2026 ECNP Congress

PS03-3153

Childhood maltreatment and precuneus/dorsal posterior cingulate cortical thickness in ADHD: a matched-group comparison

Kristóf Ágrez — Z. Vidnyánszky, N. Bunford · HUN-REN Research Centre for Natural Sciences, Clinical and Developmental Neuropsychology Research Group, Budapest, Hungary

2026 ECNP Congress

Introduction

Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk of experiencing childhood maltreatment (CM). In ADHD, CM may lead to the development of an ecophenotype [1], such that individuals with ADHD and a history of CM (CM+) may differ behaviorally and biologically from those without CM (CM-). While macrostructural alterations consistent with a maltreated ecophenotype have been documented in certain mental disorders, evidence in ADHD is limited. Guided by this framework, our aim was to compare individuals with ADHD and CM+ to individuals with ADHD and CM- on key aspects of cortical neuroanatomy, cortical thickness (CT) and surface area (SA).

Methods

Data were analyzed from the Healthy Brain Network involving individuals between ages 5 and 21 years. CT and SA were derived from T1-weighted Magnetic Resonance Imaging scans distributed through Reproducible Brain Charts. Of 249 participants having complete data and passing neuroimaging quality control, 60 were CM+ and 189 were CM-. CM+ and CM- individuals were propensity score matched 1:1 on age, estimated total intracranial volume, Euler number (image quality metric), sex, and site, resulting in an analytic sample of n=60 CM+ (M=11.85±3.67 years, 45 male, 31 White) and n=60 CM- (M=11.53±3.49 years, 47 male, 27 White) individuals. CM+ and CM- participants were compared on CT and SA using regression models with CM as a grouping variable, CM- as the reference group, and matching variables included as covariates. Lifetime diagnoses of (1) Major and Persistent Depressive Disorders (combined variable) and (2) Oppositional Defiant Disorder (ODD) were covaried in sensitivity analyses. Ten resolutions from the Schaefer 2018 parcellation were tested. p-values were Benjamini-Hochberg False Discovery Rate (FDR) adjusted.

Results

The CM+ group exhibited reduced CT in the most anterior/dorsal parcel of the precuneus/posterior cingulate cortex (PCC) in the left hemisphere, βs=[-0.365, -0.339], pFDRs=[.011, .022], significant at 7/10 resolutions. Group differences were slightly attenuated after covarying lifetime depressive disorders, βs=[-0.345, -0.323], pFDRs=[.025, .048], significant at 6/10 resolutions. Findings became non-significant after covarying lifetime ODD (although uncorrected p-values remained highly significant, ps=[<.001, .002]), βs=[-0.300, -0.272], pFDRs≥.123. CM+ and CM- groups did not differ on SA, pFDRs≥.117.

Conclusions

Findings provide modest support for the maltreated ecophenotype in ADHD. Results suggest that reduced CT in dorsal subregions of the precuneus/PCC is associated with CM in individuals with ADHD, consistent with earlier studies demonstrating reduced CT associated with CM [2]. This relatively understudied brain region is implicated in executive and memory functions, as well as salience encoding [3]. Given links between early adversity and executive dysfunction [4], as well as altered emotion and reward processing [5], the current findings may be relevant to adversity-related cognitive and affective alterations. That results became non-significant after covarying ODD invites cautious interpretation, as this may signal limited statistical power, as evidenced by only moderately attenuated effect sizes and highly significant group differences before correction for multiple comparison. At the same time, shared variance between CM and ODD, or the relevance of comorbid behavioral symptoms in ADHD, cannot be ruled out and should be acknowledged as an alternative interpretation.

References

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  3. Foster, B.L., Koslov, S.R., Aponik-Gremillion, L., Monko, M.E., Hayden, B.Y., Heilbronner, S.R., 2023. A tripartite view of the posterior cingulate cortex. Nat. Rev. Neurosci. 24 (3) 173-189.
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