Functional MR to localize sustained visual attention activation in patients with attention deficit hyperactivity disorder: a pilot study.

PURPOSE To evaluate brain control activation in patients with attention deficit hyperactivity disorder (ADHD) and to provide an initial comparison between activated regions in ADHD subjects and those previously localized in an unaffected population. METHODS Ten patients with ADHD underwent imaging with a functional blood oxygen level-dependent MR technique during sustained visual vigilance. Pixel activation was inspected visually and statistical group analysis was performed. RESULTS Activation was seen over the bilateral middle frontal gyri, the superior parietal lobules, and the inferior parietal lobules. The predominant activity occurred in the right middle frontal gyrus. Application of an additional statistical constraint revealed significant activity in the right inferior and left superior parietal lobules. CONCLUSION ADHD patients effectively tolerated the necessary MR imaging constraints despite their difficulty with confinement and immobility. Single-section functional MR imaging revealed activation in brain regions known to be involved in the maintenance of the attention in healthy subjects responding to auditory, tactile, or visual stimulation; additional areas of activity that were identified may represent true abnormal regions in the affected population or artifacts.