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Widespread alterations in the corpus callosum (CC) microstructure and organization have been found in children with attention-deficit/hyperactivity disorder (ADHD); however, few studies have investigated the diffusion characteristics and volume of transcallosal fiber tracts defined by specific cortical projections in ADHD, which is important for identifying distinct functional interhemispheric connection abnormalities. In the current study, an automated fiber-tract quantification (AFQ) approach based on diffusion tensor imaging identified seven CC tracts according to their cortical projections and estimated diffusion parameters and volume among 76 drug-naïve ADHD patients (53 boys and 23 girls) and 37 typically developing children (TDC) (20 boys and 17 girls) matched for age, IQ, and handedness. We found significantly lower fractional anisotropy (FA) in the occipital and superior parietal tracts and higher mean diffusivity (MD) in the posterior, superior parietal and anterior frontal tracts in children with ADHD compared with TDC. In addition, lower FA and higher radial diffusivity (RD) in the occipital callosal tract were significantly associated with higher hyperactivity and impulsivity performance in ADHD. In addition, sex-by-diagnosis interactions were observed in the occipital, posterior and superior parietal tracts. Girls with ADHD showed decreased FA and volume in the occipital tract, which were significantly associated with increased impulsivity performance and poor response control, and increased MD in the posterior and superior parietal callosal tracts, which were significantly associated with increased inattention performance, whereas boys with ADHD merely showed decreased volume in the frontal tract. Our results elucidated that sex-specific alterations in the CC tracts potentially underlie ADHD symptomatology and further suggested a differential contribution of abnormalities in different CC tracts to impulsivity and inattention among girls with ADHD.

Aberrant microstructure of the callosal tracts has been found in boys with attention-deficit/hyperactivity disorder (ADHD). However, it is unclear whether the previously identified white matter (WM) alterations in boys with ADHD are also present in girls with ADHD. Thus, we applied diffusion tensor imaging (DTI) to investigate WM alterations in the callosal tracts in girls with ADHD. In this study, twenty-four adolescent girls (fourteen ADHD patients and ten typically developed girls) were recruited for high-resolution DTI. Automated fiber quantification of the callosum forceps major and the callosum forceps minor was then conducted. Diffusion parameters, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD), were calculated to investigate the microstructural integrity of the two callosal tracts. We also investigated correlations between diffusion properties and clinical measurements, including scores on Conners' Parent Rating Scale, the Stroop Color-Word Test, the Wisconsin Card Sorting Test and the Continuous Performance Test, in ADHD patients and typically developed girls. Compared to typically developed adolescent girls, girls with ADHD had reduced FA values at nodes 59-70 and increased RD values at nodes 60-68 along the callosum forceps major. Lower FA values correlated with higher Hyperactivity-Impulsivity scores and lower control quotients, while higher RD values correlated with lower control quotients. This study revealed the disruption of interhemispheric connectivity, particularly across the right side of the occipital CC tract, which might be involved in visual processes in girls with ADHD. These findings enhanced current knowledge about the neuropathological basis of female ADHD.