DHA Augmentation of Cortical Attention Networks in Attention Deficit Hyperactivity Disorder

Grant Number: 2015-1053 (DSM)
PI: Robert McNamara, PhD (UC Neuroscience)
Collaborators: Jeffery Epstein, PhD

ADHD is typically diagnosed in childhood, a developmental period associated with rapid increases in cortical gray and white matter volume. Cross-sectional imaging studies have consistently observed deficits in cortical gray and white matter integrity, particularly in the frontal lobes, and connectivity deficits in fronto-striatal and fronto-cerebellum circuits, in ADHD patients. While the pathoetiological mechanisms contributing to ADHD remain poorly understood and are likely multi-factorial, a consistent body of evidence suggests that ADHD is associated with blood deficits in docosahexaenoic acid (DHA). Importantly, DHA is the principal omega-3 fatty acid in the mammalian brain, and erythrocyte (red blood cell) and cortical DHA levels are positively correlated. The childhood and adolescence period is associated with rapid increases in frontal cortex DHA levels, and deficits in cortical DHA accrual during this period may represent a modifiable risk factor for the cortical maturation deficits in ADHD patients. Prior controlled omega-3 intervention trials have observed modest benefits on measures of attention and global functioning in ADHD patients. However, many of these studies, including the only trial evaluating algal-DHA, employed medicated ADHD patients which may have precluded finding more robust therapeutic benefits. Moreover, DHA effects on cortical functional integrity and connectivity are anticipated to precede and predict clinical improvement.  While there is currently nothing known about the relationship between the low DHA status and cortical pathology observed in ADHD patients, emerging evidence from magnetic resonance imaging (MRI) studies are beginning to elucidate an important role for DHA in cortical functional integrity which are directly relevant to the pathoetiology of ADHD.

The primary goal is to determine the effects of docosahexaenoic acid (DHA) supplementation on the functional integrity of cortical attention networks in male psychostimulant-naïve ADHD children.

A sample of 30 male psychostimulant-naïve pediatric/adolescent (8-12 years of age) ADHD (combined type) subjects will be recruited for this study.