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Parlatini V, Radua J, Solanes Font A, Wichers R, Maltezos S, Sanefuji M, Dell'Acqua F, Catani M, Thiebaut de Schotten M, Murphy D. Poor response to methylphenidate is associated with a smaller dorsal attentive network in adult Attention-Deficit/Hyperactivity Disorder (ADHD). Transl Psychiatry 2023; 13:303. [PMID: 37777529 PMCID: PMC10542768 DOI: 10.1038/s41398-023-02598-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 10/02/2023] Open
Abstract
Stimulants, such as methylphenidate (MPH), are effective in treating attention-deficit/hyperactivity disorder (ADHD), but there is individual variability in response, especially in adults. To improve outcomes, we need to understand the factors associated with adult treatment response. This longitudinal study investigated whether pre-treatment anatomy of the fronto-striatal and fronto-parietal attentional networks was associated with MPH treatment response. 60 adults with ADHD underwent diffusion brain imaging before starting MPH treatment, and response was measured at two months. We tested the association between brain anatomy and treatment response by using regression-based approaches; and compared the identified anatomical characteristics with those of 20 matched neurotypical controls in secondary analyses. Finally, we explored whether combining anatomical with clinical and neuropsychological data through machine learning provided a more comprehensive profile of factors associated with treatment response. At a group level, a smaller left dorsal superior longitudinal fasciculus (SLF I), a tract responsible for the voluntary control of attention, was associated with a significantly lower probability of being responders to two-month MPH-treatment. The association between the volume of the left SLF I and treatment response was driven by improvement on both inattentive and hyperactive/impulsive symptoms. Only non-responders significantly differed from controls in this tract metric. Finally, our machine learning approach identified clinico-neuropsychological factors associated with treatment response, such as higher cognitive performance and symptom severity at baseline. These novel findings add to our understanding of the pathophysiological mechanisms underlying response to MPH, pointing to the dorsal attentive network as playing a key role.
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Affiliation(s)
- Valeria Parlatini
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer, CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Aleix Solanes Font
- Institut d'Investigacions Biomediques August Pi i Sunyer, CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Rob Wichers
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Stefanos Maltezos
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Masafumi Sanefuji
- Research Centre for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Flavio Dell'Acqua
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Marco Catani
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Michel Thiebaut de Schotten
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Brain Connectivity and Behaviour Group, Sorbonne Universities, Paris, France
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Declan Murphy
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
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Mehren A, Thiel CM, Bruns S, Philipsen A, Özyurt J. Unimpaired social cognition in adult patients with ADHD: brain volumetric and behavioral results. Soc Cogn Affect Neurosci 2021; 16:1160-1169. [PMID: 33959774 PMCID: PMC8599175 DOI: 10.1093/scan/nsab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
The present study aimed to investigate whether adult patients with attention deficit hyperactivity disorder (ADHD) show deficits in social cognition and to identify the structural neural correlates of social cognitive skills in ADHD. Twenty-six adult patients with ADHD and 26 matched healthy control participants performed the Movie for the Assessment of Social Cognition and underwent a structural magnetic resonance imaging scan. We compared theory of mind (ToM) performance between ADHD patients and healthy controls. Using voxel-based morphometry, we further compared gray matter volumes in regions that are critical for social cognition between the two groups and examined whether ToM performance was correlated with brain morphometry measures. We did not observe any between-group differences in ToM abilities or regional gray matter volumes. Across both groups, performance on affective aspects of ToM correlated positively with gray matter volumes in the medial part of the superior frontal gyri, which is typically involved in social cognition. This study is the first to relate brain structure to social cognitive abilities in adult patients with ADHD. Although our sample was small and heterogeneous, with half of the patients showing mild-to-moderate psychiatric comorbidities, our results may encourage longitudinal studies that relate social cognitive development in childhood and adolescence to brain maturation of ADHD patients.
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Affiliation(s)
- Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53127, Germany
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Christiane Margarete Thiel
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Cluster of Excellence ‘Hearing4all’, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Swantje Bruns
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53127, Germany
| | - Jale Özyurt
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
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Thomson P, Johnson KA, Malpas CB, Efron D, Sciberras E, Silk TJ. Head Motion During MRI Predicted by out-of-Scanner Sustained Attention Performance in Attention-Deficit/Hyperactivity Disorder. J Atten Disord 2021; 25:1429-1440. [PMID: 32189534 DOI: 10.1177/1087054720911988] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To characterize head movements in children with ADHD using an ex-Gaussian distribution and examine associations with out-of-scanner sustained attention. Method: Fifty-six children with ADHD and 61 controls aged 9 to 11 years completed the Sustained Attention to Response Task (SART) and resting-state functional magnetic resonance imaging (fMRI). In-scanner head motion was calculated using ex-Gaussian estimates for mu, sigma, and tau in delta variation signal and framewise displacement. Sustained attention was evaluated through omission errors and tau in response time on the SART. Results: Mediation analysis revealed that out-of-scanner attention lapses (omissions during the SART) mediated the relationship between ADHD diagnosis and in-scanner head motion (tau in delta variation signal), indirect effect: B = 1.29, 95% confidence interval (CI) = [0.07, 3.15], accounting for 29% of the association. Conclusion: Findings suggest a critical link between trait-level sustained attention and infrequent large head movements during scanning (tau in head motion) and highlight fundamental challenges in measuring the neural basis of sustained attention.
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Affiliation(s)
- Phoebe Thomson
- The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Charles B Malpas
- The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Daryl Efron
- The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Emma Sciberras
- The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia.,Deakin University, Burwood, Victoria, Australia
| | - Timothy J Silk
- The University of Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Deakin University, Burwood, Victoria, Australia
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Detecting microstructural white matter abnormalities of frontal pathways in children with ADHD using advanced diffusion models. Brain Imaging Behav 2021; 14:981-997. [PMID: 31041662 DOI: 10.1007/s11682-019-00108-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Studies using diffusion tensor imaging (DTI) have documented alterations in the attention and executive system in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). While abnormalities in the frontal lobe have also been reported, the associated white matter fiber bundles have not been investigated comprehensively due to the complexity in tracing them through fiber crossings. Furthermore, most studies have used a non-specific DTI model to understand white matter abnormalities. We present results from a first study that uses a multi-shell diffusion MRI (dMRI) data set coupled with an advanced multi-fiber tractography algorithm to probe microstructural measures related to axonal/cellular density and volume of fronto-striato-thalamic pathways in children with ADHD (N = 30) and healthy controls (N = 28). Head motion was firstly examined as a priority in order to assure that no group difference existed. We investigated 45 different white matter fiber bundles in the brain. After correcting for multiple comparisons, we found lower axonal/cellular packing density and volume in ADHD children in 8 of the 45 fiber bundles, primarily in the right hemisphere as follows: 1) Superior longitudinal fasciculus-II (SLF-II) (right), 2) Thalamus to precentral gyrus (right), 3) Thalamus to superior-frontal gyrus (right), 4) Caudate to medial orbitofrontal gyrus (right), 5) Caudate to precentral gyrus (right), 6) Thalamus to paracentral gyrus (left), 7) Caudate to caudal middlefrontal gyrus (left), and 8) Cingulum (bilateral). Our results demonstrate reduced axonal/cellular density and volume in certain frontal lobe white matter fiber tracts, which sub-serve the attention function and executive control systems. Further, our work shows specific microstructural abnormalities in the striato-thalamo-cortical connections, which have not been previously reported in children with ADHD.
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Leeman-Markowski BA, Adams J, Martin SP, Devinsky O, Meador KJ. Methylphenidate for attention problems in epilepsy patients: Safety and efficacy. Epilepsy Behav 2021; 115:107627. [PMID: 33360744 PMCID: PMC7884102 DOI: 10.1016/j.yebeh.2020.107627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including anti-seizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. Methylphenidate represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.
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Affiliation(s)
- Beth A Leeman-Markowski
- Research Service, VA New York Harbor Healthcare System, 423 E. 23rd St., New York, NY 10010, United States; Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY 10016, United States.
| | - Jesse Adams
- Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305-5723, United States.
| | - Samantha P Martin
- Research Service, VA New York Harbor Healthcare System, 423 E. 23rd St., New York, NY 10010, United States; Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY 10016, United States.
| | - Orrin Devinsky
- Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY 10016, United States; Department of Neurosurgery, New York University Langone Health, 660 1st Ave. #5, New York, NY 10016, United States; Department of Psychiatry, New York University Langone Health, 550 1st Ave., New York, NY 10016, United States.
| | - Kimford J Meador
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, 213 Quarry Road, MC 5979 (room 2856), Palo Alto, CA 94304-5979, United States.
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Chen S, Guan L, Tang J, He F, Zheng Y. Asymmetry in Cortical and Subcortical Structures of the Brain in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Neuropsychiatr Dis Treat 2021; 17:493-502. [PMID: 33603386 PMCID: PMC7886251 DOI: 10.2147/ndt.s292444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Human cognitive and emotional functions are asymmetrical between the left and right hemispheres. In neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) patients, the absence of aberrant asymmetry might serve as a neuroanatomical marker of ADHD. However, few studies have estimated abnormalities in cortical and subcortical asymmetry in children and adolescents of different ADHD subtypes. METHODS Data were from the results collected by the Peking University site in the "ADHD-200 sample" dataset, which comprised 31 eligible ADHD (20 inattentive ADHD (ADHD-I), 11 combined ADHD (ADHD-C)) and 31 matched typically developing (TD) individuals. The Asymmetry Indexes (AIs) in cortical thickness, cortical gray-matter volume and subcortical nucleus (SN) volume were calculated based on an automated surface-based approach. The differences in cortical thickness, cortical gray-matter volume, and SN volume AIs were evaluated among groups. We also analyzed the correlation between AIs and the severity of ADHD symptoms. RESULTS Compared with the TD group, SN asymmetry in ADHD group did not reveal significant differences. Altered cortical asymmetry of different subtypes in ADHD groups was located in the orbitofrontal and anterior cingulate circuits, including the medial orbitofrontal, paracentral, pars triangularis, caudal anterior cingulate, isthmus cingulate, and superior frontal regions. In the comparisons, cortical gray-matter volume AIs were significantly different in the caudal anterior cingulate, isthmus cingulate, and superior frontal regions between ADHD-I and ADHD-C groups. There were significant correlations between the severity of ADHD symptoms and asymmetric measurements in medial orbitofrontal, paracentral and isthmus cingulate regions. CONCLUSION These findings provide further evidence for the altered cortical morphological asymmetry in children and adolescents with ADHD, and these differences are associated (at least in part) with the severity of ADHD symptoms. Brain asymmetry could be an appropriate precursor of morphological alterations in neurodevelopmental disorders.
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Affiliation(s)
- Sijian Chen
- Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
| | - Lin Guan
- Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
| | - Jie Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
| | - Fan He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Yi Zheng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
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Jang KM, Kim MS, Kim DW. The Dynamic Properties of a Brain Network During Spatial Working Memory Tasks in College Students With ADHD Traits. Front Hum Neurosci 2020; 14:580813. [PMID: 33132887 PMCID: PMC7505193 DOI: 10.3389/fnhum.2020.580813] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
This study investigated deficits of spatial working memory in college students with attention-deficit/hyperactivity disorder (ADHD) traits using event-related potentials (ERPs) and the spatial 2-back task. We also computed sensory-level activity using EEG data and investigated theta and alpha neural oscillations, phase-locking values (PLV), and brain networks. Based on the scores from the Adult ADHD Self-Report Scale (ASRS) and Conners' Adult ADHD Rating Scales (CAARS), an ADHD-trait group (n = 40) and a normal control group (n = 41) were selected. Participants were required to respond to whether the presented stimulus was at the same location as that presented two trials earlier. The ADHD-trait group showed significantly slower response times than the control group in the spatial 2-back task. In terms of spectrum, the ADHD-trait group showed significantly reduced theta power than the control group. In contrast, the ADHD-trait group exhibited an increased alpha power compared to the control group with the 250-1000 ms interval after stimulus onset. In terms of the PLV, the ADHD-trait group showed significantly weaker theta phase synchrony and fewer connection numbers in frontal-occipital areas than the control group. In terms of the theta brain network, the ADHD-trait group showed a significantly lower clustering coefficient and longer characteristic path length than the control group for the theta band. The present results indicate that college students with ADHD traits have deficits in spatial working memory and that these abnormal activities in neural oscillation, functional connectivity, and the network may contribute to spatial working memory deficits.
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Affiliation(s)
- Kyoung-Mi Jang
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Myung-Sun Kim
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Do-Won Kim
- Department of Biomedical Engineering, Chonnam National University, Yeosu, South Korea
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Capri T, Santoddi E, Fabio RA. Multi-Source Interference Task paradigm to enhance automatic and controlled processes in ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 97:103542. [PMID: 31812886 DOI: 10.1016/j.ridd.2019.103542] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The role of automatic and controlled processes in children with Attention deficit hyperactivity disorder (ADHD) has recently been debated. Most theories on ADHD assume that core deficits are related to controlled processes and executive function. AIMS The main aim of the present study is to examine automatic and controlled attention in children with ADHD, compared to TD subjects. METHODS AND PROCEDURES Twenty ADHD-I children, 20 with ADHD-C and 20 typical developing children performed the Block-Formed Multi-Source Interference Task (MSIT) both in incongruent and congruent conditions. OUTCOME AND RESULTS Results show that clinical groups had a poorer performance than the TD group in both conditions. CONCLUSIONS AND IMPLICATIONS This study demonstrated that children with ADHD exhibit a deficit both in automatic and controlled processes.
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Affiliation(s)
- Tindara Capri
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98100, Messina, Italy.
| | - Erika Santoddi
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98100, Messina, Italy.
| | - Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98100, Messina, Italy.
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Shang CY, Sheng C, Yang LK, Chou TL, Gau SSF. Differential brain activations in adult attention-deficit/ hyperactivity disorder subtypes: a counting Stroop functional MRI study. Brain Imaging Behav 2019; 12:882-890. [PMID: 28699075 DOI: 10.1007/s11682-017-9749-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although previous functional neuroimaging studies have found abnormal brain activations in individuals with attention deficit hyperactivity disorder (ADHD), little was known about distinct brain dysfunctions across different ADHD subtypes. The objective of the present study was to investigate the abnormal brain activations associated with two ADHD subtypes, predominantly inattentive (ADHD-PI) and combined (ADHD-C) subtypes. Twenty-five adults with ADHD-PI, 25 with ADHD-C, and 30 healthy controls (HC) participated in this study. The brain function of the participants were assessed by using the counting Stroop task inside the scanner and the Conners' Continuous Performance Test (CCPT) outside the scanner. The HC group showed greater activations in the caudate nucleus and inferior frontal gyrus (IFG) than the ADHD-PI and ADHD-C groups. The ADHD-PI group showed greater activations in the superior parietal lobule (SPL) than the ADHD-C group. In all participants with ADHD, we found negative correlations of activation in the left caudate and the left IFG with the standard deviation of the reaction time of the CCPT, and negative correlations of activation in the left SPL with the reaction time changes across different inter-stimulus intervals. Our results demonstrated altered brain activity in the frontostriatal networks of adults with ADHD-PI and the fronto-striato-parietal networks of adults with ADHD-C. Abnormalities in the parietal areas may represent the main difference between the ADHD-PI and ADHD-C subtypes.
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Affiliation(s)
- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chia Sheng
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.,Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tai-Li Chou
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan. .,Department of Psychology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan. .,Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan. .,Department of Psychology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
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Cheng B, Du Y, Wen Y, Zhao Y, He A, Ding M, Fan Q, Li P, Liu L, Liang X, Guo X, Zhang F, Ma X. Integrative analysis of genome-wide association study and chromosomal enhancer maps identified brain region related pathways associated with ADHD. Compr Psychiatry 2019; 88:65-69. [PMID: 30529763 DOI: 10.1016/j.comppsych.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 10/24/2018] [Accepted: 11/14/2018] [Indexed: 12/17/2022] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is among the most common childhood onset psychiatric behavioral disorders, and the pathogenesis of ADHD is still unclear. Utilizing the latest genome wide association studies (GWAS) data and enhancer map, we explored the brain region related biological pathways associated with ADHD. The GWAS summary data of ADHD was driven from a published study, involving 20,183 ADHD cases and 35,191 healthy controls. The brain-related enhancer map was collected from ENCODE and Roadmap Epigenomics (ENCODE + Roadmap) including 489,581 enhancers. Firstly, the chromosomal enhancer maps of four brain regions were aligned with the ADHD GWAS summary data in order to obtain enhancer SNPs. Then the significant enhancers SNPs were subjected to the gene set enrichment analysis (GSEA) for identifying ADHD associated gene sets. A total of 866 pathways and 4 brain tissues were analyzed in this study. We detected several candidate genes for ADHD, such as AHI1, ALG2 and DNM1. We also detected several candidate biological pathways associated with ADHD, such as Reactome SEMA4D in semaphorin signaling and Reactome NCAM1 interactions. Our findings may provide a novel insight into the complex genetic mechanism of ADHD.
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Affiliation(s)
- Bolun Cheng
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Yanan Du
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Yan Wen
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Yan Zhao
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Awen He
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Miao Ding
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Qianrui Fan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Ping Li
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Li Liu
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiao Liang
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiong Guo
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Feng Zhang
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China.
| | - Xiancang Ma
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China.
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Zhao X, Rangaprakash D, Yuan B, Denney TS, Katz JS, Dretsch MN, Deshpande G. Investigating the Correspondence of Clinical Diagnostic Grouping With Underlying Neurobiological and Phenotypic Clusters Using Unsupervised Machine Learning. FRONTIERS IN APPLIED MATHEMATICS AND STATISTICS 2018; 4:25. [PMID: 30393630 PMCID: PMC6214192 DOI: 10.3389/fams.2018.00025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Many brain-based disorders are traditionally diagnosed based on clinical interviews and behavioral assessments, which are recognized to be largely imperfect. Therefore, it is necessary to establish neuroimaging-based biomarkers to improve diagnostic precision. Resting-state functional magnetic resonance imaging (rs-fMRI) is a promising technique for the characterization and classification of varying disorders. However, most of these classification methods are supervised, i.e., they require a priori clinical labels to guide classification. In this study, we adopted various unsupervised clustering methods using static and dynamic rs-fMRI connectivity measures to investigate whether the clinical diagnostic grouping of different disorders is grounded in underlying neurobiological and phenotypic clusters. In order to do so, we derived a general analysis pipeline for identifying different brain-based disorders using genetic algorithm-based feature selection, and unsupervised clustering methods on four different datasets; three of them-ADNI, ADHD-200, and ABIDE-which are publicly available, and a fourth one-PTSD and PCS-which was acquired in-house. Using these datasets, the effectiveness of the proposed pipeline was verified on different disorders: Attention Deficit Hyperactivity Disorder (ADHD), Alzheimer's Disease (AD), Autism Spectrum Disorder (ASD), Post-Traumatic Stress Disorder (PTSD), and Post-Concussion Syndrome (PCS). For ADHD and AD, highest similarity was achieved between connectivity and phenotypic clusters, whereas for ASD and PTSD/PCS, highest similarity was achieved between connectivity and clinical diagnostic clusters. For multi-site data (ABIDE and ADHD-200), we report site-specific results. We also reported the effect of elimination of outlier subjects for all four datasets. Overall, our results suggest that neurobiological and phenotypic biomarkers could potentially be used as an aid by the clinician, in additional to currently available clinical diagnostic standards, to improve diagnostic precision. Data and source code used in this work is publicly available at https://github.com/xinyuzhao/identification-of-brain-based-disorders.git.
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Affiliation(s)
- Xinyu Zhao
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Quora, Inc., Mountain View, CA, United States
| | - D. Rangaprakash
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Bowen Yuan
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
| | - Thomas S. Denney
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Department of Psychology, Auburn University, Auburn, AL, United States
- Alabama Advanced Imaging Consortium, Auburn University, University of Alabama at Birmingham, Birmingham, AL, United States
- Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Jeffrey S. Katz
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Department of Psychology, Auburn University, Auburn, AL, United States
- Alabama Advanced Imaging Consortium, Auburn University, University of Alabama at Birmingham, Birmingham, AL, United States
- Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Michael N. Dretsch
- Human Dimension Division, HQ TRADOC, Fort Eustis, VA, United States
- U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL, United States
| | - Gopikrishna Deshpande
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Department of Psychology, Auburn University, Auburn, AL, United States
- Alabama Advanced Imaging Consortium, Auburn University, University of Alabama at Birmingham, Birmingham, AL, United States
- Center for Neuroscience, Auburn University, Auburn, AL, United States
- Center for Health Ecology and Equity Research, Auburn University, Auburn, AL, United States
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12
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Bachmann K, Lam AP, Sörös P, Kanat M, Hoxhaj E, Matthies S, Feige B, Müller H, Özyurt J, Thiel CM, Philipsen A. Effects of mindfulness and psychoeducation on working memory in adult ADHD: A randomised, controlled fMRI study. Behav Res Ther 2018; 106:47-56. [DOI: 10.1016/j.brat.2018.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/16/2018] [Accepted: 05/03/2018] [Indexed: 01/22/2023]
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13
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Salavert J, Ramos-Quiroga JA, Moreno-Alcázar A, Caseras X, Palomar G, Radua J, Bosch R, Salvador R, McKenna PJ, Casas M, Pomarol-Clotet E. Functional Imaging Changes in the Medial Prefrontal Cortex in Adult ADHD. J Atten Disord 2018; 22:679-693. [PMID: 26515892 DOI: 10.1177/1087054715611492] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Functional imaging studies have found reduced frontal activity, mainly in dorso/ventro-lateral regions and reduced task-related de-activation of the default mode network in childhood ADHD. Adult studies are fewer and inconclusive. We aimed to investigate the potential neural bases of executive function in ADHD adults, examining brain activity during N-back task performance, and to explore the potential corrective effects of long-term methylphenidate treatment. METHOD We recruited a large adult ADHD-combined sample and a matched control group and obtained functional magnetic resonance imaging (fMRI) images during task. ADHD participants were subdivided in a group under long-term treatment with methylphenidate (washed out for the scan) and a treatment-naive group. RESULTS ADHD participants showed deficient de-activation of the medial prefrontal cortex during 2-back task, implying default mode network dysfunction. We found no relationship between blunted de-activation and treatment history. CONCLUSION As de-activation failure in the medial frontal cortex is linked to lapses of attention, findings suggest a potential link to ADHD symptomatology.
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Affiliation(s)
- José Salavert
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,2 Hospital Sant Rafael, Germanes Hospitalàries, Barcelona, Spain.,3 Universitat Autònoma de Barcelona, Spain
| | - Josep A Ramos-Quiroga
- 3 Universitat Autònoma de Barcelona, Spain.,4 CIBERSAM, Madrid, Spain.,5 Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Moreno-Alcázar
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,4 CIBERSAM, Madrid, Spain
| | | | - Gloria Palomar
- 3 Universitat Autònoma de Barcelona, Spain.,4 CIBERSAM, Madrid, Spain.,5 Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Joaquim Radua
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,4 CIBERSAM, Madrid, Spain.,7 King's College London, UK.,8 Karolinska Institutet, Stokholm, Sweden
| | - Rosa Bosch
- 3 Universitat Autònoma de Barcelona, Spain.,4 CIBERSAM, Madrid, Spain.,5 Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Raymond Salvador
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,4 CIBERSAM, Madrid, Spain
| | - Peter J McKenna
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,4 CIBERSAM, Madrid, Spain
| | - Miquel Casas
- 3 Universitat Autònoma de Barcelona, Spain.,4 CIBERSAM, Madrid, Spain.,5 Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Edith Pomarol-Clotet
- 1 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,4 CIBERSAM, Madrid, Spain
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14
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Rubia K. Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation. Front Hum Neurosci 2018; 12:100. [PMID: 29651240 PMCID: PMC5884954 DOI: 10.3389/fnhum.2018.00100] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/05/2018] [Indexed: 01/01/2023] Open
Abstract
This review focuses on the cognitive neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) based on functional magnetic resonance imaging (fMRI) studies and on recent clinically relevant applications such as fMRI-based diagnostic classification or neuromodulation therapies targeting fMRI deficits with neurofeedback (NF) or brain stimulation. Meta-analyses of fMRI studies of executive functions (EFs) show that ADHD patients have cognitive-domain dissociated complex multisystem impairments in several right and left hemispheric dorsal, ventral and medial fronto-cingulo-striato-thalamic and fronto-parieto-cerebellar networks that mediate cognitive control, attention, timing and working memory (WM). There is furthermore emerging evidence for abnormalities in orbital and ventromedial prefrontal and limbic areas that mediate motivation and emotion control. In addition, poor deactivation of the default mode network (DMN) suggests an abnormal interrelationship between hypo-engaged task-positive and poorly "switched off" hyper-engaged task-negative networks, both of which are related to impaired cognition. Translational cognitive neuroscience in ADHD is still in its infancy. Pattern recognition analyses have attempted to provide diagnostic classification of ADHD using fMRI data with respectable classification accuracies of over 80%. Necessary replication studies, however, are still outstanding. Brain stimulation has been tested in heterogeneously designed, small numbered proof of concept studies targeting key frontal functional impairments in ADHD. Transcranial direct current stimulation (tDCS) appears to be promising to improve ADHD symptoms and cognitive functions based on some studies, but larger clinical trials of repeated stimulation with and without cognitive training are needed to test clinical efficacy and potential costs on non-targeted functions. Only three studies have piloted NF of fMRI-based frontal dysfunctions in ADHD using fMRI or near-infrared spectroscopy, with the two larger ones finding some improvements in cognition and symptoms, which, however, were not superior to the active control conditions, suggesting potential placebo effects. Neurotherapeutics seems attractive for ADHD due to their safety and potential longer-term neuroplastic effects, which drugs cannot offer. However, they need to be thoroughly tested for short- and longer-term clinical and cognitive efficacy and their potential for individualized treatment.
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Affiliation(s)
- Katya Rubia
- Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
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15
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Das D, Cherbuin N, Anstey KJ, Abhayaratna W, Easteal S. Regional Brain Volumes and ADHD Symptoms in Middle-Aged Adults: The PATH Through Life Study. J Atten Disord 2017; 21:1073-1086. [PMID: 24567365 DOI: 10.1177/1087054714523316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We investigated whether volumetric differences in ADHD-associated brain regions are related to current symptoms of inattention and hyperactivity in healthy middle-aged adults and whether co-occurring anxiety/depression symptoms moderate these relationships. METHOD ADHD Self-Report Scale and Brief Patient Health Questionnaire were used to assess current symptoms of inattention, hyperactivity, anxiety, and depression in a population-based sample ( n = 269). Brain volumes, measured using a semi-automated method, were analyzed using multiple regression and structural equation modeling to evaluate brain volume-inattention/hyperactivity symptom relationships for selected regions. RESULTS Volumes of the left nucleus accumbens and a region overlapping the dorsolateral prefrontal cortex were positively associated with inattention symptoms. Left hippocampal volume was negatively associated with hyperactivity symptoms. The brain volume-inattention/hyperactivity symptom associations were stronger when anxiety/depression symptoms were controlled for. CONCLUSION Inattention and hyperactivity symptoms in middle-aged adults are associated with different brain regions and co-occurring anxiety/depression symptoms moderate these brain-behavior relationships.
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Affiliation(s)
- Debjani Das
- 1 Australian National University, Canberra, Australia
| | | | | | - Walter Abhayaratna
- 1 Australian National University, Canberra, Australia.,2 Canberra Hospital and Health Services, Australia
| | - Simon Easteal
- 1 Australian National University, Canberra, Australia
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16
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Newman E, Jernigan TL, Lisdahl KM, Tamm L, Tapert SF, Potkin SG, Mathalon D, Molina B, Bjork J, Castellanos FX, Swanson J, Kuperman JM, Bartsch H, Chen CH, Dale AM, Epstein JN. Go/No Go task performance predicts cortical thickness in the caudal inferior frontal gyrus in young adults with and without ADHD. Brain Imaging Behav 2017; 10:880-92. [PMID: 26404018 DOI: 10.1007/s11682-015-9453-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Response inhibition deficits are widely believed to be at the core of Attention-Deficit Hyperactivity Disorder (ADHD). Several studies have examined neural architectural correlates of ADHD, but research directly examining structural correlates of response inhibition is lacking. Here we examine the relationship between response inhibition as measured by a Go/No Go task, and cortical surface area and thickness of the caudal inferior frontal gyrus (cIFG), a region implicated in functional imaging studies of response inhibition, in a sample of 114 young adults with and without ADHD diagnosed initially during childhood. We used multiple linear regression models to test the hypothesis that Go/No Go performance would be associated with cIFG surface area or thickness. Results showed that poorer Go/No Go performance was associated with thicker cIFG cortex, and this effect was not mediated by ADHD status or history of substance use. However, independent of Go/No Go performance, persistence of ADHD symptoms and more frequent cannabis use were associated with thinner cIFG. Go/No Go performance was not associated with cortical surface area. The association between poor inhibitory functioning and thicker cIFG suggests that maturation of this region may differ in low performing participants. An independent association of persistent ADHD symptoms and frequent cannabis use with thinner cIFG cortex suggests that distinct neural mechanisms within this region may play a role in inhibitory function, broader ADHD symptomatology, and cannabis use. These results contribute to Research Domain Criteria (RDoC) by revealing novel associations between neural architectural phenotypes and basic neurobehavioral processes measured dimensionally.
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Affiliation(s)
- Erik Newman
- Center for Human Development, University of California, 9500 Gilman Drive, MC 0115, La Jolla, CA, 92093, USA.
| | - Terry L Jernigan
- Center for Human Development, University of California, 9500 Gilman Drive, MC 0115, La Jolla, CA, 92093, USA.,Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Leanne Tamm
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Steven G Potkin
- Department of Psychiatry, University of California, Irvine, Irvine, CA, USA
| | - Daniel Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Brooke Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - James Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - F Xavier Castellanos
- Department of Child and Adolescent Psychiatry, Child Study Center at NYU Langone Medical Center, New York, NY, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - James Swanson
- The Child Development Center, University of California, Irvine, Irvine, CA, USA
| | - Joshua M Kuperman
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Hauke Bartsch
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Chi-Hua Chen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.,Department of Radiology, University of California, San Diego, La Jolla, CA, USA.,Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Jeffery N Epstein
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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17
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Rapin L, Poissant H, Mendrek A. Atypical Activations of Fronto-Cerebellar Regions During Forethought in Parents of Children With ADHD. J Atten Disord 2017; 21:1050-1058. [PMID: 24591263 DOI: 10.1177/1087054714524983] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although several studies suggest heritability of ADHD, only a few investigations of possible associations between people at risk and neural abnormalities in ADHD exist. In this study, we tested whether parents of children with ADHD would show atypical patterns of cerebral activations during forethought, a feature of working memory. METHOD Using Functional Magnetic Resonance Imaging (fMRI), we compared 12 parents of children with ADHD and 9 parents of control children during a forethought task. RESULTS Parents of children with ADHD exhibited significantly increased neural activations in the posterior lobes of the cerebellum and in the left inferior frontal gyrus, relative to parents of control children. CONCLUSION These findings are consistent with previous reports in children and suggest the fronto-cerebellar circuit's abnormalities during forethought in parents of children with ADHD. Future studies of people at risk of ADHD are needed to fully understand the extent of the fronto-cerebellar heritability.
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18
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Son YD, Han DH, Kim SM, Min KJ, Renshaw PF. A functional connectivity comparison between attention deficit hyperactivity disorder and bipolar disorder in medication-naïve adolescents with mood fluctuation and attention problems. Psychiatry Res Neuroimaging 2017; 263:1-7. [PMID: 28264765 DOI: 10.1016/j.pscychresns.2017.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 11/23/2022]
Abstract
In order to compare patterns of connectivity between affective and attention networks in adolescents with bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD), we investigated differences in resting state functional connectivity (RSFC) between these populations. Study participants were medication-naïve adolescents (aged 13-18 years) with BD (N=22) or ADHD (N=25) and age- and sex-matched healthy adolescents (healthy controls [HC]) (N=22). Forty-seven adolescents with mood fluctuation and attention problems showed increased functional correlation (FC) between two pairs of regions within the affective network (AFN), compared to 22 HC: the left orbitofrontal cortex (OFC) to the left thalamus and the left OFC to the right thalamus. In post-hoc testing, adolescents with BD showed increased FC between two pairs of regions compared to ADHD: the right amygdala to the left temporoparietal junction (TPJ) and the right amygdala to the right TPJ. Adolescents with BD showed increased FC within the attention network (ATN) as well as increased FC between the ATN and the AFN, while those with ADHD showed decreased FC within the ATN. The current suggests that these features could be used as biomarkers for differentiating BD from ADHD in adolescents.
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Affiliation(s)
- Young Don Son
- Department of Biomedical Engineering, Gachon University, Incheon, South Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea.
| | - Sun Mi Kim
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea
| | - Perry F Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, USA
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19
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Tao J, Jiang X, Wang X, Liu H, Qian A, Yang C, Chen H, Li J, Ye Q, Wang J, Wang M. Disrupted Control-Related Functional Brain Networks in Drug-Naive Children with Attention-Deficit/Hyperactivity Disorder. Front Psychiatry 2017; 8:246. [PMID: 29209238 PMCID: PMC5702526 DOI: 10.3389/fpsyt.2017.00246] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/06/2017] [Indexed: 11/13/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disease featuring executive control deficits as a prominent neuropsychological trait. Executive functions are implicated in multiple sub-networks of the brain; however, few studies examine these sub-networks as a whole in ADHD. By combining resting-state functional MRI and graph-based approaches, we systematically investigated functional connectivity patterns among four control-related networks, including the frontoparietal network (FPN), cingulo-opercular network, cerebellar network, and default mode network (DMN), in 46 drug-naive children with ADHD and 31 age-, gender-, and intelligence quotient-matched healthy controls (HCs). Compared to the HCs, the ADHD children showed significantly decreased functional connectivity that primarily involved the DMN and FPN regions and cross-network long-range connections. Further graph-based network analysis revealed that the ADHD children had fewer connections, lower network efficiency, and more functional modules compared with the HCs. The ADHD-related alterations in functional connectivity but not topological organization were correlated with clinical symptoms of the ADHD children and differentiated the patients from the HCs with a good performance. Taken together, our findings suggest a less-integrated functional brain network in children with ADHD due to selective disruption of key long-range connections, with important implications for understanding the neural substrates of ADHD, particularly executive dysfunction.
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Affiliation(s)
- Jiejie Tao
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Xueyan Jiang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Xin Wang
- Department of Radiology, Yancheng First Peoples' Hospital, Yancheng, China
| | - Huiru Liu
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Andan Qian
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Chuang Yang
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Jiance Li
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Qiong Ye
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Jinhui Wang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Meihao Wang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
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20
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Fuermaier ABM, Tucha L, Koerts J, Weisbrod M, Lange KW, Aschenbrenner S, Tucha O. Effects of methylphenidate on memory functions of adults with ADHD. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:199-211. [DOI: 10.1080/23279095.2015.1124108] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
- Section for Experimental Psychopathology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Klaus W. Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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21
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Deficient interference control during working memory updating in adults with ADHD: An event-related potential study. Clin Neurophysiol 2016; 127:452-463. [DOI: 10.1016/j.clinph.2015.05.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/30/2015] [Accepted: 05/13/2015] [Indexed: 11/23/2022]
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22
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Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review. Harv Rev Psychiatry 2015; 23:245-62. [PMID: 26052877 PMCID: PMC4495876 DOI: 10.1097/hrp.0000000000000050] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The concept of comorbidity between attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) has been discussed for two decades. No review, however, has examined this question in light of the stark contrast in disorder-specific phenomenology and neurobiology. We review reported prevalence rates and the methodological, phenomenological, and theoretical issues concerning concomitant ADHD-OCD. Reported co-occurrence rates are highly inconsistent in the literature. Studies aimed at examining the potential for comorbidity have suffered from various methodological problems, including the existence of very few community samples, highly variable exclusionary criteria, and possible clinical misinterpretation of symptoms. Despite numerous studies suggesting an ADHD-OCD comorbidity, thus far etiological (i.e., genetic) backing has been provided only for a pediatric comorbidity. Additionally, inflated rates of ADHD-OCD co-occurrence may be mediated by the presence of tic disorders, and evidence of impaired neuronal maturational processes in pediatric OCD may lead to possibly transient phenotypical expressions that resemble ADHD symptomatology. Thus, clinicians are encouraged to consider the possibility that ADHD-like symptoms resulting from OCD-specific symptomatology may be misdiagnosed as ADHD. This suggestion may account for the lower co-occurrence rates reported in adolescents and adults and for the lack of a theoretical account for comorbidity in these age groups. Existing literature is summarized and critically reviewed, and recommendations are made for future research.
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23
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Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A. Are Motivation Deficits Underestimated in Patients With ADHD? A Review of the Literature. Postgrad Med 2015; 125:47-52. [DOI: 10.3810/pgm.2013.07.2677] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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24
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Case-control genome-wide association study of persistent attention-deficit hyperactivity disorder identifies FBXO33 as a novel susceptibility gene for the disorder. Neuropsychopharmacology 2015; 40:915-26. [PMID: 25284319 PMCID: PMC4330505 DOI: 10.1038/npp.2014.267] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/22/2014] [Accepted: 09/05/2014] [Indexed: 12/14/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high heritability. At least 30% of patients diagnosed in childhood continue to suffer from ADHD during adulthood and genetic risk factors may play an essential role in the persistence of the disorder throughout lifespan. To date, genome-wide association studies (GWAS) of ADHD have been completed in seven independent datasets, six of which were pediatric samples and one on persistent ADHD using a DNA-pooling strategy, but none of them reported genome-wide significant associations. In an attempt to unravel novel genes for the persistence of ADHD into adulthood, we conducted the first two-stage GWAS in adults with ADHD. The discovery sample included 607 ADHD cases and 584 controls. Top signals were subsequently tested for replication in three independent follow-up samples of 2104 ADHD patients and 1901 controls. None of the findings exceeded the genome-wide threshold for significance (PGC<5e-08), but we found evidence for the involvement of the FBXO33 (F-box only protein 33) gene in combined ADHD in the discovery sample (P=9.02e-07) and in the joint analysis of both stages (P=9.7e-03). Additional evidence for a FBXO33 role in ADHD was found through gene-wise and pathway enrichment analyses in our genomic study. Risk alleles were associated with lower FBXO33 expression in lymphoblastoid cell lines and with reduced frontal gray matter volume in a sample of 1300 adult subjects. Our findings point for the first time at the ubiquitination machinery as a new disease mechanism for adult ADHD and establish a rationale for searching for additional risk variants in ubiquitination-related genes.
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Fuermaier AB, Tucha L, Koerts J, Aschenbrenner S, Weisbrod M, Lange KW, Tucha O. Cognitive Complaints of Adults With Attention Deficit Hyperactivity Disorder. Clin Neuropsychol 2014; 28:1104-22. [DOI: 10.1080/13854046.2014.964325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sebastian A, Jung P, Krause-Utz A, Lieb K, Schmahl C, Tüscher O. Frontal dysfunctions of impulse control - a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder. Front Hum Neurosci 2014; 8:698. [PMID: 25232313 PMCID: PMC4153044 DOI: 10.3389/fnhum.2014.00698] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/20/2014] [Indexed: 12/20/2022] Open
Abstract
Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.
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Affiliation(s)
- Alexandra Sebastian
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg-University , Mainz , Germany
| | - Patrick Jung
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg-University , Mainz , Germany
| | - Annegret Krause-Utz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Klaus Lieb
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg-University , Mainz , Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Oliver Tüscher
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg-University , Mainz , Germany ; Department of Neurology, Albert-Ludwigs-University Medical Center , Freiburg , Germany
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Rubia K, Alegria A, Brinson H. Imaging the ADHD brain: disorder-specificity, medication effects and clinical translation. Expert Rev Neurother 2014; 14:519-38. [PMID: 24738703 DOI: 10.1586/14737175.2014.907526] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A plethora of magnetic resonance imaging studies have shown that ADHD is characterized by multiple functional and structural neural network abnormalities beyond the classical fronto-striatal model, including fronto-parieto-temporal, fronto-cerebellar and even fronto-limbic networks. There is evidence for a maturational delay in brain structure development which likely extends to brain function and structural and functional connectivity, but this needs corroboration by longitudinal imaging studies. Dysfunction of the ventrolateral prefrontal cortex seems to be more pronounced relative to other pediatric disorders and is also the most consistent target of acute psychostimulant medication. Future studies are likely to focus on using neuroimaging for clinical translation such as for individual diagnostic and prognostic classification and as a neurotherapy to reverse brain function abnormalities.
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Affiliation(s)
- Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
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Cao M, Shu N, Cao Q, Wang Y, He Y. Imaging Functional and Structural Brain Connectomics in Attention-Deficit/Hyperactivity Disorder. Mol Neurobiol 2014; 50:1111-23. [PMID: 24705817 DOI: 10.1007/s12035-014-8685-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 03/23/2014] [Indexed: 01/05/2023]
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Banich MT. Brain imaging of the neural systems affected in adults with attention-deficit/hyperactivity disorder. Expert Rev Neurother 2014. [DOI: 10.1586/ern.10.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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van Schouwenburg M, Onnink A, ter Huurne N, Kan C, Zwiers M, Hoogman M, Franke B, Buitelaar J, Cools R. Cognitive flexibility depends on white matter microstructure of the basal ganglia. Neuropsychologia 2014; 53:171-7. [DOI: 10.1016/j.neuropsychologia.2013.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 11/03/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
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Robb A, Findling RL. Challenges in the transition of care for adolescents with attention-deficit/hyperactivity disorder. Postgrad Med 2013; 125:131-40. [PMID: 23933901 DOI: 10.3810/pgm.2013.07.2685] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is often considered a childhood disorder. However, in those diagnosed with ADHD as children, inattention, impulsivity, and hyperactivity can persist into adulthood, causing significant functional impairment and emotional distress, even if the condition no longer meets diagnostic criteria. This review examines the developmental and psychosocial factors to consider in adolescents with ADHD and the strategies that facilitate the transition from pediatric to adult care. Our findings are based on PubMed database searches conducted on November 29, 2011, that identified articles pertaining to ADHD and continuity or transition in medical care for adolescents published in English within the 5-year period preceding this date. Adolescents with ADHD face specific burdens associated with transitioning into adulthood that can impede the achievement of academic and occupational goals. The main finding of the literature review was that ADHD treatment rates decline sharply from childhood through young adulthood, despite the fact that functional impairment often persists. Moreover, although psychosocial therapy can play an important role in resolving functional difficulties and encouraging patient adherence to pharmacotherapy, the existing literature focuses mainly on pharmacotherapy as first-line treatment for ADHD. Therefore, careful, advanced planning to ensure continuity of medical and psychiatric care is essential. This planning involves the pediatric service that has been providing care, the adult service that will assume the responsibility of providing care, the young person with ADHD, and the family. Although recommendations for planning initiatives have been developed by a variety of professional organizations, they do not seem to be routinely implemented for the transition of ADHD care. Such careful advanced transition planning can ensure continuity of treatment, encourage treatment adherence, and help young individuals adjust to new life circumstances and avoid negative educational, social, and vocational results. Guidelines designed to facilitate this transition of care may be helpful.
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Affiliation(s)
- Adelaide Robb
- Center for Translational Science, Children's National Medical Center, Washington, DC 20010, USA.
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Impact of the ADHD-susceptibility gene CDH13 on development and function of brain networks. Eur Neuropsychopharmacol 2013; 23:492-507. [PMID: 22795700 DOI: 10.1016/j.euroneuro.2012.06.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/30/2012] [Accepted: 06/20/2012] [Indexed: 12/18/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common, early onset and enduring neuropsychiatric disorder characterized by developmentally inappropriate inattention, hyperactivity, increased impulsivity and motivational/emotional dysregulation with similar prevalence rates throughout different cultural settings. Persistence of ADHD into adulthood is associated with considerable risk for co-morbidities such as depression and substance use disorder. Although the substantial heritability of ADHD is well documented the etiology is characterized by a complex coherence of genetic and environmental factors rendering identification of risk genes difficult. Genome-wide linkage as well as single nucleotide polymorphism (SNP) and copy-number variant (CNV) association scans recently allow to reliably define aetiopathogenesis-related genes. A considerable number of novel ADHD risk genes implicate biological processes involved in neurite outgrowth and axon guidance. Here, we focus on the gene encoding Cadherin-13 (CDH13), a cell adhesion molecule which was replicably associated with liability to ADHD and related neuropsychiatric conditions. Based on its unique expression pattern in the brain, we discuss the molecular structure and neuronal mechanisms of Cadherin-13 in relation to other cadherins and the cardiovascular system. An appraisal of various Cadherin-13-modulated signaling pathways impacting proliferation, migration and connectivity of specific neurons is also provided. Finally, we develop an integrative hypothesis of the mechanisms in which Cadherin-13 plays a central role in the regulation of brain network development, plasticity and function. The review concludes with emerging concepts about alterations in Cadherin-13 signaling contributing to the pathophysiology of neurodevelopmental disorders.
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De La Fuente A, Xia S, Branch C, Li X. A review of attention-deficit/hyperactivity disorder from the perspective of brain networks. Front Hum Neurosci 2013; 7:192. [PMID: 23720619 PMCID: PMC3654209 DOI: 10.3389/fnhum.2013.00192] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/26/2013] [Indexed: 01/02/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurodevelopmental disorder in childhood, which affects more than 5% of the population worldwide. ADHD is characterized by developmentally inappropriate behaviors of inattention, and/or impulsivity and hyperactivity. These behavioral manifestations contribute to diminished academic, occupational and social functioning, and have neurobiological bases. Neuronal deficits, especially in the attention and executive function processing networks, have been implicated in both children and adults with ADHD by using sophisticated structural and functional neuroimaging approaches. These structural and functional abnormalities in the brain networks have been associated with the impaired cognitive, affective, and motor behaviors seen in the disorder. The goal of this review is to summarize and integrate emerging themes from the existing neuroimaging connectivity studies based on advanced imaging techniques, applied in data of structural magnetic resonance imaging (MRI), functional MRI (fMRI), diffusion tensor imaging, electroencephalography and event related potential; and to discuss the results of these studies when considering future directions for understanding pathophysiological mechanisms and developmental trajectories of the behavioral manifestations in ADHD. We conclude this review by suggesting that future research should put more effort on understanding the roles of the subcortical structures and their structural/functional pathways in ADHD.
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Affiliation(s)
- Angelica De La Fuente
- Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, Yeshiva University Bronx, NY, USA
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Wang X, Jiao Y, Tang T, Wang H, Lu Z. Altered regional homogeneity patterns in adults with attention-deficit hyperactivity disorder. Eur J Radiol 2013; 82:1552-7. [PMID: 23684384 DOI: 10.1016/j.ejrad.2013.04.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 04/17/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE Investigating the discriminative brain map for patients with attention-deficit/hyperactivity disorder (ADHD) based on feature selection and classifier; and identifying patients with ADHD based on the discriminative model. MATERIALS AND METHODS A dataset of resting state fMRI contains 23 patients with ADHD and 23 healthy subjects were analyzed. Regional homogeneity (ReHo) was extracted from resting state fMRI signals and used as model inputs. Raw ReHo features were ranked and selected in a loop according to their p values. Selected features were trained and tested by support vector machines (SVM) in a cross validation procedure. Cross validation was repeated in feature selection loop to produce optimized model. RESULTS Optimized discriminative map indicated that the ADHD brains exhibit more increased activities than normal controls in bilateral occipital lobes and left front lobe. The altered brain regions included portions of basal ganglia, insula, precuneus, anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), thalamus, and cerebellum. Correlation coefficients indicated significant positive correlation of inattentive scores with bilateral cuneus and precuneus, and significant negative correlation of hyperactive/impulsive scores with bilateral insula and claustrum. Additionally, the optimized model produced total accuracy of 80% and sensitivity of 87%. CONCLUSION ADHD brain regions were more activated than normal controls during resting state. Linear support vector classifier can provide useful discriminative information of altered ReHo patterns for ADHD; and feature selection can improve the performances of classification.
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Affiliation(s)
- Xunheng Wang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
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Townsend JD, Sugar CA, Walshaw PD, Vasquez RE, Foland-Ross LC, Moody TD, Bookheimer SY, McGough JJ, Altshuler LL. Frontostriatal neuroimaging findings differ in patients with bipolar disorder who have or do not have ADHD comorbidity. J Affect Disord 2013; 147:389-96. [PMID: 23057969 PMCID: PMC3562405 DOI: 10.1016/j.jad.2012.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 08/16/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The inferior frontal cortical (IFC)-striatal network plays an integral role in response inhibition and is compromised in patients with Bipolar Disorder (BP) or Attention-Deficit/Hyperactivity Disorder (ADHD). Prior BP functional neuroimaging studies have not accounted for ADHD comorbidity despite its high prevalence. METHODS The authors conducted an fMRI study using a response inhibition task (Go-NoGo) in 32 euthymic adults with BP, half with comorbid ADHD (BP/ADHD); 16 adults with ADHD alone; and 30 healthy controls. Within- and between-group whole-brain analyses were performed to assess for significant neural function differences. RESULTS All groups activated frontal and striatal regions involved in response inhibition. ANOVA results demonstrated significant interaction effects of BP and ADHD in the anterior and posterior cingulate, left superior and middle frontal gyri and left inferior parietal lobule. Follow-up comparisons showed significant differences between BP subjects with and without ADHD. Other regions demonstrated main effects of BP (left inferior frontal gyrus, left middle frontal gyrus, right superior frontal gyrus and left insula) and ADHD (left inferior frontal gyrus, left precentral gyrus and right anterior cingulate). LIMITATIONS This study, as the first of its kind, requires replication using large sample sizes and controlling for potential effects of medication. CONCLUSIONS Euthymic bipolar adults with comorbid ADHD have significantly different neural activation patterns from BP patients without this comorbidity. If understanding of the neurobiology of bipolar disorder is to be achieved, it is critical to control for this potential confound, something not done by most prior fMRI studies of adults with BP.
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Affiliation(s)
- Jennifer D. Townsend
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024
| | - Catherine A. Sugar
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024,Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90024,Department of Biostatistics, School of Public Health, University of California, 650 Charles E Young Drive South, Los Angeles, CA 90095-8347
| | - Patricia D. Walshaw
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024
| | - Roxanne E. Vasquez
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024
| | - Lara C. Foland-Ross
- Laboratory of Neuro Imaging, Department of Neurology, David Geffen School of Medicine at UCLA, 635 Charles E. Young Drive South, Suite 225, Los Angeles, CA 90095-7334
| | - Teena D. Moody
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024,Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90024
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024
| | - James J. McGough
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024,Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA 90024
| | - Lori L. Altshuler
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90024,Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073
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Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX. Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am J Psychiatry 2012; 169:1038-55. [PMID: 22983386 PMCID: PMC3879048 DOI: 10.1176/appi.ajp.2012.11101521] [Citation(s) in RCA: 650] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors performed a comprehensive meta-analysis of task-based functional MRI studies of attention deficit hyperactivity disorder (ADHD). METHOD The authors searched PubMed, Ovid, EMBASE, Web of Science, ERIC, CINAHAL, and NeuroSynth for studies published through June 30, 2011. Significant differences in brain region activation between individuals with ADHD and comparison subjects were detected using activation likelihood estimation meta-analysis. Dysfunctional regions in ADHD were related to seven reference neuronal systems. The authors performed a set of meta-analyses focused on age groups (children and adults), clinical characteristics (history of stimulant treatment and presence of psychiatric comorbidities), and specific neuropsychological tasks (inhibition, working memory, and vigilance/attention). RESULTS Fifty-five studies were included (39 for children and 16 for adults). In children, hypoactivation in ADHD relative to comparison subjects was observed mostly in systems involved in executive function (frontoparietal network) and attention (ventral attentional network). Significant hyperactivation in ADHD relative to comparison subjects was observed predominantly in the default, ventral attention, and somatomotor networks. In adults, ADHD-related hypoactivation was predominant in the frontoparietal system, while ADHD-related hyperactivation was present in the visual, dorsal attention, and default networks. Significant ADHD-related dysfunction largely reflected task features and was detected even in the absence of comorbid mental disorders or a history of stimulant treatment. CONCLUSIONS A growing literature provides evidence of ADHD-related dysfunction in multiple neuronal systems involved in higher-level cognitive functions but also in sensorimotor processes, including the visual system, and in the default network. This meta-analytic evidence extends early models of ADHD pathophysiology that were focused on prefrontal-striatal circuits.
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Affiliation(s)
- Samuele Cortese
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA,Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy,UMR_S INSERM U 930, ERL 3106, François-Rabelais University, Child Psychiatry Centre, University Hospital, Tours, France
| | - Clare Kelly
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA
| | - Camille Chabernaud
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA
| | - Erika Proal
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA,Neuroingenia, México, D.F., México
| | - Adriana Di Martino
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA
| | - Michael P. Milham
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA,Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - F. Xavier Castellanos
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Abstract
The adult form of attention deficit/hyperactivity disorder (aADHD) has a prevalence of up to 5% and is the most severe long-term outcome of this common neurodevelopmental disorder. Family studies in clinical samples suggest an increased familial liability for aADHD compared with childhood ADHD (cADHD), whereas twin studies based on self-rated symptoms in adult population samples show moderate heritability estimates of 30-40%. However, using multiple sources of information, the heritability of clinically diagnosed aADHD and cADHD is very similar. Results of candidate gene as well as genome-wide molecular genetic studies in aADHD samples implicate some of the same genes involved in ADHD in children, although in some cases different alleles and different genes may be responsible for adult versus childhood ADHD. Linkage studies have been successful in identifying loci for aADHD and led to the identification of LPHN3 and CDH13 as novel genes associated with ADHD across the lifespan. In addition, studies of rare genetic variants have identified probable causative mutations for aADHD. Use of endophenotypes based on neuropsychology and neuroimaging, as well as next-generation genome analysis and improved statistical and bioinformatic analysis methods hold the promise of identifying additional genetic variants involved in disease etiology. Large, international collaborations have paved the way for well-powered studies. Progress in identifying aADHD risk genes may provide us with tools for the prediction of disease progression in the clinic and better treatment, and ultimately may help to prevent persistence of ADHD into adulthood.
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Hoogman M, Rijpkema M, Janss L, Brunner H, Fernandez G, Buitelaar J, Franke B, Arias-Vásquez A. Current self-reported symptoms of attention deficit/hyperactivity disorder are associated with total brain volume in healthy adults. PLoS One 2012; 7:e31273. [PMID: 22348063 PMCID: PMC3277496 DOI: 10.1371/journal.pone.0031273] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 01/05/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Reduced total brain volume is a consistent finding in children with Attention Deficit/Hyperactivity Disorder (ADHD). In order to get a better understanding of the neurobiology of ADHD, we take the first step in studying the dimensionality of current self-reported adult ADHD symptoms, by looking at its relation with total brain volume. METHODOLOGY/PRINCIPAL FINDINGS In a sample of 652 highly educated adults, the association between total brain volume, assessed with magnetic resonance imaging, and current number of self-reported ADHD symptoms was studied. The results showed an association between these self-reported ADHD symptoms and total brain volume. Post-hoc analysis revealed that the symptom domain of inattention had the strongest association with total brain volume. In addition, the threshold for impairment coincides with the threshold for brain volume reduction. CONCLUSIONS/SIGNIFICANCE This finding improves our understanding of the biological substrates of self-reported ADHD symptoms, and suggests total brain volume as a target intermediate phenotype for future gene-finding in ADHD.
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Affiliation(s)
- Martine Hoogman
- Department of Psychiatry, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
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Millan MJ, Agid Y, Brüne M, Bullmore ET, Carter CS, Clayton NS, Connor R, Davis S, Deakin B, DeRubeis RJ, Dubois B, Geyer MA, Goodwin GM, Gorwood P, Jay TM, Joëls M, Mansuy IM, Meyer-Lindenberg A, Murphy D, Rolls E, Saletu B, Spedding M, Sweeney J, Whittington M, Young LJ. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov 2012; 11:141-68. [PMID: 22293568 DOI: 10.1038/nrd3628] [Citation(s) in RCA: 792] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Studies of psychiatric disorders have traditionally focused on emotional symptoms such as depression, anxiety and hallucinations. However, poorly controlled cognitive deficits are equally prominent and severely compromise quality of life, including social and professional integration. Consequently, intensive efforts are being made to characterize the cellular and cerebral circuits underpinning cognitive function, define the nature and causes of cognitive impairment in psychiatric disorders and identify more effective treatments. Successful development will depend on rigorous validation in animal models as well as in patients, including measures of real-world cognitive functioning. This article critically discusses these issues, highlighting the challenges and opportunities for improving cognition in individuals suffering from psychiatric disorders.
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Affiliation(s)
- Mark J Millan
- Institut de Recherche Servier, 78290 Croissy/Seine, France.
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Mulligan RC, Knopik VS, Sweet LH, Fischer M, Seidenberg M, Rao SM. Neural correlates of inhibitory control in adult attention deficit/hyperactivity disorder: evidence from the Milwaukee longitudinal sample. Psychiatry Res 2011; 194:119-29. [PMID: 21937201 PMCID: PMC3196255 DOI: 10.1016/j.pscychresns.2011.02.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 02/01/2011] [Accepted: 02/06/2011] [Indexed: 11/20/2022]
Abstract
Only a few studies have investigated the neural substrate of response inhibition in adult attention deficit hyperactivity disorder (ADHD) using Stop-Signal and Go/No-Go tasks. Inconsistencies and methodological limitations in the existing literature have resulted in limited conclusions regarding underlying pathophysiology. We examined the neural basis of response inhibition in a group of adults diagnosed with ADHD in childhood and who continue to meet criteria for ADHD. Adults with ADHD (n=12) and controls (n=12) were recruited from an ongoing longitudinal study and were matched for age, IQ, and education. Individuals with comorbid conditions were excluded. Functional magnetic resonance imaging (fMRI) was used to identify and compare the brain activation patterns during correct trials of a response-inhibition task (Go/No-Go). Our results showed that the control group recruited a more extensive network of brain regions than the ADHD group during correct inhibition trials. Adults with ADHD showed reduced brain activation in the right frontal eye field, pre-supplementary motor area, left precentral gyrus, and the inferior parietal lobe bilaterally. During successful inhibition of an inappropriate response, adults with ADHD display reduced activation in fronto-parietal networks previously implicated in working memory, goal-oriented attention, and response selection. This profile of brain activation may be specifically associated with ADHD in adulthood.
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Affiliation(s)
- Richard C Mulligan
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA.
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Cubillo A, Halari R, Giampietro V, Taylor E, Rubia K. Fronto-striatal underactivation during interference inhibition and attention allocation in grown up children with attention deficit/hyperactivity disorder and persistent symptoms. Psychiatry Res 2011; 193:17-27. [PMID: 21601434 DOI: 10.1016/j.pscychresns.2010.12.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 12/16/2010] [Accepted: 12/23/2010] [Indexed: 10/18/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) in medication-naïve children has been associated with reduced activation in inferior/medial prefrontal, striatal and parieto-temporal cortices during inhibitory control and attention allocation. Functional magnetic resonance imaging (fMRI) studies in adult ADHD, however, have been inconsistent and confounded by medication-history and the need for a retrospective diagnosis of childhood ADHD. We used fMRI combined with a Simon task that measured interference inhibition and controlled for and co-measured attention allocation to compare brain function in 11 medication-naïve adults with persistent inattentive/hyperactive behaviours, followed up from childhood ADHD, and 15 age-matched controls. Despite comparable task performance, patients showed reduced activation compared to controls in left orbital/medial frontal cortex and striatum during interference inhibition and in left lateral inferior/dorsolateral prefrontal cortex during attention allocation. Whole-brain regression analyses within patients showed a negative correlation between symptom severity and fronto-striatal, temporo-parietal and cerebellar brain activation. The findings demonstrate that the typical fronto-striatal dysfunction observed in children with ADHD during interference inhibition and attention allocation is also observed in adults grown up from childhood ADHD with persistent symptoms. Furthermore, they show that functional deficits in adult ADHD are not related to chronic stimulant medication given that this sample was medication-naive.
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Affiliation(s)
- Ana Cubillo
- Department of Child Psychiatry, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
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43
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Dissociable functional connectivity changes during the Stroop task relating to risk, resilience and disease expression in bipolar disorder. Neuroimage 2011; 57:576-82. [DOI: 10.1016/j.neuroimage.2011.04.055] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 04/19/2011] [Accepted: 04/25/2011] [Indexed: 12/21/2022] Open
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Rubia K. "Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review. Biol Psychiatry 2011; 69:e69-87. [PMID: 21094938 DOI: 10.1016/j.biopsych.2010.09.023] [Citation(s) in RCA: 286] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 09/16/2010] [Accepted: 09/18/2010] [Indexed: 01/24/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder overlap behaviorally, clinically, and cognitively. An important question of potential future clinical relevance is whether these two overlapping disorders are mediated by similar or distinct underlying brain substrates. This article reviews the modern neuroimaging literature on brain structure, function, and connectivity in both disorders, shaping out commonalities and differences. Findings show that ADHD is characterized predominantly by abnormalities in inferior frontal, striatal, parietotemporal, and cerebellar regions and networks that mediate "cool"-cognitive, i.e., inhibitory, attention and timing functions associated with the disorder. Conduct disorder, by contrast, has consistently been associated with abnormalities of the "hot" paralimbic system that regulates motivation and affect, comprising lateral orbital and ventromedial prefrontal cortices, superior temporal lobes, and underlying limbic structures, most prominently the amygdala. Direct comparisons in functional imaging show that these associations of cool inferior fronto-striato-cerebellar dysfunction in ADHD and of hot orbitofrontal-paralimbic dysfunction in conduct disorder are disorder-specific. There is, hence, evidence for dissociated underlying pathophysiologies for these two disorders that may have implications for future anatomy-based differential diagnosis and prevention and intervention.
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Affiliation(s)
- Katya Rubia
- Department of Child Psychiatry/Medical Research Council Center for Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, London, United Kingdom.
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Reward processing in male adults with childhood ADHD--a comparison between drug-naïve and methylphenidate-treated subjects. Psychopharmacology (Berl) 2011; 215:467-81. [PMID: 21298512 DOI: 10.1007/s00213-011-2166-y] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Accepted: 01/04/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE Dysfunctional reward processing has been proposed as a main deficit in attention-deficit/hyperactivity disorder (ADHD), which could be modulated by treatment with methylphenidate (MPH). OBJECTIVES We examined differences in reward processing in adulthood (independent of actual ADHD) depending on MPH treatment during childhood. METHODS Eleven males with childhood ADHD treated with MPH, 12 drug-naïve males with childhood ADHD, and 12 controls matched by age, handedness, and smoking behavior were studied drug-free using functional magnetic resonance imaging. BOLD-responses were compared during a monetary incentive delay task using an ANOVA design focusing on the ventral striatum during anticipation and the orbitofrontal cortex during outcome. RESULTS Controls, drug-naïve, and treated subjects did not differ significantly in their activations in the ventral striatum and orbitofrontal cortex. Explorative analyses revealed decreased insula activation during outcome of loss avoidance in drug-naïve subjects in comparison to both groups, while treated subjects did not differ from controls. Insula activation correlated significantly positive with harm avoidance in the treated group. Furthermore, comparing subjects with actual ADHD symptoms, remitters and controls we observed decreased putamen activition in ADHD persisters. CONCLUSIONS Basal ganglia reward processing seemed to be unrelated to MPH pretreatment, but was related to remission. On the other hand, the revealed differences between treated and drug-naïve subjects with childhood ADHD, i.e., in the insula, give evidence for more pronounced abnormal activation in reward-associated brain regions in untreated subjects with childhood ADHD and underpin the need of prospective studies on long-term effects of psychostimulant treatment.
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Seidman LJ, Biederman J, Liang L, Valera EM, Monuteaux MC, Brown A, Kaiser J, Spencer T, Faraone SV, Makris N. Gray matter alterations in adults with attention-deficit/hyperactivity disorder identified by voxel based morphometry. Biol Psychiatry 2011; 69:857-66. [PMID: 21183160 PMCID: PMC3940267 DOI: 10.1016/j.biopsych.2010.09.053] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 08/10/2010] [Accepted: 09/29/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gray and white matter volume deficits have been reported in many structural magnetic resonance imaging (MRI) studies of children with attention-deficit/hyperactivity disorder (ADHD); however, there is a paucity of structural MRI studies of adults with ADHD. This study used voxel based morphometry and applied an a priori region of interest approach based on our previous work, as well as from well-developed neuroanatomical theories of ADHD. METHODS Seventy-four adults with DSM-IV ADHD and 54 healthy control subjects comparable on age, sex, race, handedness, IQ, reading achievement, frequency of learning disabilities, and whole brain volume had an MRI on a 1.5T Siemens scanner. A priori region of interest hypotheses focused on reduced volumes in ADHD in dorsolateral prefrontal cortex, anterior cingulate cortex, caudate, putamen, inferior parietal lobule, and cerebellum. Analyses were carried out by FSL-VBM 1.1. RESULTS Relative to control subjects, ADHD adults had significantly smaller gray matter volumes in parts of six of these regions at p ≤ .01, whereas parts of the dorsolateral prefrontal cortex and inferior parietal lobule were significantly larger in ADHD at this threshold. However, a number of other regions were smaller and larger in ADHD (especially fronto-orbital cortex) at this threshold. Only the caudate remained significantly smaller at the family-wise error rate. CONCLUSIONS Adults with ADHD have subtle volume reductions in the caudate and possibly other brain regions involved in attention and executive control supporting frontostriatal models of ADHD. Modest group brain volume differences are discussed in the context of the nature of the samples studied and voxel based morphometry methodology.
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Affiliation(s)
- Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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Cubillo A, Halari R, Smith A, Taylor E, Rubia K. A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. Cortex 2011; 48:194-215. [PMID: 21575934 DOI: 10.1016/j.cortex.2011.04.007] [Citation(s) in RCA: 313] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/03/2011] [Accepted: 04/11/2011] [Indexed: 12/18/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) has long been associated with abnormalities in frontal brain regions. In this paper we review the current structural and functional imaging evidence for abnormalities in children and adults with ADHD in fronto-striatal, fronto-parieto-temporal, fronto-cerebellar and fronto-limbic regions and networks. While the imaging studies in children with ADHD are more numerous and consistent, an increasing number of studies suggests that these structural and functional abnormalities in fronto-cortical and fronto-subcortical networks persist into adulthood, despite a relative symptomatic improvement in the adult form of the disorder. We furthermore present new data that support the notion of a persistence of neurofunctional deficits in adults with ADHD during attention and motivation functions. We show that a group of medication-naïve young adults with ADHD behaviours who were followed up 20 years from a childhood ADHD diagnosis show dysfunctions in lateral fronto-striato-parietal regions relative to controls during sustained attention, as well as in ventromedial orbitofrontal regions during reward, suggesting dysfunctions in cognitive-attentional as well as motivational neural networks. The lateral fronto-striatal deficit findings, furthermore, were strikingly similar to those we have previously observed in children with ADHD during the same task, reinforcing the notion of persistence of fronto-striatal dysfunctions in adult ADHD. The ventromedial orbitofrontal deficits, however, were associated with comorbid conduct disorder (CD), highlighting the potential confound of comorbid antisocial conditions on paralimbic brain deficits in ADHD. Our review supported by the new data therefore suggest that both adult and childhood ADHD are associated with brain abnormalities in fronto-cortical and fronto-subcortical systems that mediate the control of cognition and motivation. The brain deficits in ADHD therefore appear to be multi-systemic and to persist throughout the lifespan.
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Affiliation(s)
- Ana Cubillo
- Department of Child Psychiatry, Institute of Psychiatry, King's College London, UK
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Pompei F, Jogia J, Tatarelli R, Girardi P, Rubia K, Kumari V, Frangou S. Familial and disease specific abnormalities in the neural correlates of the Stroop Task in Bipolar Disorder. Neuroimage 2011; 56:1677-84. [PMID: 21352930 DOI: 10.1016/j.neuroimage.2011.02.052] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Revised: 02/09/2011] [Accepted: 02/17/2011] [Indexed: 01/14/2023] Open
Abstract
Patients with Bipolar Disorder (BD) perform poorly on tasks of selective attention and inhibitory control. Although similar behavioural deficits have been noted in their relatives, it is yet unclear whether they reflect dysfunction in the same neural circuits. We used functional magnetic resonance imaging and the Stroop Colour Word Task to compare task related neural activity between 39 euthymic BD patients, 39 of their first-degree relatives (25 with no Axis I disorders and 14 with Major Depressive Disorder) and 48 healthy controls. Compared to controls, all individuals with familial predisposition to BD, irrespective of diagnosis, showed similar reductions in neural responsiveness in regions involved in selective attention within the posterior and inferior parietal lobules. In contrast, hypoactivation within fronto-striatal regions, implicated in inhibitory control, was observed only in BD patients and MDD relatives. Although striatal deficits were comparable between BD patients and their MDD relatives, right ventrolateral prefrontal dysfunction was uniquely associated with BD. Our findings suggest that while reduced parietal engagement relates to genetic risk, fronto-striatal dysfunction reflects processes underpinning disease expression for mood disorders.
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Affiliation(s)
- Francesco Pompei
- Section of Neurobiology of Psychosis, Institute of Psychiatry, Kings College, London, UK
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