Neuroanatomical Differences Between Boys and Girls with ADHD: A Critical Review and Implications for Treatment

Attention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity (Diagnostic and Statistical Manual of Mental Disorders; 5th ed., American Psychiatric Association, 2013). About 5% of school age children are diagnosed with this disorder and about 65% will have symptoms that persist beyond adolescence (Friedman and Rapport, 2015). Although girls with ADHD exhibit different symptoms relative to boys with ADHD, there is a lack of research on sex-differences in ADHD-related neuroanatomical structures. There is evidence, however, that girls with ADHD have a 10% decrease in total cerebral gray matter volume compared to boys with ADHD, although they peak 3.5 years earlier than boys (Mahone and Wodka, 2008). Given that teacher’s rate boys as having higher ADHD symptomology compared to girls (Gaub and Carlson, 1997), it is necessary to inform educators on peak maturational age differences to ensure successful referrals. This review focuses on neuroanatomical differences between boys and girls with ADHD and summarizes results from 59 articles between 1999-2017. Deficits in neuroanatomical structures and levels of functioning are identified. Implications for future research and treatment options will be discussed.