Effect of exposure to polycyclic aromatic hydrocarbons on basal ganglia and attention-deficit hyperactivity disorder symptoms in primary school children

Background Polycyclic aromatic hydrocarbons (PAHs) have been proposed as environmental risk factors for attention deficit hyperactivity disorder (ADHD). The effects of these pollutants on brain structures potentially involved in the pathophysiology of ADHD are unknown. Objective The aim of this study was to investigate the effects of PAHs on basal ganglia volumes and ADHD symptoms in school children. Methods We conducted an imaging study in 242 children aged 8–12 years, recruited through a set of representative schools of the city of Barcelona, Spain. Indoor and outdoor PAHs and benzo[a]pyrene (BPA) levels were assessed in the school environment, one year before the MRI assessment. Whole-brain volumes and basal ganglia volumes (caudate nucleus, globus pallidus, putamen) were derived from structural MRI scans using automated tissue segmentation. ADHD symptoms (ADHD/DSM-IV Scales, American Psychiatric Association 2002) were reported by teachers, and inattentiveness was evaluated with standard error of hit reaction time in the attention network computer-based test. Results Total PAHs and BPA were associated with caudate nucleus volume (CNV) (i.e., an interquartile range increase in BPA outdoor level (67 pg/m3) and indoor level (76 pg/m3) was significantly linked to a decrease in CNV (mm3) (β = − 150.6, 95% CI [− 259.1, − 42.1], p = 0.007, and β = − 122.4, 95% CI [− 232.9, − 11.8], p = 0.030 respectively) independently of intracranial volume, age, sex, maternal education and socioeconomic vulnerability index at home). ADHD symptoms and inattentiveness increased in children with higher exposure to BPA, but these associations were not statistically significant. Conclusions Exposure to PAHs, and in particular to BPA, is associated with subclinical changes on the caudate nucleus, even below the legislated annual target levels established in the European Union. The behavioral consequences of this induced brain change were not identified in this study, but given the caudate nucleus involvement in many crucial cognitive and behavior processes, this volume reduction is concerning for the children's neurodevelopment. © 2017 The Authors
Marion Mortamais is supported by a Marie Sk?odowska-Curie Individual Fellowship (H2020-MSCA-IF-2014; EU project 656294). This work was supported by the European Research Council under the ERC [grant number 268479]?the BREATHE project. The Agency of University and Research Funding Management of the Catalonia Government participated in the context of Research Group SGR2014-1673. We also thank the Caixa Foundation for their financial support in the PAHs analyses.