Solving pieces of the ADHD puzzle: trajectories of ADHD

ADHD outcomes can take different paths as patients grow up. In an effort to predict and therefore possibly prevent severe ADHD outcomes, researchers at the Donders Institute are currently running an exciting study. I’m a research assistant in this special project. Read on for some insider facts about it!

This post is also available in Dutch.

Currently, if a child is diagnosed with ADHD, a doctor cannot tell if the child will have many ADHD-related impairments or only mild/no impairments when the child grows up—which would be super useful to know. This kind of prediction could, for example, influence doctors’ choices for certain treatments. Dr. Emma Sprooten is currently leading a project called DELTA (Determinants of Long-term Trajectories of ADHD).  We’ve already collected a serious bunch of data and now we’re about to begin processing and analyzing all of it (the hard, but very exciting part). In this blog, I will give you a peek into her project!

Why this matters: One diagnosis, two life stories

Two of my classmates in primary school, Jurgen and Marie, were diagnosed with ADHD. Jurgen showed up late for school almost daily and literally never remembered the homework. He even forgot when we had an exam. Marie was always spontaneous; her chatter cheered up our class. Even when the teacher wanted us to listen to him instead of chatting, Marie could not concentrate on her schoolwork for more than 10 minutes. Both received the same diagnosis, but their lives currently look very different:

Jurgen works as a school teacher and is an enthusiast runner. He lives with his girlfriend and their dog. During puberty, Jurgen became better at concentrating and when he discovered which career path to take, his concentration problems became manageable. Running three times a week allowed him to manage his energy.

Marie’s life has been more like a bumpy road. At age 20, she suffered from depression, forcing her to quit school. Nowadays, she still finds it very hard to concentrate. Marie was recently forced to resign from her job due to her inability to control her emotions.

What we’ve done

With DELTA, we have a unique opportunity to investigate ADHD in people from whom we have a lot of information available at different time points throughout their lives! We asked 60 adults to take part in our study. The special part is that these people already participated in a related study when they were children. Back then, they came to the Donders Centre for MRI scans, cognitive tasks and diagnostic interviews for ADHD and related disorders, all of which took place at two separate times during their childhood. Recently, they came back for DELTA in order to undergo all of the same measurements for a third time. We are very grateful!

This study knows no bounds: Besides conducting interviews and behavioral tests in Nijmegen, we even drove participants across the border. The 7 Tesla MRI scanner in Essen, Germany, located in an old coalmine plant (it’s even a UNESCO World Heritage site!), enabled us to include a sophisticated MRI scan using a stronger scanner that can pick up more subtle brain differences. If you are interested in how a test day for our participants looks like, click here.

What we know

Past research studies have shown us that one of the things involved in ADHD is a part of the brain called the prefrontal cortex (located in the front of the brain) and its connections to other parts of the brain. These connections have been shown to be different in people with ADHD (ref) through alterations in brain activity (even when you do nothing, your brain is still active) or structure (e.g. in white matter). White matter is like the ‘highways’ of the brain, or paths through which information is sent. Some studies show that differences in white matter between people with and without ADHD are linked to symptom severity.

White matter is still developing in early adulthood, which is the current age range of our participants. However, there isn’t much knowledge about the course of ADHD in relation to white matter through years. With DELTA, we eagerly go a step beyond the usual comparison of patients versus healthy controls. We investigate how the relationship between white matter and symptomatology develops over time.

Where are we now?

Besides collecting data for scientific use, we learned a lot about how people integrate ADHD into their daily lives. We got to talk to them during testing, as well as at lunchtime during test days. We heard stories like Jurgen’s and like Marie’s. Our research has not only taught us things about ADHD, but also even more about life and its twists and turns. Some participants told us afterwards that they learned new things about themselves—a compliment that makes us grateful.

Now it’s time to start analyzing the data. We’re very curious to see what happens next! 

Original language: English

Author: Janneke Dammers

Buddy: Francie Manhardt

Editor: Christienne Gonzales Damatac

Translator: Jill Naaijen

Editor translation: Felix Klaassen

Image by Hans-Peter Gauster via Unsplash.

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