Brain maturation patterns forecast ADHD symptom trajectories in teens

A large longitudinal study using ABCD data shows ADHD symptom paths in adolescence—persistent, remitting, emergent, and control—map to distinct brain development signs. Persistent symptoms link to faster cortical thinning in frontal areas; emergent symptoms to slower thinning in the right posterior cingulate; remitting symptoms to faster left hippocampal growth. A machine-learning model with baseline brain data predicted symptom severity three years later and was replicated in European adult samples. Medication did not reliably predict remission; findings point to brain-based biomarkers and non-pharmacological interventions like aerobic exercise, while acknowledging observational limitations.