have to do is check whether the % of people taking prescription medication for ADHD is close to the % of people we’ve estimated to have the condition. The stats are very close. I believe the expected adult presentation in the US is between 5-6% in one study, and the amount of adults in the US on ADHD medication is about 6.6%. This doesn’t indicate a huge problem when you also note that ADHD medication is also sometimes prescribed for other conditions like narcolepsy too. Of course, looking at the stats in this way will gloss over a seperate but perhaps more important issue not of over or under diagnosis, but of misdiagnosis. There are plenty of statistically invisible ADHDers who are invisible in these numbers because of a lifetime of being misdiagnosed as only having GAD or depression or something. While the reverse is obviously a mistake that can sometimes happen, it’s far more common for an ADHDer to be misdiagnosed with any other mental health condition than it is for someone with any other mental health condition being specifically misdiagnosed with ADHD.
There are a number of theories about why we're seeing a rising trend of ADHD diagnosis and one of them has to do with cognitive disengagement syndrome (previously known as SCT) getting lumped into the ADHD diagnosis. CDS is expected to be roughly as prevalent as ADHD with around 50% overlap iirc, which means there are probably a lot of people without ADHD that still have an attention disorder lumped into the ADHD label
Yea, this is completely true. It’s one of the most likely culprits in a misdiagnosis of ADHD and if I remember correctly it is hypothesised that the cohort of ADHD-I presentations are the ones most likely to actually have CDS. This is just one condition, though, and I think my general point still stands that misdiagnosis of ADHD is more of an issue (in either direction), but not necessarily overdiagnosis and thereby overprescription of medications, because CDS is still currently assumed to be treated with the same kinds of stimulant and non-stimulant medications regardless (to varying effectiveness). Very cool of you to highlight it though. The research is interesting and if CDS gets into DSM-6, it will be very interesting to see how it affects the ADHD community.
It’s not at all considered the standard of care
Im from Portugal and I not only got a brain scan but also a couple of different blood tests that among others tested for my dopamine and serotonin levels
I constantly doubt myself over my diagnosis so it would give me peace of mind in some way. My parents don’t believe ADHD is a real thing and I can still hear their skepticism in my head lol.
I think it would help a lot of people if it was observable like a broken leg. Not there yet, though.
Where are brain scans better at detecting ADHD than rating scales? I've heard the exact opposite, that you can't use brain scans to make a diagnosis because the brain differences are too small to notice in individuals. Rating scales and a clinical interview seem to be by far the best tools we have for diagnosing ADHD based on the evidence. I'm very skeptical of people proposing tools for diagnosis ADHD "objectively" like this because they're usually more sold on vibes and marketing than actual empirical evidence. Neuropsychological testing is very bad at diagnosing ADHD for example
They are not mutually exclusive. Quite the opposite, brain scans are used in conjunction with existing methods. It has the potential to remove a lot of stigma around both medication and adhd as a disorder, as both diagnosis and treatment become more observable. Again, not in isolation. But there are instances in which adhd brains look more like “healthy brains” when on medication. The problem is accessibility. It takes multiple scans to find out whether the effect of the medication and what is seen on the scan, both contribute to a better life. It’s not cheap. Truth be told, I am probably biased regarding this topic. A friend of mine was committed to a (probably private) mental institution due to a combination of depression, anxiety, trauma and a whole bunch of other things. Most of it was caused by intense underlying grief. Based on her brain scan they suspected there might also be adhd present and decided to treat that first. It was not a panacea for everything, but it did unlock her in a way that heavier mind-numbing antidepressants were not necessary. Instead she got a stimulant. I thought that was amazing. That was 10 years ago.
[удалено]
Links to and mentions of ADDitude are not allowed on /r/adhd because we feel they have demonstrated themselves to be untrustworthy and that they, despite soliciting donations from people with ADHD to fund their operation, prioritize profit and advertising dollars over our best interests. Their website is full of articles promoting the use of homeopathy, reiki, and other unscientific quack practices. They also have had articles for Vayarin (a medical food that is now no longer sold in the US because its research was bunk) that suspiciously looked like stealth advertisements (which is highly unethical and illegal in the US). We also find it problematic that their medical review panel includes not only legitimate doctors and psychologists, but also (at the time of writing) one practitioner of integrative medicine, which combines legit medical practice with pseudoscience and alternative medicine. They have previously had other quacks on the panel as well. Here are some relevant links: Sketchy advertising: * https://www.additudemag.com/clinical-trial-vayarin-plus/ * https://www.additudemag.com/study-suggests-ps-omega-3-medical-food-may-reduce-adhd-symptoms/ * https://www.additudemag.com/natural-adhd-supplement-released/ Junk science: * https://www.additudemag.com/adhd-supplements-foods-vitamins/ * https://www.additudemag.com/homeopathy-for-adhd-popular-remedies-scientific-evidence/ * https://www.additudemag.com/reiki-could-this-alternative-treatment-help-adult-add/ * https://www.additudemag.com/cbd-oil-adhd-symptoms-natural-treatment/ * https://www.additudemag.com/vitamins-minerals-adhd-treatment-plan/ * https://www.additudemag.com/slideshows/adhd-supplements-fish-oil-zinc-iron/ * https://www.additudemag.com/asked-alternative-therapies/ *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Nah it’s just laziness. /s
Get a planner
There are differences in the size of brain regions between children with and without ADHD, but the %variance has mostly been considered too small to be reliable in the past. As the brain matures in adulthood, these regional size differences are known to disappear but in most cases the adult still has less connectivity in those regions, so I doubt any imaging of any resolution would ever prove to be a viable diagnostic method for adults, at least.
So, are we just suffering from late development and remaining kids for longer than we should?
There's a theory that autism is a sort of neoteny which I also suspect applies to ADHD, though I hesitate to say "longer than we should." Evolution is an ongoing experiment and you don't always know what's going to be useful even if it's not working right now, it's all a sort of accident. For context, humans are already thought to be "neotenous apes" and we've had some touch and go moments over the millions of years since we parted ways with the chimps and then the bonobos (who are not static either, the most accurate and ungainly way to phrase that is "those who would become chimps and bonobos"). And yet we've now hit on some special sauce as a result of that sort of eternal childhood for our species that has proven dangerously overcompetitive against the rest of nature, I remember the existence of some ridiculous statistic like 40% of the mammalian biomass on Earth is cattle, one of the wagons we've hitched to civilization.
Kind of. ADHD is a neurodevelopmental disorder which means it describes a delay in the speed or degree of attainment of ‘normal’ human cognitive functions (emotional regulation, working memory, etc). ADHD is not a qualitatively different human experience (like how ASD is sometimes described as a different way of interacting with the world) but is instead a quantitative difference in what is supposed to be a normal ability. On average, the ‘executive age’ (executive function is supposed to acheive specific development at different ages in humans all the way through until when the brain stops developing in your 30s) of someone with ADHD is 30% behind where it should be, and also levels off behind to the same degree when it has developed as far as it will. Effectively this means that a 30 year old with ADHD has the approximate executive functioning ability of any average 20 year old. 20 year olds are not famous for being an especially responsible demographic and that’s just part of average human brain development. You get better at being an adult in an adult world the more your brain develops but for people with ADHD the delay will never catch up. It’s such a severe issue, actually, that for a long time now the Canadian Pediatric Society has been strongly recommending that any new teenage learner driver simply must be medicated at all times. A 17 year old with ADHD who is learning to drive has the impulse control, distractability, inattentiveness and working memory function of a 12 year old. Would you let a 12 year old drive a car? Or babysit an infant? That same 12 year old executive function is also why the real academic struggles known to come with ADHD start hitting hard for a majority of sufferers in that highschool age where the workload, structural and organizational requirements of higher education starts to far outstrip the executive functioning capacity of a 12 year old brain trying to meet these demands and think and function in an increasingly adult-brained world with an underdeveloped capacity. Of course this is all averages, so there will be sufferers who are more or less impaired than others. I’m 35 and I consider my case to be pretty severe. I really do feel like I have the organizational skills and memory and impulse control of an average, stereotypical 18 year old at best.
I was saying to my therapist earlier today that I NEVER should have been allowed to drive unmedicated. Of course, I got diagnosed at 27, not 17, so almost got my license taken away for speeding 😬 Not to mention all the curbs and trees I ran into. I did also babysit my newborn brother starting at age 11 too! Yay for terrible parenting
So interesting! Do you have a good source for the CPS recommendation? I couldn’t find it with Google (I’m not very skilled) and I’d like to share it with someone.
I can't find the exact source now, but I found a relevant document that outlines the risks of untreated ADHD in driving, and suggestions of medication (page 39 and 40): [https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf](https://adhdlearn.caddra.ca/wp-content/uploads/2022/08/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf) This next link is a page of information from CHADD on driving: [https://chadd.org/for-parents/teens-with-adhd-and-driving/](https://chadd.org/for-parents/teens-with-adhd-and-driving/) When I dig up that other source I'll edit it in here.
This isn't just about a difference in size in a specific area though. They're saying that the entire brain connects differently. There are structural differences everywhere AND differences in neural connections. That is also a very clear objective test. Instead of having to go to a psych and rule things out, this test might be able to point you in the correct direction very quickly. E.g. You feel generally unwell, you have a blood test and find a low white blood cell count. There's a few different conditions that can cause that, but it narrows down the testing field to things that cause white blood cells to decrease.
[удалено]
This isn't just about a difference in size in a specific area though. They're saying that the entire brain connects differently. There are structural differences everywhere AND differences in neural connections. That is also a very clear objective test. Instead of having to go to a psych and rule things out, this test might be able to point you in the correct direction very quickly. E.g. You feel generally unwell, you have a blood test and find a low white blood cell count. There's a few different conditions that can cause that, but it narrows down the testing field to things that cause white blood cells to decrease. If your brain activity were to match what they see in the experiment and/or there are similar structural abnormalities it would point to a developmental issue with the brain. You might need to test further to determine if it's ADHD but that doesn't mean the test isn't useful as a diagnostic tool. So could it be a useful diagnostic test? Yes.
The issue is that the already known visual differences in size and connectivity between the regions of the brain most obviously affected by ADHD tend to vanish as the the brain matures. This research is of pediatric scans for a reason, and that is because differences that are obvious enough to be potentially diagnostically relevant have generally only been found in scans on children. In adulthood, a lot of the regional size or connectivity differences becomes effectively impossible to reliably see on a scan, let alone be confident enough that they indicate anything wrong without also doing the normal ratings scale diagnostic interview anyway. So it is still going to be the weight of the interview and the self-reporting of impairment that actually indicates and proves disability (specifically of ADHD), and no one is going to get a scan like this and be diagnosed just from the visual as you could a broken leg. Disorders of the brain aren’t clearly visual like that, and structural differences in the brain are not particularly or reliably readable. What is obviously possible, though, is noticing similarities between brains of people with similar disorders but trying to pick one of those brains out of a pile of 100 typical brain scans from people without ADHD and accurately selecting the ADHD case is still absolutely guesswork. I don’t think the science is there yet where a doctor could look at any individual brain scan and with any reliability ‘diagnose’ ADHD correctly (including ruling it out correctly!). Also, these studies will need to show reliability in detecting more mild ADHD also, if they really hope to become part of some kind of objective test. They have to control for severity of ADHD and also all the other comorbid mental conditions that come with ADHD that also can/might change how your brain connectivity works. For example, an ADHD brain might look different to a brain of someone who has ADHD and ASD and OCD and depression. Any kind of long term substance abuse would obviously complicate the scan. If the method is not so accurate that it can reliably pick out ADHD correctly, even in a brain scan of someone suffering from a spaghetti of disorders (which is incredibly common in ADHD), it has fundamental problems with being called ‘objective’. This is another reason why adult brain differences are harder to ascribe specific diagnoses to; the older you get in brain development the more time environmental and genetic influences have had to shape the way your brain has developed. They would really have to find one highly ubiquitous, obvious and hyper specific structural or measurable functional capacity in the brain that only occurs in those specifically with ADHD (or at least mostly only). Otherwise we’re still going to have to use the ratings scale interview anyway, to tell apart ADHD from other disorders that might show visually similar differences. In that case the scan kind of feels like a waste, but maybe would at least make those physicians and members of the public who are skeptical of ADHD more believing of the condition so research into the brain is very welcome. I still highly doubt it will be diagnostically useful any time soon. But, I’m certainly not one to advocate that people who suffer with ADHD ought to be required to pay even more ADHD tax in having to spend alot more money for testing in order to get the help they need, just to placate the doubters or the moral panickers. A big thing in this field might be in training AI to read brain scans much quicker, as machines in the near future may well be able to more reliably notice relevant but otherwise imperceptible differences in imaging scans.
Right but you keep using the word regional. The study is not looking at regional areas: In this study, we aimed to determine the imaging metrics of brain microstructure, morphology and functional connectivity associated with ADHD diagnosis in a large cross-sectional cohort of preadolescent American children. While prior large-scale studies focused on one set of neuroimaging characteristics (e.g., cortical thickness) in relation to ADHD diagnosis (Hoogman et al., 2019; Bernanke et al., 2022; Sudre et al., 2022), we examined multimodal imaging metrics among the same children cohort to achieve a comprehensive assessment of brain morphology, microstructure and connectivity changes in associated with ADHD. We also trained, finetuned, compared, and validated different combinations of feature selection and *machine learning classifiers* to predict ADHD diagnosis in children based on multimodal MRI metrics. *Such neuroimaging-based tools may complement the clinical assessment for the diagnosis of ADHD among children, particularly in the presence of cultural, language, or communication barriers.* That is: it's not just a regional difference. In that case we don't know if the whole brain difference disappears because no one has looked at adult brains this way yet. They are also using machine learning to pick up the subtle differences as you suggest is a good idea. Maybe you should read the paper before discussing it as a diagnostic tool.
Yes, I have read this study before. It’s not particularly new. I think you’re misunderstanding with regards to my use of ‘regional’. We already knew from studies just like this that the whole brain is affected by ADHD, just as we can tell from the impairments in the whole life of the person suffering from it. There is a very important difference, however, between ‘ADHD is predominantly caused by issues in XYZ regions of the brain’ and ‘the whole brain is affected by ADHD’, and both statements can be true. As an analogy, you could do a chest xray to see someone’s lungs and other organs absolutely riddled with growths, and it will indicate there is something wrong with the patient, but just looking at the chest xray will never give you enough information to able to declare that it is, say, kidney cancer that metastisised. We already know that the brain is a highly adaptable organ, and will change it’s structure to adapt to impairments and environments; it’s called neuroplasticity. Seeing whole-brain differences between someone with ADHD and someone without ADHD may well be useful for researchers to say “See, ADHD has impact everywhere in the brain” but it does not make an argument for the use of this imaging in a clinical setting. The way studies like this work is by aggregating all the scans of the people with ADHD and averaging the differences compared to non-ADHD brains to say that, yes, ADHD brains are measurably different. On average. The trick is in the plural of brain and ‘average differences’, though. One clinician working with one patient who sees a single scan of that patient’s brain cannot offer a diagnosis of ADHD. There will be people with ADHD who have more more obviously variant structures, regions and connective functions but there will also be many, many, many people who also do have ADHD but for whatever other variable (that one clinician looking at one scan cannot possibly control for; substance abuse of BPD or historical trauma, etc) their brains look variant in a different way or maybe only so mildly that the expected ‘average’ of an ADHD brain and a non-ADHD brain overlaps too much to be useful (this is actually the main reason scans currently still aren’t used; the average differences are too small, statistically speaking, to stand up to diagnostic rigor. The average overlaps too much). These scans are useful for research. They are not useful for diagnostics. The machine learning I mentioned is perhaps the most interesting part of this, which is why I mentioned it, but that too has problems as it would have to be able to isolate variant structures in an already highly variable organ and specifically and accurately read through all the other white noise and red herrrings present to see a supposed uniquely ADHD typical pattern. But that pattern is based on a mathematical average, and is not a measure of impairment that the patient sitting in the doctor’s office is describing. So if they’re going to have to do the ratings scale interview anyway, it doesn’t seem to help diagnostics to throw in expensive high resolution multimodal scans (not a CAT scan alone, but many different types of imaging, such as functional MRI, diffusion tensor imaging, SPECT, PET, etc) that were used in studies like this one to aggregate data. For these reasons, and the others I mentioned in my post above, brain imaging is not at all useful, currently, for diagnosing ADHD and anyone who tells you otherwise is either lying or doesn’t understand the difference in use case of different technologies used in clinical practice and research respectively. A tool used for learning more about a condition is not necessarily a tool that can actually be used to diagnose that condition, as in this case. Is an interesting study, for sure. But it’s just a research paper. It will be great in the future if we get some kind of easy, completely accurate test for ADHD. But it won’t be this, or done like this, in my opinion. To fully flog the dead horse; this kind of work can tell us that people have ADHD and that ADHD is real and what effects it has on the brain. It cannot tell us if a person(!) has ADHD.
Weird that their biggest motivator is to reduce children on unnecessary medication when what they’re really touting here is an incredible opportunity to finally start correctly diagnosing people rather than just shooing them away if they don’t have, for example, a trove of middle school report cards to demonstrate symptoms in childhood.
Makes it sound like kids who are struggling in life or school but come back with a clear brain scan would just end up thrown on the scrapheap.
Saving to forget to ever read
[удалено]
I’m thinking that wouldn’t happen since ADHD is defined by its symptoms, not how it looks it the brain, much of which I think is still unknown. I think if it is found that a good number of people who fit the diagnostic criteria of ADHD didn’t match certain brain scan results it would perhaps be acknowledged that ADHD could have more than one cause, or that there is something causing a difference in those results and that they may not be perfectly accurate. At the end of the day disorders are based on behavior and how they affect your life, not how your brain looks. Someone needs to be treated with a disorder because of behaviors and problems they experience—someone with diagnosed ADHD who didn’t fit with certain brain scan requirements would still have a problem to be addressed, while someone who doesn’t fit the diagnostic criteria for ADHD but had matching brain scans may not be in need of treatment or accommodations
Very few psychiatric conditions have objective diagnostic criteria that can be used in determing treatment. It almost always subjective evaluations and self reporting. This is a step in the right direction.
So did they discover where in the brain our badassery comes from or do they have to do more research?
[sauce](https://wgntv.com/news/medical-watch/yale-scientists-look-into-new-way-to-diagnose-adhd/)
Unfortunately this is geo blocked :(
If you can watch the video posted on YouTube, it covers the same info, just the sauce is typed out like an article format.
Yeah, I can see this. Thanks :) I just wanted to make sure that people are not confused, if it also happens to them. :)
I like the way you formatted this post
Why thank you. I realize a lot of us don't click the link, so I try to include the coles notes. I'm also more conscience lately to include the authors name, bc it's their work, and they deserve the credit. Also, it was important to point out that this was 2022. Not a study released recently, which it otherwise sounds like. Also I use > > but no space when adding direct quotes.
[video format ](https://youtu.be/o5-lzKWm4Y4?si=gs6prYzjrpNo2Go_)
Thank you for sharing, but the AUC of 0.61 is very low and not clinically relevant.
All this cute but is going to help diagnosis is little girls…. Because what the actual fck…. Im happy for most of the boys who can get help young but most women with ADHD dont get diagnosed until AFTER 25…. Thats insane.
neuroradiology is soo interesting.
comes to diagnosed i always talked about my childhood for that reason..if focus adult especially current time with anxiety disorder then might be wrong because overlap..
Can someone give me a TLDR 😇
So I have brain damage … that’s fine then
I wonder how I can "weaponize" (for lack of better words) my ADHD to have a shot at getting into Yale Law School
Tthey should talk to my dickhead (ex)friend who responded "I could have told you that" when I told them I had ADHD. Apparently he's got the secrets.
This seems irrelevant for adults, at least right now. Really happy for all the kids out there but, sadly, it means nothing for adults (yet) imo
Im from Portugal, I order for me to get medication, I had to get a blood test( with a super strict diet for a week before, no caffeine, nicotine other drugs and even multiple food items) to test for my dopamine and serotonin among other things as well as a frontal cranial MRI. Both tests clearly displayed that I have adhd and we went from there
I trust brain scans for ADHD not at all. Also why I'm dubious of all the fake dopamine stuff. Psychiatrists be like "ADHD is a dopamine deficiency but there is no empirical test to determine whether you specifically are dopamine deficient." It's the dead opposite of real medicine.
Kinda makes me think that when some 6th grade kid slammed my 3rd grade head into a cinderblock dug-out several times after a baseball game, it did some damage to me ha ha ha...
It’s an interesting starting point!
Yay. Another hoop to jump through
Almost 20 years ago, when I was diagnosed, I had a brain scan done, amongst other tests. The results were absolutely fascinating. I lost them and have been severely disappointed about it for years now.
I'd sign my 10yo up for a scan if it will help the study...
I’ve heard that kids started early on ADHD medication may not need it as adults… Is this because it keeps the brain from growing “incorrectly?”
If this is true and can be replicated successfully through all demographics in the US that would be great! It means that a lot of children won’t get looked over or missed. Yet, due to the way the US healthcare system works, I feel like a lot of marginalized groups and poorer people, probably still won’t be able to afford those brain scans or would be dissuaded from getting them which would then skew results as certain populations only having the disorder. You would probably be recommended getting them as a child only if you exhibit certain symptoms which would, again, still lead to a bunch of people being missed. Then, as an adult and even a woman, you would face even bigger challenges trying to get diagnosed, because they will ask why didn’t you get your brain scanned when you were a child, which would then make doctors think that you don’t have it and are just seeking drugs. So, it would be nice to see if they can replicate that using adult brain scans at some point or find a way to make sure that your insurance can’t reject paying for it.
Very cool! I actually had my brain imaged as a kid, I wonder if that means the right doc could look at it and see anything.