Brain Activation Gradients in Ventrolateral Prefrontal Cortex Related to Persistence of ADHD in Adolescent Boys

Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 02/2005; 44(1):47-54. DOI: 10.1097/01.chi.0000145551.26813.f9
Source: PubMed


To explore the possible role that functional abnormalities of the prefrontal cortex and basal ganglia play in the persistence of attention-deficit/hyperactivity disorder (ADHD) in adolescents aged 15 to 19 years.
Ten male adolescents who were diagnosed with ADHD during childhood were grouped into those who continued to meet full diagnostic criteria for DSM-IV ADHD (persisters; n = 5) and those in whom symptoms had remitted sufficiently to warrant a diagnosis of ADHD in partial remission (remitters; n = 5). Persisters, remitters, and five carefully matched controls with no history of ADHD were scanned using functional magnetic resonance imaging while performing a go/no-go task.
Parallel linear trends were found in performance on the go/no-go task and activation of ventrolateral prefrontal cortex, such that persisters made the most commission errors (33%) and showed the greatest activation, remitters made fewer commission errors (24%) and had lower activity, and activation was lowest in controls who made the fewest errors (13%).
These preliminary results suggest that developmental changes in ADHD symptomatology are associated with functional changes in ventrolateral prefrontal cortex activity.


Available from: Jin Fan, Aug 09, 2015
  • Source
    • "neuroimaging findings, individuals with ADHD have a wide array of neurocognitive deficits that likely contribute to their maladaptive behavior patterns (Frazier, Demaree, & Youngstrom, 2004; Willcutt, Doyle, Nigg, Faraone, & Pennington, 2005). Importantly, emerging neuroimaging (Schulz et al., 2005; Shaw et al., 2006; Suskauer et al., 2008) and neuropsychological (Halperin, Trampush, Miller, Marks, & Newcorn, 2008; Healey, Marks, & Halperin, 2011) data suggest that the diminution of ADHD symptoms is linked to the development of improved neural functioning . Thus, interventions that target neural growth and development may provide an avenue for more sustained benefits for ADHD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To examine whether cognitive enhancement can be delivered through play to preschoolers with ADHD and whether it would affect severity of ADHD symptoms. Method: Twenty-nine 4- and 5-year-old children and their parents participated in separate group sessions (3-5 children/group). Child groups were introduced games designed to enhance inhibitory control, working memory, attention, visuospatial abilities, planning, and motor skills. Parent groups were encouraged playing these games with their children at least 30 to 45 min/day and taught strategies for scaffolding difficulty levels and dealing with obstacles to daily playing. Results: Parent ratings and session attendance indicated considerable satisfaction with the program. Parent (p < .001) and teacher (p = .003) ratings on the ADHD-Rating Scale-IV (ADHD-RS-IV) indicated significant improvement in ADHD severity from pre- to post-treatment, which persisted 3 months later. Conclusion: This play-based intervention for preschoolers with ADHD is readily implemented at home. Preliminary evidence suggests efficacy beyond the termination of active treatment. (J. of Att. Dis. 2012; XX(X) 1-XX).
    Journal of Attention Disorders 03/2012; 17(8). DOI:10.1177/1087054711435681 · 3.78 Impact Factor
  • Source
    • "However, studies with ADHD adolescents suggested the opposite: that is poor inhibitory function was associated with greater frontal engagement. Specifically, higher frontal activation was associated with lower inhibitory performance in adolescents with ADHD (Schulz et al. 2005a) and in adolescents with persisting symptoms and worse performance relative to those with remitted symptoms and better performance (Schulz et al. 2005b). With just a handful of studies, it cannot be discerned whether these mixed findings reflect age (children versus adolescents) or task differences (Flanker interference versus stimulus and response conflict) or both. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Structural and functional imaging studies in subjects with attention deficit hyperactivity disorder (ADHD) are reviewed with the goal of gleaning information about neurodevelopmental abnormalities characterizing the disorder. Structural imaging studies, particularly those with longitudinal designs, suggest that brain maturation is delayed by a few years in ADHD. However, a maturational delay model alone is incomplete: alternate courses are suggested by differences associated with phenotypic factors, such as symptom remission/persistence and exposure to stimulant treatment. Findings from functional imaging studies point to multiple loci of abnormalities that are not limited to frontal-striatal circuitry, which is important for executive and motivational function, but also include parietal, temporal and motor cortices, and the cerebellum. However, a definitive conclusion about maturational delays or alternate trajectories cannot be drawn from this work as activation patterns are influenced by task-specific factors that may induce variable performance levels and strategies across development. In addition, no studies have implemented cross-sectional or longitudinal designs, without which the developmental origin of differences in activation cannot be inferred. Thus, current task-evoked functional imaging provides information about dynamic or state-dependent differences rather than fixed or trait-related differences. In the future, task-free functional imaging holds promise for revealing neurodevelopmental information that is minimally influenced by performance/strategic differences. Further, studies using longitudinal designs that identify sources of phenotypic heterogeneity in brain maturation and characterize the relationship between brain function and underlying structural properties are needed to provide a comprehensive view of neurodevelopmental abnormalities in ADHD.
    Current Topics in Behavioral Neurosciences 05/2011; 9:49-66. DOI:10.1007/7854_2011_138
  • Source
    • "processing and increased movement, but only those with persistent ADHD showed deficits in effortful executive processing relative to healthy controls. Earlier this research group reported that behavioral trends of performance on a task of response inhibition were accompanied by neural activation gradients such that those with persistent ADHD with most errors on a response inhibition tasks showed greatest activation of the ventrolateral prefrontal cortex, followed by those with remitted ADHD (who had an intermediate level of performance in response inhibition) and then healthy controls [Schulz et al., 2005]. While this activation pattern of increased inferior frontal activation in ADHD is controversial, the study is one of the few to examine the neural mechanisms of recovery in ADHD and supports the concept of a convergence toward typical brain activity accompanying cognitive improvement in remitting ADHD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Childhood psychiatric disorders are rarely static; rather they change over time and longitudinal studies are ideally suited to capture such dynamic processes. Using longitudinal data, insights can be gained into the nature of the perturbation away from the trajectory of typical development in childhood disorders. Thus, some disorders may reflect a delay in neurodevelopmental trajectories. Our studies in children with attention-deficit/hyperactivity disorder (ADHD) suggest that cortical development is delayed with a rightward shift along the age axis in cortical trajectories, most prominent in prefrontal cortical regions. Other disorders may be characterized by differences in the velocity of trajectories: the basic shape of neurodevelopmental curves remains intact, but with disrupted tempo. Thus, childhood onset schizophrenia is associated with a marked increase during adolescence in the velocity of loss of cerebral gray matter. By contrast, in childhood autism there is an early acceleration of brain growth, which overshoots typical dimensions leading to transient cerebral enlargement. Finally, there may be more profound deviations from typical neurodevelopment, with a complete "derailing" of brain growth and a loss of the features which characterize typical brain development. An example is the almost complete silencing of white matter growth during adolescence of patients with childhood onset schizophrenia. Adopting a longitudinal perspective also readily lends itself to the understanding of the neural bases of differential clinical outcomes. Again taking ADHD as an example, we found that remission is associated with convergence to the template of typical development, whereas persistence is accompanied by progressive divergence away from typical trajectories.
    Human Brain Mapping 06/2010; 31(6):917-25. DOI:10.1002/hbm.21028 · 5.97 Impact Factor
Show more