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Guo Z, Cui Y, Qiu R, Bu L, Yang T, Li Y, Zhu X. The association of impulsivity with depression and anxiety symptoms: A transdiagnostic network analysis and replication. J Affect Disord 2024; 359:100-108. [PMID: 38772504 DOI: 10.1016/j.jad.2024.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Impulsivity increases the risk for depression and anxiety. However, the granular pathways among them remain unknown. A network approach that moves from disorder-level analysis to symptom-level analysis can provide further understanding of psychopathological mechanisms. In this study, we examined the network structure of impulsivity and separate and comorbid symptoms of depression and anxiety. METHODS Regularized partial-correlation networks were estimated using cross-sectional data from 1047 Chinese participants aged 18-26 years (main dataset, mean age = 21.45 ± 2.01 years) and 325 Chinese participants aged 18-36 years (an independent replication dataset, mean age = 21.49 ± 3.73 years), including impulsivity-depression, impulsivity-anxiety, and impulsivity-depression-anxiety networks. The datasets were collected from 1 June 2023 to 4 August 2023 and from 27 April 2022 to 16 May 2022, respectively. Impulsivity, depression, and anxiety were assessed using Barratt Impulsiveness Scale Version 11, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, respectively. Bridge centrality was analyzed, and a network comparison test (NCT) was conducted to investigate the differences between the main dataset and replication dataset. RESULTS The motor impulsivity dimension was revealed to be closely connected with individual symptoms of depression and anxiety regardless of whether they were in separate disorder forms or comorbid forms. In all the networks, motor impulsivity was the most important bridge node. The NCT showed comparable network connectivity and network structure between the main and replication datasets. LIMITATIONS The use of cross-sectional data limited the inferences about the direction of causality between variables. CONCLUSIONS These findings elucidate the psychopathological mechanisms underlying how impulsivity functions within depression, anxiety, and comorbidity and support that motor impulsivity is an important risk factor across different mental disorders and is responsible for comorbidity. The implications of these findings are discussed.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lingbo Bu
- Teaching Evaluation Center, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
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Kofler MJ, Groves NB, Chan ESM, Marsh CL, Cole AM, Gaye F, Cibrian E, Tatsuki MO, Singh LJ. Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions. Front Psychiatry 2024; 15:1277583. [PMID: 38779551 PMCID: PMC11110569 DOI: 10.3389/fpsyt.2024.1277583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/07/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Children with ADHD demonstrate difficulties on many different neuropsychological tests. However, it remains unclear whether this pattern reflects a large number of distinct deficits or a small number of deficit(s) that broadly impact test performance. The current study is among the first experiments to systematically manipulate demands on both working memory and inhibition, with implications for competing conceptual models of ADHD pathogenesis. Method A clinically evaluated, carefully phenotyped sample of 110 children with ADHD, anxiety disorders, or co-occurring ADHD+anxiety (Mage=10.35, 44 girls; 69% White Not Hispanic/Latino) completed a counterbalanced, double dissociation experiment, with two tasks each per inhibition (low vs. high) x working memory (low vs. high) condition. Results Bayesian and frequentist models converged in indicating that both manipulations successfully increased demands on their target executive function (BF10>5.33x108, p<.001). Importantly, occupying children's limited capacity working memory system produced slower response times and reduced accuracy on inhibition tasks (BF10>317.42, p<.001, d=0.67-1.53). It also appeared to differentially reduce inhibition (and non-inhibition) accuracy for children with ADHD relative to children with anxiety (BF10=2.03, p=.02, d=0.50). In contrast, there was strong evidence against models that view working memory deficits as secondary outcomes of underlying inhibition deficits in ADHD (BF01=18.52, p=.85). Discussion This pattern indicates that working memory broadly affects children's ability to inhibit prepotent tendencies and maintain fast/accurate performance, and may explain the errors that children with ADHD make on inhibition tests. These findings are broadly consistent with models describing working memory as a causal mechanism that gives rise to secondary impairments. In contrast, these findings provide evidence against models that view disinhibition as a cause of working memory difficulties or view working memory as a non-causal correlate or epiphenomenon in ADHD.
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Affiliation(s)
- Michael J. Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Nicole B. Groves
- Department of Psychiatry, Seattle Children’s Hospital, Seattle, WA, United States
| | - Elizabeth S. M. Chan
- Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, United States
| | - Carolyn L. Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Alissa M. Cole
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Enrique Cibrian
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Miho O. Tatsuki
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Leah J. Singh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Bullard CC, Roberts DK, Tatsuki MO, Sullivan MA, Kofler MJ, Alderson RM. Social functioning in children with ADHD: an examination of inhibition, self-control, and working memory as potential mediators. Child Neuropsychol 2024:1-23. [PMID: 38269494 PMCID: PMC11269528 DOI: 10.1080/09297049.2024.2304375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) experience a host of social problems, in addition to significant impairments in behavioral inhibition, working memory, and self-control. Behavioral inhibition and working memory difficulties have been linked with social functioning deficits, but to date, most studies have examined these neurocognitive problems either in isolation or as an aggregate measure in relation to social problems, and none has considered the role of self-control. Thus, it remains unclear whether all of these executive functions are linked with social problems or if the link can be more parsimoniously explained by construct overlap. Fifty-eight children with ADHD and 63 typically developing (TD) children completed tests assessing self-control, behavioral inhibition, and working memory; parents and teachers rated children's social functioning. Examination of potential indirect effects with the bootstrapping procedure indicated that working memory mediated the relation between group membership (ADHD, TD) and child social functioning based on teacher but not parent ratings. Behavioral inhibition and self-control did not have direct relations with either parent- or teacher-rated social functioning. These findings point to important differences regarding how executive functioning difficulties manifest at school compared to home, as well as the specific executive function components that predict ADHD-related social difficulties.
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Affiliation(s)
| | - Delanie K. Roberts
- Oklahoma State University, Department of Psychology
- Children’s Hospital of Los Angeles
| | - Miho O. Tatsuki
- Oklahoma State University, Department of Psychology
- Florida State University, Department of Psychology
| | | | | | - R. Matt Alderson
- Oklahoma State University, Department of Psychology
- Posthumous author
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Psotta R, Sarvestan J, Valtr L, Ješina O. Quiet eye training-based intervention can ameliorate inhibitory control but not visuospatial working memory in children with ADHD. Brain Behav 2023; 13:e3251. [PMID: 37715345 PMCID: PMC10636405 DOI: 10.1002/brb3.3251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/20/2023] [Accepted: 08/28/2023] [Indexed: 09/17/2023] Open
Abstract
INTRO The purpose of this study was to investigate the effects of quiet eye training (QET) on inhibitory control, visuospatial working memory (WM), and tonic attention in children with attention-deficit hyperactivity disorder (ADHD). METHODS Forty-eight children with ADHD aged 9-12 years were randomly assigned to QET and control (CON) groups. The QET group practiced targeted hand-eye tasks within a QET protocol developed to optimize controlled attention and gaze through eye fixations. We used the go/no-go (GNG) test, the Corsi test, and the reaction test of alertness (RTA) to verify the effects of QET on inhibition control, WM, and tonic attention. RESULTS QET group showed significantly shorter reaction times, a higher number of correct responses, and a lower number of omissions in the GNG inhibition test after QET as compared to the pre-measurements, whereas the CON group did not demonstrate significant changes in this test. The measures of WM (Corsi test) and tonic attention (RTA) did not change significantly with the QET-based intervention. CONCLUSION The study demonstrated that the QET protocol, which includes instructions and a video demonstration to optimize eye fixation on a target during aiming tasks, is acceptable and usable for children with ADHD. Overall, a short-term, 5-week visuomotor training intervention based on the quiet eye paradigm was shown to be effective in improving inhibitory control and focused visual attention, but not visuospatial WM and intrinsic attention in 9-12-year-old children with inattentive or combined ADHD.
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Affiliation(s)
- Rudolf Psotta
- Faculty of Physical CulturePalacky UniversityOlomoucCzech Republic
- College of Physical Education and Sport PALESTRAPragueCzech Republic
| | - Javad Sarvestan
- Faculty of Physical CulturePalacky UniversityOlomoucCzech Republic
| | - Ludvík Valtr
- Faculty of Physical CulturePalacky UniversityOlomoucCzech Republic
| | - Ondrej Ješina
- Faculty of Physical CulturePalacky UniversityOlomoucCzech Republic
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Zhao S, Yuan R, Gao W, Liu Q, Yuan J. Neural substrates of behavioral inhibitory control during the two-choice oddball task: functional neuroimaging evidence. PSYCHORADIOLOGY 2023; 3:kkad012. [PMID: 38666128 PMCID: PMC10917370 DOI: 10.1093/psyrad/kkad012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/21/2023] [Accepted: 07/20/2023] [Indexed: 04/28/2024]
Abstract
Background Behavioral inhibitory control (BIC) depicts a cognitive function of inhibiting inappropriate dominant responses to meet the context requirement. Despite abundant research into neural substrates of BIC during the go/no-go and stop signal tasks, these tasks were consistently shown hard to isolate neural processes of response inhibition, which is of primary interest, from those of response generation. Therefore, it is necessary to explore neural substrates of BIC using the two-choice oddball (TCO) task, whose design of dual responses is thought to produce an inhibition effect free of the confounds of response generation. Objective The current study aims at depicting neural substrates of performing behavioral inhibitory control in the two-choice oddball task, which designs dual responses to balance response generation. Also, neural substrates of performing BIC during this task are compared with those in the go/no-go task, which designs a motor response in a single condition. Methods The present study integrated go/no-go (GNG) and TCO tasks into a new Three-Choice BIC paradigm, which consists of standard (75%), deviant (12.5%), and no-go (12.5%) conditions simultaneously. Forty-eight college students participated in this experiment, which required them to respond to standard (frequent) and deviant stimuli by pressing different keys, while inhibiting motor response to no-go stimuli. Conjunction analysis and ROI (region of interest) analysis were adopted to identify the unique neural mechanisms that subserve the processes of BIC. Results Both tasks are effective in assessing BIC function, reflected by the significantly lower accuracy of no-go compared to standard condition in GNG, and the significantly lower accuracy and longer reaction time of deviant compared to standard condition in TCO. However, there were no significant differences between deviant and no-go conditions in accuracy. Moreover, functional neuroimaging has demonstrated that the anterior cingulate cortex (ACC) activation was observed for no-go vs. standard contrast in the GNG task, but not in deviant vs. standard contrast in the TCO task, suggesting that ACC involvement is not a necessary component of BIC. Second, ROI analysis of areas that were co-activated in TCO and GNG showed co-activations in the right inferior frontal cortex (triangle and orbital), with the signals in the TCO task significantly higher than those in the GNG task. Conclusions These findings show that the designed responses to both standard and deviant stimuli in the TCO task, compared to the GNG task, produced a more prominent prefrontal inhibitory processing and extinguished an unnecessary component of ACC activation during BIC. This implies that prefrontal involvement, but not that of ACC, is mandatory for the successful performance of inhibiting prepotent behaviors.
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Affiliation(s)
- Shirui Zhao
- The Affect Cognition and Regulation Laboratory (ACRLab), Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
- Faculté des Sciences Psychologiques et de l’Éducation, Université Libre de Bruxelles (ULB)Brussels 1050, Belgium
| | - Ruosong Yuan
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Wei Gao
- The Affect Cognition and Regulation Laboratory (ACRLab), Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Qiang Liu
- The Affect Cognition and Regulation Laboratory (ACRLab), Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Jiajin Yuan
- The Affect Cognition and Regulation Laboratory (ACRLab), Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision (Sichuan Normal University), Chengdu 610066, China
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Guo Z, Qiu R, Qiu H, Lu H, Zhu X. Long-term effects of repeated multitarget high-definition transcranial direct current stimulation combined with cognitive training on response inhibition gains. Front Neurosci 2023; 17:1107116. [PMID: 36968503 PMCID: PMC10033537 DOI: 10.3389/fnins.2023.1107116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundFew studies have investigated the effects of repeated sessions of transcranial direct current stimulation (tDCS) combined with concurrent cognitive training on improving response inhibition, and the findings have been heterogeneous in the limited research. This study investigated the long-lasting and transfer effects of 10 consecutive sessions of multitarget anodal HD-tDCS combined with concurrent cognitive training on improving response inhibition compared with multitarget stimulation or training alone.MethodsNinety-four healthy university students aged 18–25 were randomly assigned to undergo different interventions, including real stimulation combined with stop-signal task (SST) training, real stimulation, sham stimulation combined with SST training, and sham stimulation. Each intervention lasted 20 min daily for 10 consecutive days, and the stimulation protocol targeted right inferior frontal gyrus (rIFG) and pre-supplementary motor area (pre-SMA) simultaneously with a total current intensity of 2.5 mA. Performance on SST and possible transfer effects to Stroop task, attention network test, and N-back task were measured before and 1 day and 1 month after completing the intervention course.ResultsThe main findings showed that the combined protocol and the stimulation alone significantly reduced stop-signal reaction time (SSRT) in the post-intervention and follow-up tests compared to the pre-intervention test. However, training alone only decreased SSRT in the post-test. The sham control exhibited no changes. Subgroup analysis revealed that the combined protocol and the stimulation alone induced a decrease in the SSRT of the low-performance subgroup at the post-test and follow-up test compared with the pre-test. However, only the combined protocol, but not the stimulation alone, improved the SSRT of the high-performance subgroup. The transfer effects were absent.ConclusionThis study provides supportive evidence for the synergistic effect of the combined protocol, indicating its superiority over the single intervention method. In addition, the long-term after-effects can persist for up to at least 1 month. Our findings also provide insights into the clinical application and strategy for treating response inhibition deficits.
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He Y, Yang T, He C, Sun K, Guo Y, Wang X, Bai L, Xue T, Xu T, Guo Q, Liao Y, Liu X, Wu S. Effects of audiovisual interactions on working memory: Use of the combined N-back + Go/NoGo paradigm. Front Psychol 2023; 14:1080788. [PMID: 36874804 PMCID: PMC9982107 DOI: 10.3389/fpsyg.2023.1080788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/27/2023] [Indexed: 02/19/2023] Open
Abstract
Background Approximately 94% of sensory information acquired by humans originates from the visual and auditory channels. Such information can be temporarily stored and processed in working memory, but this system has limited capacity. Working memory plays an important role in higher cognitive functions and is controlled by central executive function. Therefore, elucidating the influence of the central executive function on information processing in working memory, such as in audiovisual integration, is of great scientific and practical importance. Purpose This study used a paradigm that combined N-back and Go/NoGo tasks, using simple Arabic numerals as stimuli, to investigate the effects of cognitive load (modulated by varying the magnitude of N) and audiovisual integration on the central executive function of working memory as well as their interaction. Methods Sixty college students aged 17-21 years were enrolled and performed both unimodal and bimodal tasks to evaluate the central executive function of working memory. The order of the three cognitive tasks was pseudorandomized, and a Latin square design was used to account for order effects. Finally, working memory performance, i.e., reaction time and accuracy, was compared between unimodal and bimodal tasks with repeated-measures analysis of variance (ANOVA). Results As cognitive load increased, the presence of auditory stimuli interfered with visual working memory by a moderate to large extent; similarly, as cognitive load increased, the presence of visual stimuli interfered with auditory working memory by a moderate to large effect size. Conclusion Our study supports the theory of competing resources, i.e., that visual and auditory information interfere with each other and that the magnitude of this interference is primarily related to cognitive load.
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Affiliation(s)
- Yang He
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Chunyan He
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Kewei Sun
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Yaning Guo
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Lifeng Bai
- Faculty of Humanities and Social Sciences, Aviation University of Air Force, Changchun, China
| | - Ting Xue
- Faculty of Humanities and Social Sciences, Aviation University of Air Force, Changchun, China
| | - Tao Xu
- Psychology Section, Secondary Sanatorium of Air Force Healthcare Center for Special Services, Hangzhou, China
| | - Qingjun Guo
- Psychology Section, Secondary Sanatorium of Air Force Healthcare Center for Special Services, Hangzhou, China
| | - Yang Liao
- Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Fourth Military Medical University, Xi'an, China
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Panah MT, Taremian F, Dolatshahi B, Seddigh SH, Raeisian FS, Panah E. A comparison of Barkley's behavioral inhibition model (1997) with Barkley's updated executive functioning model in predicting adult ADHD symptoms: A preliminary report using structural equation modeling. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-13. [PMID: 36576870 DOI: 10.1080/23279095.2022.2158441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
One of the most comprehensive approaches to explaining attention-deficit/hyperactivity disorder (ADHD) symptoms is Barkley's behavioral inhibition model (BBIM) (1997), in which behavioral inhibition (BI) plays a primary role. Due to the substantial role of working memory (WM) in explaining ADHD symptoms, Barkley recently updated his model and elevated WM from a mediator variable (in BBIM) to a primary position as an exogenous variable alongside BI, and titled his new model as Barkley's updated executive functioning model (BUEFM). However, since the information about the explanatory power of the new model is sparse, this study aims to investigate the impact of this change in WM role by comparing these two models to explain ADHD symptoms. The study involved a sample of 184 (96 females and 88 males) undergraduate students with high ADHD symptoms who were selected using the purposive sampling method. For assessing models, we have utilized four tools that include: CNS-Vital Sign Test Battery; Barkley Deficit in Executive Functioning Scale; self-verbalization questionnaire (SVQ); and trail making test. We analyzed the data by running structural equation modeling (SEM) analysis using IBM AMOS software version 22. The results show that Model Comparison Measurement (e.g. AIC was 197.583 and 144.614 for BBIM and BUEFM, respectively) and Model Fit Indices (e.g. root mean square error of approximation (RMSEA) obtained 0.076 and 0.067 for BBIM and BUEFM, respectively) representing that BUEFM had a better value than BBIM, which means that the BUEFM was considered better fitting to the data. The findings of this study show that BUEFM has more Predictive power than BBIM to predict symptoms of ADHD through the motor control fluency (MOT) variable.
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Affiliation(s)
- Mohammad Taher Panah
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhad Taremian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Behrouz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyyed Hamzeh Seddigh
- Department of Psychiatry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Sadat Raeisian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ebrahim Panah
- Modern Language Department, University College of Yayasan Pahang, Kuantan Pahang, Malaysia
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Guo Z, Gong Y, Lu H, Qiu R, Wang X, Zhu X, You X. Multitarget high-definition transcranial direct current stimulation improves response inhibition more than single-target high-definition transcranial direct current stimulation in healthy participants. Front Neurosci 2022; 16:905247. [PMID: 35968393 PMCID: PMC9372262 DOI: 10.3389/fnins.2022.905247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022] Open
Abstract
Prior studies have focused on single-target anodal transcranial direct current stimulation (tDCS) over the right inferior frontal gyrus (rIFG) or pre-supplementary motor area (pre-SMA) to improve response inhibition in healthy individuals. However, the results are contradictory and the effect of multitarget anodal stimulation over both brain regions has never been investigated. The present study aimed to investigate the behavioral and neurophysiological effects of different forms of anodal high-definition tDCS (HD-tDCS) on improving response inhibition, including HD-tDCS over the rIFG or pre-SMA and multitarget HD-tDCS over both areas. Ninety-two healthy participants were randomly assigned to receive single-session (20 min) anodal HD-tDCS over rIFG + pre-SMA, rIFG, pre-SMA, or sham stimulation. Before and immediately after tDCS intervention, participants completed a stop-signal task (SST) and a go/nogo task (GNG). Their cortical activity was recorded using functional near-infrared spectroscopy (fNIRS) during the go/nogo task. The results showed multitarget stimulation produced a significant reduction in stop-signal reaction time (SSRT) relative to baseline. The pre-to-post SSRT change was not significant for rIFG, pre-SMA, or sham stimulation. Further analyses revealed multitarget HD-tDCS significantly decreased SSRT in both the high-performance and low-performance subgroups compared with the rIFG condition which decreased SSRT only in the low-performance subgroup. Only the multitarget condition significantly improved neural efficiency as indexed by lower △oxy-Hb after stimulation. In conclusion, the present study provides important preliminary evidence that multitarget HD-tDCS is a promising avenue to improve stimulation efficacy, establishing a more effective montage to enhance response inhibition relative to the commonly used single-target stimulation.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yue Gong
- School of Psychology, Shaanxi Normal University, Xi’an, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xinlu Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
- *Correspondence: Xia Zhu,
| | - Xuqun You
- School of Psychology, Shaanxi Normal University, Xi’an, China
- Xuqun You,
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He Y, Guo Z, Wang X, Sun K, Lin X, Wang X, Li F, Guo Y, Feng T, Zhang J, Li C, Tian W, Liu X, Wu S. Effects of Audiovisual Interactions on Working Memory Task Performance—Interference or Facilitation. Brain Sci 2022; 12:brainsci12070886. [PMID: 35884692 PMCID: PMC9313432 DOI: 10.3390/brainsci12070886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The combined n-back + Go/NoGo paradigm was used to investigate whether audiovisual interactions interfere with or facilitate WM. (2) Methods: College students were randomly assigned to perform the working memory task based on either a single (visual or auditory) or dual (audiovisual) stimulus. Reaction times, accuracy, and WM performance were compared across the two groups to investigate effects of audiovisual interactions. (3) Results: With low cognitive load (2-back), auditory stimuli had no effect on visual working memory, whereas visual stimuli had a small effect on auditory working memory. With high cognitive load (3-back), auditory stimuli interfered (large effect size) with visual WM, and visual stimuli interfered (medium effect size) with auditory WM. (4) Conclusions: Audiovisual effects on WM follow the resource competition theory, and the cognitive load of a visual stimulus is dominated by competition; vision always interferes with audition, and audition conditionally interferes with vision. With increased visual cognitive load, competitive effects of audiovisual interactions were more obvious than those with auditory stimuli. Compared with visual stimuli, audiovisual stimuli showed significant interference only when visual cognitive load was high. With low visual cognitive load, the two stimulus components neither facilitated nor interfered with the other in accordance with a speed–accuracy trade-off.
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Affiliation(s)
- Yang He
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Xinlu Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Kewei Sun
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Xinxin Lin
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Fengzhan Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Yaning Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Junpeng Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Congchong Li
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Wenqing Tian
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
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Friedman LM, Rapport MD, Fabrikant-Abzug G. Consistently Inconsistent Working Memory Performance Among Children with ADHD: Evidence of Response Accuracy Variability (RAV). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09967-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kofler MJ, Wells EL, Singh LJ, Soto EF, Irwin LN, Groves NB, Chan ESM, Miller CE, Richmond KP, Schatschneider C, Lonigan CJ. A randomized controlled trial of central executive training (CET) versus inhibitory control training (ICT) for ADHD. J Consult Clin Psychol 2020; 88:738-756. [PMID: 32700955 DOI: 10.1037/ccp0000550] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Executive function deficits are well-established in ADHD. Unfortunately, replicated evidence indicates that executive function training for ADHD has been largely unsuccessful. We hypothesized that this may reflect insufficient targeting, such that extant protocols do not sufficiently and specifically target the neurocognitive systems associated with phenotypic ADHD behaviors/impairments. METHOD Children with ADHD ages 8-12 (M = 10.41, SD = 1.46; 12 girls; 74% Caucasian/Non-Hispanic) were randomized with allocation concealment to either central executive training (CET; n = 25) or newly developed inhibitory control training (ICT; n = 29). Detailed data analytic plans were preregistered. RESULTS Both treatments were feasible/acceptable based on training duration, child-reported ease of use, and parent-reported high satisfaction. CET was superior to ICT for improving its primary intervention targets: phonological and visuospatial working memory (d = 0.70-0.84). CET was also superior to ICT for improving go/no-go (d = 0.84) but not stop-signal inhibition. Mechanisms of change analyses indicated that CET-related working memory improvements produced significant reductions in the primary clinical endpoints (objectively assessed hyperactivity) during working memory and inhibition testing (indirect effects: β ≥ -.11; 95% CIs exclude 0.0). CET was also superior to ICT on 3 of 4 secondary clinical endpoints (blinded teacher-rated ADHD symptoms; d = 0.46-0.70 vs. 0.16-0.42) and 2 of 4 feasibility/acceptability clinical endpoints (parent-reported ADHD symptoms; d = 0.96-1.42 vs. 0.45-0.65). CET-related gains were maintained at 2-4 month follow-up; ICT-related gains were maintained for attention problems but not hyperactivity/impulsivity per parent report. CONCLUSIONS Results support the use of CET for treating executive function deficits and targeting ADHD behavioral symptoms in children with ADHD. Findings for ICT were mixed at best and indicate the need for continued development/study. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Breitling-Ziegler C, Tegelbeckers J, Flechtner HH, Krauel K. Economical Assessment of Working Memory and Response Inhibition in ADHD Using a Combined n-back/Nogo Paradigm: An ERP Study. Front Hum Neurosci 2020; 14:322. [PMID: 32848679 PMCID: PMC7426064 DOI: 10.3389/fnhum.2020.00322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/20/2020] [Indexed: 11/25/2022] Open
Abstract
The development of cognitive interventions in attention-deficit/hyperactivity disorder (ADHD) often requires the assessment of multiple cognitive functions. However, experimental settings consisting of various tasks are particularly strenuous for patients and can thus result in poor data quality. For the economical assessment of working memory and response inhibition, this study aims to validate a combined n-back/nogo paradigm by comparing it to single task versions and to demonstrate its applicability for ADHD research. Twenty-five healthy individuals and 34 ADHD patients between 9 and 16 years participated in this event-related potential (ERP) study. Healthy controls underwent single task versions of a 2-back working memory task and a go/nogo response inhibition task as well as the introduced combined 2-back/nogo task. This combined task demonstrated a comparable ERP structure for working memory and response inhibition aspects as single task versions. Behaviorally, higher working memory performance during the combined paradigm indicated lower task difficulty, while high correlations between combined and single task versions still indicated valid working memory measures. For response inhibition performance, different task versions resulted in similar outcomes. The application of the combined n-back/nogo paradigm in ADHD patients revealed the expected working memory and response inhibition deficits, increased omission errors, reaction times, and standard deviation of reaction time, as well as diminished n-back P3 and nogo P3 amplitudes. We conclude that the combined n-back/nogo task is an effective paradigm for the economical assessment of working memory and response inhibition deficits in ADHD on a behavioral and neurophysiological level.
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Affiliation(s)
- Carolin Breitling-Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jana Tegelbeckers
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Breitling C, Zaehle T, Dannhauer M, Tegelbeckers J, Flechtner HH, Krauel K. Comparison between conventional and HD-tDCS of the right inferior frontal gyrus in children and adolescents with ADHD. Clin Neurophysiol 2020; 131:1146-1154. [PMID: 32029377 PMCID: PMC7250280 DOI: 10.1016/j.clinph.2019.12.412] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate whether the effects of HD-tDCS and conventional tDCS of the right IFG are superior to the effects of sham stimulation for the improvement of working memory performance in ADHD. METHODS 15 ADHD patients between 10 and 16 years underwent three tDCS sessions in which conventional, HD and sham tDCS of the right IFG were applied. In all sessions a 2-back working memory task was solved and EEG was recorded. Baseline data were assessed from 15 age matched healthy controls. RESULTS In ADHD patients, increased positive values of P300 and N200 mean amplitudes were found after conventional and HD-tDCS. Thus, both components were more in resemblance to ERPs in healthy controls. Behavioral performance was not generally influenced by tDCS but effects of HD-tDCS depended on individual hyperactive/impulsive symptom load. The rate of responders for HD-tDCS was equivalent to the responder rate for conventional tDCS. CONCLUSIONS ERP data indicate that HD-tDCS is equally suitable as conventional tDCS for the recruitment of the right IFG in the context of working memory processing. SIGNIFICANCE HD-tDCS of the right IFG is a promising approach for neuromodulation in ADHD but further research is necessary to develop adaptations that produce reliable behavioral benefits.
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Affiliation(s)
- Carolin Breitling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany.
| | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany.
| | - Moritz Dannhauer
- Scientific Computing and Imaging Institute, Center for Integrated Biomedical Computing, University of Utah, Salt Lake City, UT, USA.
| | - Jana Tegelbeckers
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany.
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany.
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15
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The influence of metacognitive training on the improvement of working memory in children with ADHD. CURRENT PROBLEMS OF PSYCHIATRY 2020. [DOI: 10.2478/cpp-2019-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The purpose of the study is to check whether the memory will be strengthened after three months of metacognitive training using such mnemonic techniques as Mind Maps and Sketchnoting in children diagnosed with ADHD. According to the most recent, the Fifth Edition of The Diagnostic and Statistical Manual of Mental Disorders, working memory plays a key role both in the symptoms of ADHD and in secondary problems such as: learning disorders, professional or social difficulties.
Method: 45 schoolchildren took part in the experimental study (M=1,42; SD = 10,41;). .Each child had a diagnosed psychomotor overexcitability and attention disorders. The participants were randomly qualified into three groups: the first group was tested for the effect of Mind Maps; the second group, for the effect of Sketchnoting while the third group was assigned the role of a control group. All of the groups were administered The Deferred Naming Test before and after the training. This assessment method belongs to the PU-1 Set of Diagnostic Tests.
Results: The working memory improved in each of the three groups. The smallest number of errors were made by the children in the group with Mind Maps, while the biggest number of errors were made by the children in the control group.
Conclusion: Mind Maps can be an important complement to other forms of therapeutic treatment for children with ADHD diagnosis. Regular use of this tool in education or therapy strengthens the memory. The improvement of this executive function can be substantial in learning to write and read (memorization of the correct shapes of letters), remembering and recalling from memory the rules agreed with the child or better time orientation.
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Inattentive Behavior in Boys with ADHD during Classroom Instruction: the Mediating Role of Working Memory Processes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:713-727. [PMID: 28825170 DOI: 10.1007/s10802-017-0338-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Children with ADHD exhibit clinically impairing inattentive behavior during classroom instruction and in other cognitively demanding contexts. However, there have been surprisingly few attempts to validate anecdotal parent/teacher reports of intact sustained attention during 'preferred' activities such as watching movies. The current investigation addresses this omission, and provides an initial test of how ADHD-related working memory deficits contribute to inattentive behavior during classroom instruction. Boys ages 8-12 (M = 9.62, SD = 1.22) with ADHD (n = 32) and typically developing boys (TD; n = 30) completed a counterbalanced series of working memory tests and watched two videos on separate assessment days: an analogue math instructional video, and a non-instructional video selected to match the content and cognitive demands of parent/teacher-described 'preferred' activities. Objective, reliable observations of attentive behavior revealed no between-group differences during the non-instructional video (d = -0.02), and attentive behavior during the non-instructional video was unrelated to all working memory variables (r = -0.11 to 0.19, ns). In contrast, the ADHD group showed disproportionate attentive behavior decrements during analogue classroom instruction (d = -0.71). Bias-corrected, bootstrapped, serial mediation revealed that 59% of this between-group difference was attributable to ADHD-related impairments in central executive working memory, both directly (ER = 41%) and indirectly via its role in coordinating phonological short-term memory (ER = 15%). Between-group attentive behavior differences were no longer detectable after accounting for ADHD-related working memory impairments (d = -0.29, ns). Results confirm anecdotal reports of intact sustained attention during activities that place minimal demands on working memory, and indicate that ADHD children's inattention during analogue classroom instruction is related, in large part, to their underdeveloped working memory abilities.
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Fosco WD, Kofler MJ, Alderson RM, Tarle SJ, Raiker JS, Sarver DE. Inhibitory Control and Information Processing in ADHD: Comparing the Dual Task and Performance Adjustment Hypotheses. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:961-974. [PMID: 30547312 PMCID: PMC6698914 DOI: 10.1007/s10802-018-0504-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Inhibition is a key neurocognitive domain in ADHD that is commonly assessed with the stop-signal task. The stop-signal involves both "go" and "stop" trials; previous research indicates that response times are reliably slower to "go" trials during tasks with vs. without intermittent "stop" trials. However, it is unclear whether this pattern reflects deliberate slowing to maximize inhibitory success (performance adjustment hypothesis) and/or disrupted bottom-up information processing due to increased cognitive demands (dual-task hypothesis). Given the centrality of "go" responding for estimating children's inhibitory speed, finding that children with ADHD slow differently -or for different reasons- has the potential to inform cognitive and self-regulatory theories of ADHD. The current study used a carefully-controlled experimental design to assess the mechanisms underlying stop signal-related slowing in ADHD. Children ages 8-13 with (n = 81) and without ADHD (n = 63) completed the stop-signal task and a control task that differed only in the presence/absence of "stop" trials. Using drift-diffusion modeling, Bayesian repeated-measures ANOVAs revealed a pattern consistent with the performance adjustment hypothesis, such that children adopted more cautious response strategies (BF10 = 6221.78; d = 0.38) but did not show changes in processing speed (BF01 = 3.08; d = 0.12) or encoding/motor speed (BF01 = 5.73; d = 0.07) when inhibition demands were introduced. Importantly, the ADHD/Non-ADHD groups showed equivalent effects of intermittent "stop" trials (BF01 = 4.30-5.56). These findings suggest intact self-regulation/performance monitoring in the context of adapting to increased inhibitory demands in ADHD, which has important implications for the continued isolation of potential mechanisms associated with ADHD symptoms and impairment.
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Affiliation(s)
- Whitney D Fosco
- Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, 14260, USA
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, 32306, USA
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Stephanie J Tarle
- Department of Psychology, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Joseph S Raiker
- Department of Psychology, Center for Children & Families, Florida International University, Miami, FL, 33199, USA
| | - Dustin E Sarver
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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Ramos AA, Hamdan AC, Machado L. A meta-analysis on verbal working memory in children and adolescents with ADHD. Clin Neuropsychol 2019; 34:873-898. [PMID: 31007130 DOI: 10.1080/13854046.2019.1604998] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings are inconsistent. The main objective of this meta-analysis was to investigate the performance of children and adolescents with ADHD in the Digit Span Backwards (DSB) subtest from the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale. We also sought to provide an updated meta-analysis on WM in children and adolescents with ADHD.Method: PubMed, PsyINFO, Scopus, and Web of Science were searched to locate studies published between 1990 and 2016 that report DSB scores both of children and adolescents with ADHD and matched controls. Potential moderator variables were also analyzed.Results: Forty-nine studies comparing children and adolescents with ADHD (n = 4956) against healthy controls (n = 3249) generated a medium-sized effect (Hedges' g) of 0.56 (95% CI [0.49, 0.64]), indicating poorer verbal WM performance in those with ADHD. A subgroup meta-analysis of studies with participants aged 8-16 years only demonstrated low heterogeneity (I2 = 17.06, cf. 55.50 for the main analysis). Moreover, the meta-regression showed a negative association (β = -.05, p = .02) between DSB performance differences and increasing age, indicating that for every one year increase in age the effect size decreased by .05.Conclusion: These results, which emanated from the largest meta-analysis concerning verbal WM in ADHD reported to date, reinforce WM as a key domain of cognitive dysfunction in ADHD, and point to age as the main variable influencing DSB performance difficulties.
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Affiliation(s)
- Ari Alex Ramos
- Department of Psychology, Federal University of Paraná, Curitiba, Brazil.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Liana Machado
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Zhao Q, Li H, Yu X, Huang F, Wang Y, Liu L, Cao Q, Qian Q, Zang Y, Sun L, Wang Y. Abnormal Resting-State Functional Connectivity of Insular Subregions and Disrupted Correlation with Working Memory in Adults with Attention Deficit/Hyperactivity Disorder. Front Psychiatry 2017; 8:200. [PMID: 29075206 PMCID: PMC5641567 DOI: 10.3389/fpsyt.2017.00200] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/25/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Executive function (EF) deficits are major impairments in adults with attention deficit/hyperactivity disorder (ADHD). Previous studies have shown that the insula is involved in cognitive and EFs. However, the insula is highly heterogeneous in function, and few studies have focused on functional networks which related to specific insular subregions in adults with ADHD. We explored the functional networks of the insular subregions [anterior insula (AI), mid-insula (MI), and posterior insula (PI)]. Furthermore, their correlations with self-ratings of ecological EFs, including inhibition, shifting, and working memory were investigated. METHODS Resting-state functional magnetic resonance imaging data in 28 adults with ADHD and 30 matched healthy controls (HCs) were analyzed. The seed-based resting-state functional connectivity (RSFC) of the insular subregions was evaluated. We also investigated their associations with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) inhibition, working memory, and shifting factor scores. RESULTS Compared with HCs, adults with ADHD showed altered RSFC of the AI, with the precuneus, precentral gyrus, and inferior temporal gyrus extended to the middle temporal gyrus, lingual gyrus, and superior occipital gyrus, respectively. There were no significant differences in RSFC of the MI and PI between the two groups. Within the HC group, working memory scores were associated with the RSFC of AI with precuneus and temporal gyrus. However, there was no correlation between these variables in the ADHD group. CONCLUSION The study evaluated RSFC patterns of the insular subregions in adults with ADHD for the first time. Altered RSFC of the AI which is a crucial region of salience network (SN) and part of regions in default mode network (DMN), were detected in adults with ADHD in both results with and without global signal regression (GSR), suggesting that disrupted SN-DMN functional connectivity may be involved in EF impairments in adults with ADHD, especially with respect to working memory. Deficits of the AI which is involved in salient stimuli allocation, might be associated with the pathophysiology of ADHD. The inconsistent results of MI and PI between analyses with and without GSR need further exploration.
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Affiliation(s)
- Qihua Zhao
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Hui Li
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Xiaoyan Yu
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Fang Huang
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yanfei Wang
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Qingjiu Cao
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Qiujin Qian
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yufeng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Li Sun
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital, Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
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