Broken Brains or Flawed Studies? An update on Leo and Cohen's Critical Review of ADHD Neuroimaging

Charles Marley, Anna O’Leary, Vasiliki-Aliki Nikopoulou

Research output: Contribution to journalArticlepeer-review


This systematic review sought to examine neuroimaging results on Attention Deficit Hyperactivity Disorder (ADHD) published between 2003 and 2015, paying special attention to the major confound of prior medication use first brought to attention by Leo and Cohen (2003) and subsequently acknowledged in the ADHD literature. Neuroimaging studies comparing children and adolescents with ADHD were identified through searches in Web of Science (BIOSIS, Web of Science Core Collection, MEDLINE), PsychINFO, and EMBASE. All studies focusing on neuroimaging and ADHD were selected for consideration (n=62). Forty studies (64.5%) still included pre-medicated samples despite the confound and eight studies (13%) did not provide information to determine this, leaving only 14 studies with medication-free participants to be analysed. The findings on reported differences in physical systems and in electrical activation between ADHD participants and controls were inconsistent and, in part, short on methodological rigour. Despite technological advances, the current state of research suggests that the understanding of neurobiological underpinnings of ADHD and the significance of that research for individuals diagnosed with ADHD has not advanced since the Leo and Cohen review.
Original languageEnglish
Pages (from-to)205-228
JournalJournal of Mind and Behavior
Issue number3
Publication statusPublished - 28 Aug 2018


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