Rubia K, Cubillo A, Woolley J, Brammer MJ, Smith AB. Disorder-specific dysfunctions in patients with attention-deficit/hyperactivity disorder compared to patients with obsessive-compulsive disorder during interference inhibition and attention allocation. Hum Brain Mapp (in press)

Department of Child Psychiatry, Institute of Psychiatry, King's College London, London, UK.
Human Brain Mapping (Impact Factor: 5.97). 04/2011; 32(4):601-11. DOI: 10.1002/hbm.21048
Source: PubMed


Abnormalities in inhibitory control and underlying fronto-striatal networks is common to both attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive-disorder (OCD). The aim of this study was to investigate disorder-specific abnormalities in neural networks mediating interference inhibition and selective attention.
Event-related functional magnetic resonance imaging (fMRI) was used to compare brain activation of boys with ADHD (18), with OCD (10), and healthy boys during (20) during a Simon task that measures interference inhibition and controls for and therefore comeasures attention allocation.
During interference inhibition, both patient groups shared mesial frontal dysfunction compared to controls. Disorder-specific dysfunctions were observed in OCD patients in dorsolateral prefrontal cortex during the oddball condition and in ADHD patients in inferior parietal lobe during interference inhibition and in caudate and posterior cingulate during the simpler oddball condition. The decreased activation in caudate and cingulate in ADHD was furthermore negatively correlated with ADHD symptoms and positively with OCD behavioral traits.
The study shows that ADHD and OCD patients have shared but also disorder-specific brain dysfunctions during interference inhibition and attention allocation. Both disorders shared dysfunction in mesial frontal cortex. Disorder-specific dysfunctions, however, were observed in dorsolateral prefrontal cortex in OCD patients and in caudate, cingulate, and parietal brain regions in ADHD patients. The disorder-specific dissociation of striato-cingulate activation that was increased in OCD compared to ADHD patients, was furthermore inversely related to the symptomatology of the two disorders, and may potentially reflect differential dopamine modulation of striatal brain regions.

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Available from: Katya Rubia, Jun 29, 2015
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    • "Instead, it also depends on attentional orienting processes because different stimuli signaling for distinct responses have to be integrated with information on the spatial position of these stimuli (for review: Hommel, 2011). Consequently, functional imaging evidence suggests that thalamic processing is important for performance in the Simon task (Rubia et al., 2011). We will therefore also investigate the role of the thalamic GABAergic system for the above-mentioned modulations of sensorimotor integration processes by proprioceptive information using GABA-MRS. "
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    ABSTRACT: The selection of appropriate responses is a complex endeavor requiring the integration of many different sources of information in fronto-striatal-thalamic circuits. An often neglected but relevant piece of information is provided by proprioceptive inputs about the current position of our limbs. This study examines the importance of striatal and thalamic GABA levels in these processes using GABA-edited magnetic resonance spectroscopy (GABA-MRS) and a Simon task featuring proprioception-induced interference in healthy subjects. As a possible model of deficits in the processing of proprioceptive information, we also included Parkinson’s disease (PD) patients in this study. The results show that proprioceptive information about unusual postures complicates response selection processes in controls, but not in PD patients. The well-known deficits of PD patients in processing proprioceptive information can turn into a benefit when altered proprioceptive information would normally complicate response selection processes. Striatal and thalamic GABA levels play dissociable roles in the modulation of response selection processes by proprioceptive information: Striatal GABA levels seem to be important for the general speed of responding, most likely because striatal GABA promotes response selection. In contrast, the modulation of response conflict by proprioceptive information is closely related to thalamic GABA concentrations with higher concentration being related to a smaller response conflict effect. The most likely explanation for this finding is that the thalamus is involved in the integration of sensorimotor, attentional, and cognitive information for the purpose of response formation. Yet, this effect in the thalamus vanishes when controls and PD patients were analyzed separately.
    NeuroImage 06/2015; 120. DOI:10.1016/j.neuroimage.2015.06.066 · 6.36 Impact Factor
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    • "Stimulus interference in ADHD has been linked to disturbed activation in ACC, DLPFC, and VLPFC (Bush et al., 1999; Banich et al., 2009). Similarly, patients with ADHD exhibit hypofunction of medial prefrontal regions and ventrolateral regions during response interference (Cubillo et al., 2010, 2011; Rubia et al., 2011; Sebastian et al., 2012; Hart et al., 2013). During behavioral inhibition, prefrontal dysfunction in patients with ADHD has mainly been associated with hypoactivation in bilateral PFC (Epstein et al., 2007; Cubillo et al., 2010; Sebastian et al., 2012). "
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    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 reso-lution 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 con-cepts 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 differ-ent 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 com-ponents to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.
    Frontiers in Human Neuroscience 09/2014; 8:698. DOI:10.3389/fnhum.2014.00698 · 3.63 Impact Factor
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    • "Disorder-specific alterations in brain activation of children with OCD were less pronounced. They differed from healthy controls and ADHD patients only in the oddball condition by showing reduced activation in the right superior and middle frontal gyri of the dorsolateral prefrontal cortex (Rubia et al. 2011). It however remains questionable whether this finding is confounded by effects of medication and symptom severity in the relatively small group of partly remitted OCD patients with only low symptom levels (Rubia et al. 2010). "
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    ABSTRACT: Obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neuropsychiatric diseases in paediatric populations. The high comorbidity of ADHD and OCD with each other, especially of ADHD in paediatric OCD, is well described. OCD and ADHD often follow a chronic course with persistent rates of at least 40-50 %. Family studies showed high heritability in ADHD and OCD, and some genetic findings showed similar variants for both disorders of the same pathogenetic mechanisms, whereas other genetic findings may differentiate between ADHD and OCD. Neuropsychological and neuroimaging studies suggest that partly similar executive functions are affected in both disorders. The deficits in the corresponding brain networks may be responsible for the perseverative, compulsive symptoms in OCD but also for the disinhibited and impulsive symptoms characterizing ADHD. This article reviews the current literature of neuroimaging, neurochemical circuitry, neuropsychological and genetic findings considering similarities as well as differences between OCD and ADHD.
    ADHD Attention Deficit and Hyperactivity Disorders 07/2014; 6(3). DOI:10.1007/s12402-014-0146-x
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