Altered brain substrates and neuroplastic potential in pediatric psychiatric disorders: A neuroimaging perspective

Introduction/Objective. Attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), mood disorders, anxiety disorders, and early-onset psychotic disorders could significantly impact child development, affecting emotional regulation, cognitive function, and social competence. This narrative review integrates neuroimaging evidence from large-scale consortia to delineate altered brain substrates and evaluate neuro-plastic effects of interventions in these conditions. Methods. We analyzed findings from structural and functional magnetic resonance imaging (MRI), positron emission tomography (PET), and electroencephalography (EEG) studies published up to March 2025, focusing on key brain regions (prefrontal cortex, amygdala, basal ganglia, cerebellum, hippocampus) and brain networks (default mode network). Results. Structural anomalies, such as reduced subcortical/cortical volumes in ADHD and altered amygdala trajectories in ASD, coexist with functional disruptions, including hypoactivation and dysconnectivity. Pharmacological (stimulants, SSRIs) and behavioral interventions induce neuroplastic changes, modulating regional activity and connectivity. Conclusion. These findings reveal shared and disorder-specific neurobiological mechanisms, offering pathways for early diagnosis and targeted treatments. We propose a multidisciplinary framework integrating neuroimaging with genetic, environmental, and clinical data to advance early diagnosis and treatment of disorders precision psychiatry. Understanding brain alterations and their plastic-ity in childhood can guide strategies to reduce long-term morbidity.