Sex-based brain iron differences and inhibitory control in ADHD adolescents

<p data-start="204" data-end="1461">ADHD affects children across sexes but is often underdiagnosed in girls, potentially due to differences in neurobiology and behavioral presentation. This study investigated whether there are sex-dependent differences in regional brain iron concentrations among children with ADHD and whether these differences predict performance on a Go/No-Go inhibitory control task. Using BrainMAP neuroimaging data, tissue iron levels were compared across three brain regions in males and females with ADHD. Results revealed that females had significantly lower brain iron concentrations than males in all regions, with all comparisons reaching statistical significance. However, no significant differences were observed in omission rates between sexes, and no correlations were found between brain iron levels and inhibitory control performance. These findings highlight a potential disconnect between biological markers and behavioral measures and underscore the importance of incorporating sex-specific neurobiological data into ADHD assessment frameworks. This work contributes to efforts to improve equitable diagnosis and intervention, particularly for girls whose symptoms may go unrecognized by behavior-based tools alone.