Efforts to identify structural brain correlates of attention-deficit/hyperactivity disorder (ADHD) have yielded inconsistent results, with no common structural biomarker emerging across studies. Methodological factors may obscure underlying brain–behavior relations in the study of ADHD symptomatology, including the use of categorical diagnoses [1], relying on behavioral ratings from a single informant, and small sample sizes. Indeed, empirically based assessment of psychopathology has revealed aspects of dimensionality with regard to many psychiatric conditions, including ADHD [2]. Further, recent reports suggest that information from multiple informants increases the validity of ADHD assessment [3]. Population-based neuroimaging studies provide the opportunity to more rigorously characterize the neurobiological underpinnings of ADHD symptomatology by using dimensional, multi-informant behavioral ratings, and by examining convergence across multiple assessment modalities—including genetic and neurocognitive domains.

Studying a population-based sample of adolescents (N = 1538; 785 females) (M = 14.53 years old, SD = 0.41), we investigated the relationship between dimensional measures of ADHD symptomatology, brain structure, and reaction time variability (RTV)—an objective index of attentional lapses [4]. Parent ratings of ADHD symptoms, adolescent self-reports of ADHD symptoms, and RTV were each negatively associated with gray matter volume (GMV) in an overlapping region of the ventromedial prefrontal cortex (vmPFC). To our knowledge, this study represents the largest voxel-based morphometry (VBM) study to date on adolescent ADHD symptomatology. Despite modest correlations between multi-informant behavioral ratings (r = 0.36–0.66), we observed striking convergence in the vmPFC with regard to the anatomical correlates of each behavioral measure. Similarly, while RTV was weakly correlated with behavioral ratings of ADHD symptomatology (r = 0.11–0.14), there was considerable overlap with regard to anatomical correlates. Given convergence across dimensional, multi-informant behavioral ratings, and a measure of neurocognitive functioning that has been previously tied to ADHD, our findings indicate that vmPFC structure is a brain-based marker for inattention in adolescents.

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