Authors: Francesca Biondo; Charlotte Nymberg Thunell; Bing Xu; Congying Chu; Tianye Jia; Alex Ing; Erin Burke Quinlan; Nicole Tay; Tobias Banaschewski; Arun L. W. Bokde; Christian Büchel; Sylvane Desrivières; Herta Flor; Vincent Frouin; Hugh Garavan; Penny Gowland; Andreas Heinz; Bernd Ittermann; Jean-Luc Martinot; Hervé Lemaitre; Frauke Nees; Dimitri Papadopoulos Orfanos; Luise Poustka; Sabina Millenet; Juliane H. Fröhner; Michael N. Smolka; Henrik Walter; Robert Whelan; Edward D. Barker; Gunter Schumann · Research

How Do Brain Differences Between Boys and Girls Relate to ADHD Symptoms?

New research reveals key brain differences between boys and girls that may influence how ADHD symptoms manifest

Source: Biondo, F., Thunell, C. N., Xu, B., Chu, C., Jia, T., Ing, A., ... & Schumann, G. (2021). Sex differences in neural correlates of common psychopathological symptoms in early adolescence. Psychological Medicine, 52, 3086-3096. https://doi.org/10.1017/S0033291720005140

What you need to know

  • Boys and girls show different patterns of brain structure associated with ADHD symptoms
  • Higher hyperactivity/inattention symptoms are linked to lower gray matter volume in key brain regions in boys
  • Girls show the opposite pattern - more gray matter volume in some regions with higher symptoms
  • These differences may help explain why ADHD manifests differently between boys and girls

The ADHD Gender Gap

Have you ever wondered why ADHD seems to affect boys and girls differently? While we’ve known for decades that ADHD is diagnosed more frequently in boys, researchers are still working to understand the biological basis for these gender differences. An important new study provides compelling evidence that the brains of boys and girls with ADHD symptoms develop and function in distinct ways.

What the Research Found

Using brain imaging data from over 1,500 14-year-olds, researchers discovered fascinating differences in how ADHD symptoms relate to brain structure between boys and girls. They found that in boys, higher levels of hyperactivity and inattention were associated with less gray matter volume in several key brain regions. However, in girls, the opposite pattern emerged - more symptoms actually correlated with greater gray matter volume in some areas.

The Key Brain Regions

The study identified four main brain regions where these sex differences appeared:

  1. The temporoparietal-opercular region - involved in attention and sensory processing
  2. The anterior and mid-cingulum - important for decision-making and behavior control
  3. The cerebellum and fusiform area - linked to motor control and visual processing
  4. The frontal cortex - critical for executive function and behavior regulation

These regions form networks that help us pay attention, control impulses, process sensory information, and regulate our behavior - all functions that can be challenging for people with ADHD.

Why This Matters

This research helps explain why ADHD can look different in boys versus girls. The distinct brain patterns suggest that boys and girls may develop ADHD through different biological pathways, even when showing similar behavioral symptoms. Understanding these differences could lead to more personalized and effective treatments.

What This Means for You

For parents, teachers, and healthcare providers:

  • Be aware that ADHD may manifest differently between boys and girls
  • Don’t assume ADHD looks the same in every child
  • Consider that different approaches might work better for boys versus girls
  • Remember that current diagnostic criteria may not capture sex-specific presentations well

Conclusions

  • Boys and girls show opposite patterns in how brain structure relates to ADHD symptoms
  • These biological differences may explain why ADHD presents differently between sexes
  • More research is needed to develop sex-specific diagnostic criteria and treatments
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