CohortDevelopmental medicine and child neurology2026

Childhood white matter morphology and longitudinal change in symptoms of attention-deficit/hyperactivity disorder.

Keri S Rosch, Christian Hyde, Ian Fuelscher and 3 others

PMID 40768121

WHAT IT FOUND

Girls with ADHD showed more severe inattention than boys but improved more over time.

Childhood white matter structure in the corticospinal tract predicted better hyperactivity outcomes. No brain marker predicted inattention change. These are preliminary findings from a small imaging subgroup.

Key findings

01Girls with ADHD had higher baseline inattention scores than boys but showed greater reduction in inattention symptoms from childhood to adolescence.

02Higher childhood fiber cross-section in the corticospinal tract was associated with greater reduction in hyperactivity and impulsivity symptoms, but no white matter marker predicted changes in inattention.

03The imaging analyses were limited to a subsample of 43 children with ADHD, and the authors state the findings are preliminary due to the small sample size.

STILL TO COME

How it was doneWhat they found

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What it does not show

The imaging analyses were restricted to a small subsample of 43 children with ADHD, severely limiting statistical power and generalizability. Most participants were taking stimulant medication, which may have influenced symptom ratings and brain morphology. Symptoms were assessed at only two time points, preventing the modeling of non-linear developmental trajectories. The study did not include a healthy control group in the imaging analysis of symptom change, so it is unclear if the brain-behavior relationships are specific to ADHD. Findings are exploratory and preliminary; the authors explicitly state that the small sample size is a significant limitation.

The easy way to misread this

Do not use these brain imaging markers to predict individual patient outcomes or to guide treatment selection. The findings are from a very small subgroup of 43 children, are preliminary, and have not been validated for clinical use.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →


The study

Participants
165 children at baseline; 43 children with ADHD had usable diffusion imaging data
Certainty of evidence
Low

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    Cite

    Keri S Rosch, Christian Hyde, Ian Fuelscher, et al. Childhood white matter morphology and longitudinal change in symptoms of attention-deficit/hyperactivity disorder. Developmental medicine and child neurology. 2026.

    Read the original — we summarise, we never replace the paper.