"Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review.
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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ABSTRACT: Attention to self and environment form the basis of effective social exchange and relationships. Although implicit in this basic social competency is the ability to be self-aware and responsive to the circumstances of others, many neuropsychologists have yet to understand or measure its basic functions, let alone recognize the brain-behavior relationships that govern this area. Several years ago, interest in "emotional intelligence" rose to the forefront of popular psychology, but we are still unraveling the cortical, subcortical, and neurocellular interactions that produce this nebulous construct, and we are determining how dysfunctional frontal-subcortical and cortico-cerebellar circuitry can lead to aberrant social dynamics and ultimately psychopathology when maladaptive patterns become routinized. In this article, we explore the orbital-ventral medial circuitry thought to govern emotional attention, personal self-regulation, social concern and exchange, and affective aspects of interpersonal relationships. Our examination notes both the dearth of and need for neuropsychological research on the biological basis and measurement of executive regulation of emotional attention, behavioral regulation, and social competence. We conclude with a call for development of neuropsychological measures and methods that can foster differential diagnosis and targeted treatment strategies for children with orbital-ventral medial circuit dysfunction.
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ABSTRACT: The frontoparietal control network, anatomically and functionally interposed between the dorsal attention network and default mode network, underpins executive control functions. Individuals with attention-deficit/hyperactivity disorder (ADHD) commonly exhibit deficits in executive functions, which are mainly mediated by the frontoparietal control network. Involvement of the frontoparietal control network based on the anterior prefrontal cortex in neurobiological mechanisms of ADHD has yet to be tested. We used resting-state functional MRI and seed-based correlation analyses to investigate functional connectivity of the frontoparietal control network in a sample of 25 children with ADHD (7-14 years; mean 9.94±1.77 years; 20 males), and 25 age-, sex-, and performance IQ-matched typically developing (TD) children. All participants had limited in-scanner head motion. Spearman's rank correlations were used to test the associations between altered patterns of functional connectivity with clinical symptoms and executive functions, measured by the Conners' Continuous Performance Test and Spatial Span in the Cambridge Neuropsychological Test Automated Battery. Compared with TD children, children with ADHD demonstrated weaker connectivity between the right anterior prefrontal cortex (PFC) and the right ventrolateral PFC, and between the left anterior PFC and the right inferior parietal lobule. Furthermore, this aberrant connectivity of the frontoparietal control network in ADHD was associated with symptoms of impulsivity and opposition-defiance, as well as impaired response inhibition and attentional control. The findings support potential integration of the disconnection model and the executive dysfunction model for ADHD. Atypical frontoparietal control network may play a pivotal role in the pathophysiology of ADHD. (JINS, 2015, 21, 1-14).Journal of the International Neuropsychological Society 04/2015; DOI:10.1017/S135561771500020X · 3.01 Impact Factor
Criminal Justice and Behavior 09/2014; 41(10):1232-1249. DOI:10.1177/0093854814537812 · 1.71 Impact Factor