Recent study shows ADD *IS* brain-based


Not really “news” but . . .
FINALLY convincing evidence

© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
from the Brain-based Series

Researchers show that critical areas of the brain are smaller in ADDers, proving that the oft-marginalized and scoffed at condition is indeed a brain-based disorder.

Imaging Study Shows Structural Brain Differences

According to a new report funded by The National Institutes of Health [NIH], MRIs of more than 3,000 individuals provide further evidence that those with ADD/ADHD have structurally different brains than those with “vanilla” brains (no ADD/ADHD/EFD ‘mix-ins’)

The differences were more pronounced in children than in adults, but they clearly support the assertions that ADD/ADHD is a developmental brain disorder, NOT simply a “label.”

Related Post: ADD or ADHD: What’s in a NAME?

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About the Study

The NIH-funded study, published February 15 in The Lancet, was conducted by the ENIGMA Consortium** an international cooperative focusing on the genetic roots of psychiatric disorders.

**ENIGMA: Evidence-based Network for the
Interpretation of Germline Mutant Alleles

ENIGMA recruited 3,242 volunteers between the ages of 4 and 63 — 1,713 with ADD/ADHD and 1,529 without — to undergo MRI scans.

Participants with ADD/ADHD showed smaller volumes in seven key regions of the brain — most of which had already been associated with ADD/ADHD for some time, well-known among the expert doctors and researchers in the field but not well publicized:

  1. the caudate nucleus
  2. putamen
  3. nucleus accumbens
  4. pallidum
  5. thalamus
  6. amygdala, and
  7. the hippocampus

Look Twice at the Last Two

  • Our old friend Mr. Amygdala may be particularly important, since it plays a key role in memory, decision-making, and emotional regulation — all a tad klugdy in ADD/ADHD brains.
  • The hippocampus is important for both short-term and long-term memory, areas of impact which are frequently impaired in members of the ADD/ADHD tribe.

Similar size differences have been found in the brains of people with major depressive disorder, by the way — long known to have what is called “high comorbidity” with ADD/ADHD.

Results differ by Age

The researchers noted that the variations were largest in children and, though many of the ADD/ADHD group were modulating ADD affect with medication, it didn’t appear to have any effect on the MRI results.

The disparity between children and adults led the researchers to hypothesize that ADD/ADHD is linked to a delay in brain maturation — though further longitudinal work is needed to fully understand how ADD/ADHD brains change throughout the life cycle.

Finally! 
A clear and hopefully precedent-setting
statement of awareness that they do, in fact, change
(as opposed to the very old “goes away at puberty” mythology).

Sample size matters

Overall, while these differences are small  (only a few percentage points in some cases), the unusually large sample size allowed the research team to clearly identify patterns, confirming previous studies that had reached the same conclusions through smaller sample sizes that rendered them inconclusive.

With more than 3,000 participants, this was the largest study of its kind — adding clear evidence that ADD/ADHD IS, in fact, a brain-based disorder, and not the result of “bad parenting” or a lack of willpower.

The lead investigator of the study, Martine Hoogman, Ph.D., had this to say:

“The results from our study confirm that people with ADHD have differences in their brain structure and therefore suggest that ADHD is a disorder of the brain.”

“We hope that this will help to reduce stigma that ADHD is ‘just a label’ for difficult children or caused by poor parenting. This is definitely not the case, and we hope that this work will contribute to a better understanding of the disorder.”

——————
Edited Reposting
from “Large Imaging Study Shows Structural Brain Differences in People with ADHD” — from Attention Magazine online.

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About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

90 Responses to Recent study shows ADD *IS* brain-based

  1. Pingback: Take Me Out to the BALLGAME! | ADD . . . and-so-much-more

  2. dgkaye says:

    Now this was interesting! You are a wealth of information my friend, much like the old ‘walking encyclopedia’ lol remember that? 🙂 ❤

    Liked by 1 person

    • This is not the first time I’ve been accused of being a walking encyclopedia on the topic. I’m a certifiable neuro-nerd. 🙂

      ADD is where I began my career – years before the majority of doctors got the news that the idea that ADD went away after puberty was always a misunderstanding that became a myth — and when it was still possible to read almost everything in print about it.

      It wasn’t long before I branched out to work with ALL of what I call “attentional spectrum disorders,” regardless of cause, so I had to research and keep up with comorbid disorders, neuro-chemistry and the workings of the brain.

      The challenge is always making the information accessible to folks who don’t have my background and/or drop by only occassionally – and keeping science articles short enough that anybody would ever read them. 🙂 I’m learning.

      Before Brain Injury Awareness Month is over I hope to post an article I’m currently working on about how common brain injuries are, how long they can take to heal, and the symptom overlap with ADD.

      Fun, huh?
      xx,
      mgh

      Liked by 1 person

  3. Humm. For a moment I wondered what “brain based” was going to mean — but it was quite literal. Your posts are always fascinating, Madelyn. Have a thriving Thursday. Mega hugs!

    Liked by 1 person

    • Thanks Teagan. The terms neurological or neurologically sound complicated and tend to send folks away screaming. lol I explain my writing as “non-fiction, brain-based self-help.” People are used to those words, can pronounce them and know what they mean.

      Brain-based coaching is another matter.
      It refers to coaching techniques based in how the brain, medication, neuro-chemistry, etc. work to produce and influence behavior (not just symptoms) – vs. coaches trained in methods that are based in older psychological theories (many since disproven, btw) or models from the self-help field that may or may not be consistent with what we know today.

      It takes longer to train – and staying current is a non-stop task – but brain-based coaching is rarely more expensive, and generally much more effective. For the neurodiverse, it is generally the only kind that works. (As I disclose in my more comprehensive bio, I’ve trained BOTH kinds of coaches in my career, btw. so I’m not shooting from the hip here).
      xx,
      mgh

      Liked by 1 person

  4. Pingback: Recent study shows ADD *IS* brain-based | ADD . . . and-so-much-more *SLIGHT PROBLEM!! The research was funded by Shire! They invented ADDERALL!* /ed70 – Powers That Beat

    • My FIRST response, before I noted the addendum to the title when reblogged. Below is a more considered response I hope EVERYONE will take the time to read. THANKS!
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      Thank you SO much for this reblog – hopefully it will reduce the “make wrong” that is so shamefully disheartening for so many who are struggling to cope. To bad all the supposed educational experts (like Ken Richardson) can’t be forced to read studies like these. Still, I greatly appreciate your help spreading the word. THANKS!
      xx,
      mgh

      Like

    • Thanks for the reblog – I hope folks will read the article with an open mind and with care, despite your addition to the title of the post on the reblog

      You can’t ALWAYS look simply at funding sources to determine the credibility of the studies – but in this instance it is actually extremely unfair.

      I hope everyone reading will stick with me to read why I say that Shire has always been one of the ADD good guys.

      I have been in the field long enough (almost 3 decades now) that I was around and paying attention when what I am about to say was happening, and know personally some of the people who discovered & documented the Scientology information below.

      #1- The National Institutes of Health [NIH] is a credible watch-dog. Click the link I provided near the top of the article to investigate yourself.

      #2- Most studies are incredibly expensive and MOST of them are funded, at least in part, by the makers of whatever drug is prescribed to treat them, from diabetes research to many cancer studies. AND I’m willing to bet we’d see even more “big-bad pharma” comments if they did not.

      Who else has that kind of money?
      The American government has not exactly been unilaterally science-aware or science-friendly, frequently unwilling (the current administration and during the Bush years, for example) and/or economically unable to allocate funding for more than a limited few.

      #3- What you and many others may not know about Shire is that they have always been one of the ADD good guys.

      Are they running a profitable business? Yes. Are they required by law to conduct business in a manner that will show a profit for their shareholders? Of course – that’s how it works in our Corporate Capitalist country.

      Are they ONLY about money? No way Jose.

      They have always stepped forward with funding for many of the Support Organizations (CH.A.D.D./ADDA/ADDien) as well as many of the expenses for Conferences put on for actual sufferers.

      I have attended many of these conferences and at NO TIME was I given a sales spiel from any of the 1 or 2 young reps standing quietly smiling next to their conference table where I could pick up brochures, pens, notepads etc. (or not) — EVEN when I asked questions that might have given them an opening to do so. (They paid a pretty penny for the right to that table, btw – as did any other exhibitor with similar placement and space.)
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      BTW- anyone bothered that Shire helps to fund ADD support organizations, take the time to see who funds OTHER support organizations and I believe you will see the makers of the meds high on the list. Why is that seen as a BAD thing?
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

      More impressive, Shire actually took a significant financial hit on Adderal JUST to make sure ADDers who were doing well on it did not suffer during the years they were forced to jump through FDA approvals a second time.


      An Important Lesson in ADD History

      _____________________________________

      Back when Scientology was going after all ADD meds with BIG guns, they forced Shire to pay for FDA approval a second time for ADDerall (then named Obetrol and approved for obesity, with what they call “off-label” usage when it proved to be helpful for ADD). “Off-label” usage is common with MANY meds for many diseases and disorders, btw.

      FDA approvals can cost MILLIONS. There would be very little testing at all off-label usage was not in place. NO company could afford to test for every single disease or disorder and remain in business, and we would have far fewer much needed medications as a result.

      Immediately following the initial ruling, Shire was no longer allowed to manufacture one pill more than what was required for testing. Shire responded by hiring legal representation to be allowed to manufacture enough medication for everyone who was doing well on it. Ask ANY manufacturer about how limited production runs impact economies of scale. Each item (in this case, each pill) becomes more expensive to produce. Yet they continued to pay court fees and legal expenses until they prevailed. AND they did not raise the prices for end users.

      Many companies would have abandoned the users, and many would have abandoned drug (only to take the years necessary to develop a new one with similar properties — which was, no doubt, Scientology’s objective) – but Shire knew how beneficial ADDeral was and would be for a great many ADDers, and went another way.

      I will always admire them for the way they responded, and I wish more people were aware of their business philosophy.

      Sincere thanks to those of you who took the time to read this comment.
      xx,
      mgh
      (Madelyn Griffith-Haynie – ADDandSoMuchMORE dot com)
      ADD Coach Training Field founder; ADD Coaching co-founder
      “It takes a village to educate a world!”

      Like

  5. joliesattic says:

    Update on my son. He was diagnosed with ADHD and social anxiety and rated class 2 if that means anything. He will have more tests but they are also exploring dysthemia? So, they will also do a study to discover what career he may be best suited for so he can begin to function more normally. So, there is more to do. Yea!

    Liked by 1 person

    • Congrats. Dysthymia (diss-thigh-me-uh)is persistent, low-level chronic depression.

      I know you will be cautious with medication, especially what I call “cocktails” – but please remain aware that many of the diagnoses may well turn out to be auxiliary to ADD (for which there ARE no tests, still) and frequently abate when the ADD is appropriately treated. Too many doctors still use the “rule out by medicating the others first” approach. (one of the points in Top Ten Stupid Comments from [supposedly] ADD Professionals tells you more about that – and more).

      RE: TESTING — Knowledgeable doctors often test for functioning and to create baselines, but if you are being told that these tests rule in or out much of anything, ask for a second opinion. Mental Health tests are not there yet and can be pricey, so don’t go into hock erroneously believing your son’s future is at stake if you don’t agree to every single one.

      Also ask what each study is designed to uncover, WHICH ones they are (so you can google for more info) and how long they have been using them in their office (which will give you some idea of how WELL they apply the results). If you get the BS answer that they are “standard” tests, ask “standard for what?” Everyone? ADD? Kids? Boys?

      See the links above and Depression and ADD/EFD – one or both? for a discussion of a few concepts to have behind you — NOT that dysthymia and major depressive disorder are the same, btw.

      Hope this helps!
      xx,
      mgh

      Liked by 1 person

      • joliesattic says:

        Dysthymia is what he thought might be an additional issue. The following is what he wrote: ” he diagnosed me with ADHD and social anxiety. But I think the latter is mild because it’s situational. I think I might have disthymia as well. So vocational rehab paid for the diagnosis so they kind of own. It did get me into category 2 however and I got activated from the waiting list in under a month when she told me it could be 2-4. So we will determine while finding me a suitable career, whether or not medication or coaching would be beneficial. And since they have limited funds and that is expensive, she recommended Medicaid or whichever one that is. Meanwhile I got a part-time job at the Gap just this week so I have the job to get me by aspect fulfilled which will allow me to use them to find something more permanent. Which is what we decided on. I have some career assessments and things to work on, in the meantime. Let you know how second session goes.”
        So it looks like they aren’t going to rush into giving him medication. This organization is more interested in seeing him become a functioning and productive human being. He is fortunately in Utah, so I’m guessing they are inclined to be more conservative over all as well. I let him know what you said and told him … “More reading for you” LOL

        Liked by 1 person

  6. noelleg44 says:

    I never doubted that this would prove true for a moment! My son’s birth father had ADHD.. And my son has shown some improvement as he’s aged.

    Liked by 1 person

    • Thanks Noelle – few who are field-aware in more than a perfunctory fashion have embraced the often cruel – and always unthinking and unresearched – opinions of the nay-sayers. As the article discloses, smaller studies supporting this one have been around for decades. The sheer size of this study will, hopefully, finally open a few closed minds and close a few shame-and-blame mouths.

      Glad your son is doing better — good to know from the onset what to watch out for, right? Growth frequently results in symptom improvement, for a number of reasons which I will need to outline in a post — too many to list even in my long comments. I would be eager to see a study similar to The Nun Study, following a large sampling of ADD/EFDers throughout a lifetime, cross-referencing the neuro-protective factors with successful/unsuccessful outcomes in those with ADD/EFD.

      I’m fairly certain that you already know and embrace what I’m about to say, Noelle – included in this comment primarily for anyone else reading along.

      In some individuals, symptoms are the result of delayed development – up to 3 years behind same-aged peers is what the studies indicate. As long as accommodations have been in place to facilitate in-time learning of skills basics, and self-esteem has not been decimated, many of those catch up in adulthood and go on to have very successful lives – seemingly symptom-free if they have learned how to work around their cognitive challenges and are engaged in work that plays to their strengths.

      Not ALL, however — no shoulds appropriately extrapolated from that finding.

      As researchers continue to say, “Biology is not destiny: genes are expressed in environment” – i.e., “turned on and off,” metaphorically, in a manner similar to the way good nutrition can avoid the onset of other genetic challenges, and bad nutrition can bring them on. However, if the genes are not present to begin with, the game changes.

      “Environment” includes our interior world, our education, our perceptions, etc. — as well as how we are parented, so “blame the parents” couldn’t be more off-base. Any ONE factor appears to be contributory, not causative.
      xx,
      mgh

      Liked by 1 person

  7. Can totally believe this! Although parenting I believe can exacerbate.

    Like

  8. -Eugenia says:

    Your posts are very informative, Madelyn, and I appreciate it. The more we learn from a trusted source the better off we are.

    Liked by 1 person

    • Your supportive comments always bring a smile to my face, Eugenia, and this one especially.

      I do my best to remain known as a trusted source – even if newer studies were to overturn something I have already happily disclosed I would post them, along with my thoughts about implications. Has already happened, actually.
      xx,
      mgh

      Like

  9. Great to hear this. I’m still trying to convince my ex that ADHD is a possibility as far as he’s concerned. Wish me luck!

    Liked by 1 person

    • I understand the problem. A friend is struggling to get her husband to accept the reality that he has been *diagnosed* with a physical ailment – where there are definitive tests we still don’t have with ADD.

      I find it most effective to encourage “suspects” to investigate work-arounds for identified challenges that are “similar” to those in diagnostic ADDers. (note the wording, NOT “the same as.”) i.e., “If it works for people who have been officially diagnosed, it would probably work even better for you.”

      Then wait, quietly praying he’ll come to it on his own, or that the techniques he discovers will allow him to manage effectively *enough,* even if he never does, or if it turns out that he is not himself across the diagnostic line – and it IS a line.

      Unless he comes to it on his own, what you are likely to see is ever increasing push-back. Which is a real shame for all concerned.
      xx,
      mgh

      Liked by 1 person

  10. lwbut says:

    Great Post!

    The Internet could be a wonderful way of shortening that trickle down time – 17 years ago we barely had social media sharing.

    Trouble is as well as sharing good stuff like the above it can just as easily be used to share the crap stuff a la Crump. It’s not really helping our critical assessment capabilities i fear.

    love.

    Liked by 1 person

    • Thanks. Let us pray it trickles down faster.

      Speaking of that horror of a man, I just read a post about a mandatory genetic testing bill before Congress.
      From the blog:
      ~~~~~~~
      According to the Washington Post in an article published today titled You May Face Penalties At Work For Refusing Genetic Testing by Lena H. Sun, recently a bill has been proposed, already passing a U.S. House committee vote, in an effort to enact a law that would allow employers the right to genetically test employees, something that is currently illegal at a federal level.

      Currently, the government must obtain a warrant or individual consent to collect this type of private citizen information. More, employers currently have no rights to private citizen information without voluntary consent, as the collection of such information is out of alignment with current employment laws surrounding disability and non-discrimination work practices.

      However, the Trump administration aims to circumvent these currently held federal legal positions through new law that would allow the gathering of personal information by employers, specifically your genetic information, for use as part of a “wellness” program, where the goal is to “reward” some employees with reduced insurance rates for “healthy” living and “punish” employees for less than “healthy” life choices by up to a 30% increase in premium costs. An interesting concept for an administration that doesn’t seem to believe in science . . .

      For anyone interested, Read it yourself HERE

      HELP!
      xx,
      mgh

      Like

  11. thanks, that was very interesting to read. and maybe now the doc’s are able to treat it much better and to find the diagnosis much faster…. it’s awful to run a doctors marathon first before you get treatment and help…

    Liked by 1 person

    • “Doctor’s marathon” – love it! I believe it will be a while before this information trickles down, however.

      A group of studies, initiated by how long it took radical mastectomies to fade from standard procedure with breast cancer, has shown that it usually takes an average of 17 years for updated information to reach “the doctor down the street.”

      Information and self-advocacy is the only way to make sure you are treated appropriately — and we ALL need to remember that health-care professionals are our employees, not our bosses.
      xx,
      mgh

      Liked by 2 people

  12. Great 👍 always so well defined posts Madelyn and yes many children do have this problem and then we need to know how to handle them. Thanks 🙏

    Liked by 1 person

  13. That’s great that they conducted a large enough study to allow the differences to be magnified. I bet a lot of parents are relieved to be able to refute w/evidence people who misunderstand and attempt to place blame squarly on parents. Good job!

    Liked by 1 person

  14. I saw that at a conference about 10 years ago – that’s really “not really news”!

    Liked by 1 person

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