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Three distinct brain biotypes exist in children who have attention-deficit/hyperactivity disorder, anxiety disorder or both, a new Stanford Medicine–led study has shown. The discovery could help clarify a confusing picture of two of the most common mental health conditions of childhood, which often overlap. Each biotype is characterized by malfunctions in a specific set of brain circuits, according to the study, published in Nature Mental Health.

The biotypes, which were identified through an analysis of thousands of fMRI scans of children's brains, correspond to three sets of symptoms. The biotypes could aid early diagnoses, provide new therapeutic targets and make it easier to match patients to effective treatments, the research team said.

"The high overlap between ADHD and anxiety actually hinders our understanding of the neurobiology underlying traditional, symptom-based diagnoses," said co-senior study author Yu Zhang, Ph.D., assistant professor of psychiatry and behavioral sciences. ADHD and anxiety are diagnosed using symptom checklists, but children with one condition often have several symptoms of the other, he noted.

The study's lead author is Yong Jiao, Ph.D., a postdoctoral scholar at the University of Iowa. Zhang shares senior authorship of the study with Jing Jiang, Ph.D., assistant professor of pediatric neurology at the University of Iowa.

"We wanted to know whether the biological differences among children with ADHD and anxiety follow the diagnostic labels used in the clinic," Zhang said.

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