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@ARTICLE{Schulze:285454,
author = {Schulze, Marcel and Autenrieth, Erik and Aslan, Behrem and
Stirnberg, Rüdiger and Stoecker, Tony and Lux, Silke and
Coghill, David and Silk, Tim and Philipsen, Alexandra},
title = {{Q}uantitative susceptibility mapping of brain iron in
adult {ADHD}.},
journal = {Frontiers in psychiatry},
volume = {17},
issn = {1664-0640},
address = {Lausanne},
publisher = {Frontiers Research Foundation},
reportid = {DZNE-2026-00236},
pages = {1735191},
year = {2026},
abstract = {Attention-deficit/hyperactivity disorder (ADHD) is a
neurodevelopmental condition that frequently persists into
adulthood and is linked to alterations in fronto-striatal
circuitry and dopaminergic signaling. Brain iron is
essential for dopamine synthesis and neural metabolism and
can be indexed in vivo using quantitative susceptibility
mapping (QSM), which reflects regional magnetic
susceptibility. Pediatric studies have mostly reported
reduced tissue iron susceptibility in ADHD, but data in
adults are limited. This study investigated regional
susceptibility in adults with ADHD, its relationship to
current and retrospective ADHD symptoms, and
depression.Twenty-five adults with ADHD and 24 healthy
controls underwent 3T MRI, including high-resolution QSM.
Mean susceptibility was extracted from 89 cortical and
subcortical regions of interest. For each ROI, group effects
were estimated using linear regression with
heteroskedasticity-consistent (HC3) inference. To account
for group differences in depressive symptoms, additional
models included Beck Depression Inventory (BDI-II) scores.
Dimensional associations with ADHD symptoms were tested
using covariate-adjusted ROI-symptom correlations for
current symptoms (CAARS) and retrospective childhood
symptoms (WURS-k). Benjamini-Hochberg false discovery rate
(FDR) correction was applied within each analysis across
ROIs.No ADHD-control group difference survived FDR
correction in any model. At the uncorrected level, adults
with ADHD showed lower susceptibility in ventral temporal
and posterior midline regions, most consistently in the
fusiform gyrus and posterior cingulate cortex
(small-to-moderate effect sizes across models). When
additionally adjusting for depressive symptoms, nominal
group differences remained confined to ventral
temporal/temporo-limbic and orbitofrontal regions (fusiform,
entorhinal cortex, medial orbitofrontal cortex), but again
did not survive FDR. Covariate-adjusted ROI-symptom
associations did not meet FDR significance; nominally,
higher ADHD symptom burden (particularly impulsivity) was
associated with lower susceptibility in posterior midline
regions (posterior cingulate, precuneus) and ventral
temporal cortex (fusiform).In this adult sample, QSM
provided no robust evidence for widespread or regionally
specific alterations in brain iron susceptibility in ADHD
after multiple-comparison correction. Nevertheless, the
reproducible pattern of nominal effects-centered on ventral
temporal and default-mode network hub regions-suggests that
inter-individual variation in cortical susceptibility may
relate to clinical heterogeneity and neurodevelopmental
timing rather than constituting a strong diagnostic
signature. Larger, medication-stratified and developmentally
informed studies are needed to clarify whether subtle
iron-related susceptibility patterns track symptom
dimensions, treatment exposure, and longitudinal
trajectories.},
keywords = {ADHD (Other) / QSM (Other) / brain iron (Other) /
neurodevelopment (Other) / symptom-coupling (Other)},
cin = {AG Stöcker},
ddc = {610},
cid = {I:(DE-2719)1013026},
pnm = {354 - Disease Prevention and Healthy Aging (POF4-354)},
pid = {G:(DE-HGF)POF4-354},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41767150},
pmc = {pmc:PMC12946022},
doi = {10.3389/fpsyt.2026.1735191},
url = {https://pub.dzne.de/record/285454},
}