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Functional abnormalities in Broca’s area in adolescents with ADHD: A resting-state fMRI study

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There is evidence that attention-deficit/hyperactivity disorder (ADHD) is associated with linguistic difficulties. However, the pathophysiology underlying these difficulties is yet to be determined. This study investigates functional abnormalities in Broca's area, which is associated with speech production and processing, in adolescents with ADHD by means of resting-state fMRI. Data for the study was taken from the ADHD-200 project and included 267 ADHD patients (109 with combined inattentive/hyperactive subtype and 158 with inattentive subtype) and 478 typically-developing control (TDC) subjects. An analysis of fractional amplitude of low-frequency fluctuations (fALFF), which reflects spontaneous neural activity, in Broca's area (Brodmann Areas 44/45) was performed on the data and the results were compared statistically across the participant groups. fALFF was found to be significantly lower in the ADHD inattentive group as compared to TDC in BA 44, and in the ADHD combined group as compared to TDC in BA 45. The results suggest that there are functional abnormalities in Broca's area with people suffering from ADHD, and that the localization of these abnormalities might be connected to particular language deficits associated with ADHD subtypes, which we discuss in the article. The findings might help explore the underlying causes of specific language difficulties in ADHD. Pikusa, M. and R. Jończyk. In press. " Functional abnormalities in Broca's area in adolescents with ADHD: resting-state fMRI ". PSiCL
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Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
Functional abnormalities in Broca’s area in adolescents with ADHD: resting-
state fMRI study
Authors manuscript version: 11 February 2015
Michał Pikusaa
Rafał Jończyka
aFaculty of English, Adam Mickiewicz University, al. Niepodległości 4, 61-874,
Poznań, Poland
Corresponding author:
Rafał Jończyk, Faculty of English of Adam Mickiewicz University, al. Niepodległości
4, 61-874 Poznań, Poland; e-mail: rjonczyk@wa.amu.edu.pl
Abstract
There is evidence that attention-deficit/hyperactivity disorder (ADHD) is associated
with linguistic difficulties. However, the pathophysiology underlying these difficulties
is yet to be determined. This study investigates functional abnormalities in Broca’s
area, which is associated with speech production and processing, in adolescents with
ADHD by means of resting-state fMRI. Data for the study was taken from the
ADHD-200 project and included 267 ADHD patients (109 with combined
inattentive/hyperactive subtype and 158 with inattentive subtype) and 478 typically-
developing control (TDC) subjects. An analysis of fractional amplitude of low-
frequency fluctuations (fALFF), which reflects spontaneous neural activity, in Broca’s
area (Brodmann Areas 44/45) was performed on the data and the results were
compared statistically across the participant groups. fALFF was found to be
significantly lower in the ADHD inattentive group as compared to TDC in BA 44,
and in the ADHD combined group as compared to TDC in BA 45. The results suggest
that there are functional abnormalities in Broca’s area with people suffering from
ADHD, and that the localization of these abnormalities might be connected to
particular language deficits associated with ADHD subtypes, which we discuss in the
article. The findings might help explore the underlying causes of specific language
difficulties in ADHD.
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
1. Introduction
Attention deficit hyperactivity disorder (ADHD), characterized by developmentally
inappropriate symptoms of excessive inattention, hyperactivity and impulsivity, is the
most common childhood-onset neurodevelopmental disorder with a worldwide
prevalence estimated at 5.3 % (American Psychiatric Association 2013). Unlike
previously thought, the condition frequently continues into adolescence with ADHD
symptoms being reported in adult patients in as many as 65% of cases (Nakao et al.
2011). Individuals with ADHD have been reported to show impairment in executive
functions, in particular those pertaining to response inhibition and working memory
(Tannock 1998). This deficit has been regarded the primary cause of ADHD with
multiple neuroimaging studies reporting neural abnormalities in the prefrontal brain
regions leading to hyperactive and/or impulsive behaviours (cf. Cortese et al. 2012) as
well as behavioural studies indicating poor performance in executive functions tasks
(cf. Fuster 1997). To date, ample neuroimaging research has been devoted to the
investigation of neural underpinnings of the disorder (for a detailed review, see
Cortese et al. 2012; Dickstein et al. 2006; Bush et al. 2005). According to the
research, the primary neural abnormality in ADHD is the late development of the
fronto-striatal and fronto-parietal/temporal networks. This is reflected in ADHD
patients' experiencing problems with attention as well as higher-level cognitive
functions (Nakao et al. 2011). Structural abnormalities in ADHD, however, affect the
whole neural network and thus are not confined to discrete brain areas (Konrad and
Eickhoff 2010).
Recent neuroimaging research has used an emerging technique called resting
state functional connectivity MRI (rs-fcMRI) to study spontaneous fluctuations in
brain activity during resting state, i.e. when participants stay awake in the scanner
without performing any tasks (Fox and Greicius 2010; Posner et al. 2014). Rs-fcMRI
studies often focus on analyzing connectivity within the so called Default Mode
Network (DMN) as well as between the DMN and the cognitive control network. The
DMN is a neural network that houses the precuneus, the medial prefrontal cortex, and
the lateral parietal lobules, i.e. brain regions that are most active when participants are
at wakeful rest and not focused on any particular task. The cognitive control network;
by contrast, houses brain regions that are most active during high-level cognitive
processing (e.g. working memory, inhibitory control): dorsolateral prefrontal cortex,
anterior cingulate cortex, dorsal premotor cortex, anterior insular cortex, inferior
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
frontal junction, and posterior parietal cortex (Posner et al. 2014; Cole and Schneider
2007). In short, the greater attention demands the less activation in the DMN and the
more activation in the cognitive control network. This inverse relationship between
the DMN and cognitive control network is weakened in individuals with ADHD
(Posner et al. 2014). This means that the task-induced inhibition of activation in DMN
is impaired in ADHD, resulting in attention deficits during cognitive performance.
This has been referred to as the default mode hypothesis of ADHD (Sonuga-Barke
and Castellanos 2007; Qiu et al. 2011). Other functional connectivity studies have
consistently reported hypoconnectivity between regions within the DMN in
individuals with ADHD relative to healthy controls (Castellanos et al. 2008; Fair et al.
2010). Abnormal functional connectivity in ADHD has been also reported in ACC and
inferior frontal gyrus (IFG; e.g. Zang et al. 2007; Cao Q et al. 2006; Wang et al. 2009;
for a review see Oldehinkel et al. 2013), possibly resulting in response inhibition in
ADHD. Furthermore, a few recent studies reported abnormalities in the functional
connectivity of the orbito-frontal cortex and the ventrial striatum, which is a possible
cause of impulsivity in ADHD individuals (Tomasi and Volkow 2012; Costa Dias et
al. 2013). Finally, reduced connectivity in ADHD has also been found in the regions
of cognitive and limbic cortico-striato-thalamo-cortical feedback circuitry, leading to
impulsivity and emotional instability (Mills et al. 2012; Cao et al. 2009; Posner et al.
2013).
A large number of studies to date have reported a relationship between
psychiatric disorders and language deficits (e.g. Camarata et al. 1988; Cantwell and
Baker 1991; Warr-Leeper et al. 1994), with ADHD being the most common
psychiatric diagnosis for children with language deficits (American Psychiatric
Association 2013; Cohen et al. 1998). Despite this fact, there is still very little
research devoted to the investigation of the language-ADHD interface. So far, studies
conducted in this area have demonstrated that children with ADHD experience
difficulties in all language domains showing particular deficiencies in the domain of
pragmatics, narrative discourse, and language comprehension as these areas of
language tend to rely heavily on the capacities of the executive functions (American
Psychiatric Association 2013; Baird et al. 2000; Bruce et al. 2006; Cohen et al. 2000;
Geurts and Embrechts 2008; Oram et al. 1999; Tannock and Schachar 1996).
Pragmatic deficits in ADHD, e.g. stereotyped conversations or problems with
establishing and/or maintaining conversational rapport, have been also indicative of
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
Autism Spectrum Disorder (ASD). That is why ADHD has been often treated as an
accompanying disorder in ASD (Keen and Ward 2004). Notably, ADHD has been
found to co-occur with typical language disorders such as Reading Disorder (Willcutt
et al. 2007), and Dyslexia (Eden and Vaidya 2008). For example, Willcutt et al. (2007)
investigated the co-occurence of ADHD and Reading Disorder in a sample of twins.
The study found a correlation between the two conditions that was ascribed to a
common genetic influence. Other studies have reported considerable similarities
between ADHD and Dyslexia (e.g. Fisher and DeFries 2002; Willcutt et al. 2003;
Rucklidge and Tannock 2002; Willcutt et al. 2001). These studies report that the
percentage of co-morbidity of the two conditions is relatively high, whereby 15-40 %
of dyslexics are also diagnosed with ADHD, and 25-40% of children with ADHD also
develop dyslexia (Willcutt and Pennington 2000; Semrud-Clikeman et al. 1992).
Furthermore, both conditions exhibit verbal working memory and processing speed
deficits (Rucklidge and Tannock 2002; Willcutt et al. 2001). In terms of treatment,
with sufficient training, reading and executive functions can be significantly improved
in both conditions, or even completely restored in adulthood (Sohlberg and Mateer
2001; Eden et al. 2004).
Two hypotheses have been put forward with an aim to explain the co-morbidity
between ADHD and dyslexia: the phenocopy hypothesis and the cognitive subtype
hypothesis. The former points to a bi-directional influence between ADHD and
dyslexia such that having ADHD leads to problems with reading, hence making a
child appear dyslexic, or, by the same logic, frustrations due to reading problems may
make a dyslexic child inattentive (Hinshaw 1992; Pennington et al. 1993). The latter
holds that the co-occurring ADHD and dyslexia symptoms are in fact symptoms of a
third disorder whose etiology may be distinct when compared to that of ADHD and
dyslexia alone (Rucklidge and Tannock 2002) or shared and thus increasing
susceptibility to both disorders (Willcutt et al. 2003).
The co-morbidity between ADHD and language-related deficits such as RD or
dyslexia may constitute an additional source of information about language problems
in ADHD. Despite these findings, however, the specific pathophysiology that
underlies linguistic problems in ADHD is yet to be determined (Hagberg et al. 2010).
A recent study found that deficits in semantic skills and verbal working memory are
associated with ADHD (Bailly 2005), and imaging studies implicated Broca’s area in
semantic processing (Gremillion and Martel 2012) and verbal working memory tasks
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
(Newman et al. 2003; Chen and Desmond 2005; Chen et al. 2002; Gruber 2001).
Drawing on the existing research findings and modern neuroimaging techniques, the
aim of this study is to investigate the region of Broca’s area in terms of functional
abnormalities in ADHD.
Since slow fluctuations in activity are a key feature of the resting brain, with
the development of resting-state fMRI (rs-fMRI), amplitudes of spontaneous low
frequency fluctuations (ALFF) of the blood oxygen level dependent (BOLD) signal
have been widely analyzed in different imaging studies. It is suggested that ALFF
may reflect regional spontaneous neuronal activity (Kiviniemi et al. 2000). As the
magnitude of these fluctuations can differ between subjects and brain regions, ALFF
may act as a marker of individual differences or dysfunction. ALFF studies conducted
on ADHD patients (Yang et al. 2011; Zang et al. 2007) revealed abnormal ALFF in
comparison to healthy control subjects in a number of brain regions (e.g. the ACC).
These studies, however, focused on the whole-brain differences among a limited
sample of participants. To our knowledge, our study is the first to focus on the
language-related brain region, which is Broca’s area (BA 44/45), in a large sample in
order to investigate abnormalities in spontaneous neuronal activity that might cause
language deficits in ADHD. Because ALFF has been shown to be prone to
physiological noise (Zuo et al. 2010; Zou et al. 2008), in this study we used a measure
of fractional ALFF (fALFF) instead of ALFF, as it is more sensitive in detecting
spontaneous brain activity (Zou et al. 2008). ALFF is defined as the total power
within the frequency range 0.01 Hz and 0.1 Hz; hence, it indexes the strength of low
frequency oscillations (LFO). fALFF, on the other hand, is defined as a value of ALFF
divided by the total power in the entire detectable frequency range, and thus shows
the relative contribution of specific LFO to the whole frequency range (Zuo et al.
2010). Drawing on the existing research on language deficits in ADHD, as well as
abnormal functional connectivity in numerous brain regions in ADHD we expected to
find abnormal fALFF in Broca’s (BA 44/45) in ADHD individuals compared to
healthy controls.
2. Methods
2.1. Participants
A set of data from ADHD-200 Project (The ADHD-200 Consortium 2012), including
raw resting-state fMRI data from 745 individuals gathered at 8 centers, was
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
preprocessed and analyzed in terms of abnormalities in low frequency fluctuations in
Broca’s area. The set used in the study included the data from 158 subjects with
diagnosed ADHD predominantly inattentive subtype (ADHD-I), 109 subjects with
diagnosed ADHD predominantly combined subtype (ADHD-C), and 478 typically-
developing control subjects (TDC). The set also included the data from subjects with
diagnosed ADHD predominantly hyperactive subtype, but these data were discarded,
as the sample size was significantly smaller and thus did not constitute a good basis
for a meaningful comparison. Participants were included in the ADHD groups on the
basis of psychiatric diagnoses that were carried out in the imaging centers.
Diagnoses were based on an evaluation using the Child Schedule for Affective
Disorders Present and Lifetime version (KSADS-PL) and the Conners’ Parent Rating
Scale-Revised, Long version (CPRS-LV), which were administered to all
participants. All the participants also completed the Wechsler Abbreviated Scale of
Intelligence (WASI) as an overall measure of cognitive ability. Children in the ADHD
groups had to meet the Diagnostic and Statistical Manual 4th Edition Text Revision
(DSM-IV-TR) criteria for ADHD, as determined by the answers to the KSADS-PL.
Exclusion criteria included comorbid mood or anxiety disorders, autistic or Asperger’s
disorder, medical illness that was unstable or could cause psychiatric symptoms, or
substance abuse within 2 months of participation in the study. The ADHD participants
were scanned when medication-free for at least 4 days drug half-lives.
The TDC participants were included on the basis of a negative history of
psychiatric illness in the participant and their first-degree relatives. Exclusion criteria
included pregnancy, ongoing medical or neurological illness or past psychiatric
disorder and substance abuse. All the participants had an IQ greater than 70.
Phenotypic information on subjects included in this study is presented in Table 1.
Table 1. Phenotypic information
Group
TDC
ADHD-I
ADHD-C
N
478
158
109
Age (mean in years, SD)
12.23 (3.26)
11.24 (3.25)
12.05 (1.77)
Male (n, %)
253 (52%)
130 (82%)
85 (77%)
2.2. Scanning procedure and data analysis
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
As the scanning sessions took place in 8 different imaging centers, scan parameters
differed slightly across the centers, including the duration (6 to 8.5 minutes),
repetition time (2000-2500ms), echo time (15-30ms), and slice thickness (3-3.5mm).
Image preprocessing was based on an established method (Biswal et al. 2010)
and was done using AFNI (http://afni.nimh.nih.gov/) and FSL
(http://www.fmrib.ox.ac.uk/) software. The first step of the preprocessing involved
discarding the first five timepoints of each scan in order to remove possible T1
stabilization effects. Then, correction for motion was applied by aligning each volume
to the mean image volume using Fourier interpolation in AFNI, and spatial smoothing
was performed using a 6-mm FWHM Gaussian kernel. Afterward, mean-based
intensity was normalized by scaling all volumes by the same factor, i.e. 10,000. In
order to prepare the data for the seed-based functional analysis, the data were
temporally filtered using high-pass filter, i.e. Gaussian-weighted least squares
straight-line fitting, and low-pass filter, i.e. Gaussian low-pass temporal filtering,
followed by linear detrending to remove any residual drifts.
Then, the skull in each volume was removed using AFNI, and each subject's
high resolution anatomic scan was registered to a standard stereotactic space; an MNI
152-brain template with 3mm isotropic voxel size using FSL's FLIRT. The resulting
transformation was then applied to each subject's functional scan.
Afterward, nuisance signals were removed using multiple regression in order
to control for the effects of physiological processes, such as fluctuations related to
motion, and cardiac and respiratory cycles. Each subject's functional data was
regressed using 9 predictors, namely white matter and cerebrospinal fluid covariates,
which were generated using FSL's FAST, the global signal, which was generated by
averaging across the time series of all voxels in the brain, and six motion parameters,
which were calculated during motion correction.
In this study, fractional ALFF (fALFF) was used as a marker for spontaneous
brain activity, as it reflects the relative contribution of specific low frequency
fluctuations to the whole frequency range, and is regarded to be a normalized variant
of ALFF (Zou et al. 2008). Calculations of fALFF were done using AFNI and FSL
and followed an established procedure, in which the fractional amplitude of the low
frequency bandpass at each voxel was calculated by dividing the amplitude of the
BOLD signal at the specified bandpass (0.010.08 Hz by the amplitude of the entire
BOLD signal at that voxel (0.010.25 Hz; Zou et al., 2008)). After the calculation of
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
fALFF for the whole brain, the mean values for BA 44 and BA 45 were extracted
using masks derived from the Juelich histological atlas for these areas (Eickhoff et al.
2007), and compared between groups to elicit statistically significant differences
using the Welch Two Sample T-Test.
3. Results and discussion
Using an emerging neuroimaging technique, the fractional amplitudes of spontaneous
low frequency fluctuations (fALFF), the present study investigated the region of
Broca’s area in terms of functional abnormalities in ADHD. Drawing on existing
research, we expected fALFF abnormalities in Broca’s area (BA 44 and 45) in the
ADHD participant group relative to TDC.
fALFF in BA 44 was significantly higher in TDC than in ADHD-I (T = 2.10, P =
.035), while there was no significant differences between TDC and ADHD-C, and
between both ADHD groups (Figure 1). However, fALFF in BA 45 was significantly
higher in TDC in comparison to ADHD-C (T = 2.64, P = .0088), while no other
between-group comparisons yielded any significant differences (Figure 2). There was
also a weak significant negative correlation between age and fALFF in BA 44 (r = -
.32, p < .01) and BA 45 (r =- .21, p < .01) in TDC, and between fALFF in BA 44 (r =
-.31, p < .01) in ADHD-I. A significant difference in age means was found between
TDC and ADHD-I (T = 3.49, P = .0005), while no other inter-group comparisons
revealed any differences.
It is suggested that BA 44 and 45 play different roles in language
comprehension (Skipper et al. 2007); thus, the results might reflect connections to
different language deficits associated with ADHD subtypes. BA 45 is believed to
correspond to semantic retrieval (Moss et al. 2005), and the higher effect of poor
semantic skills on reading underachievement has been previously shown in ADHD-C
(Gremillion and Martel 2012), which could explain the lower fALLF in ADHD-C. BA
44, on the other hand, has been linked to auditory speech processing (Gough et al.
2005), and it is hypothesized that auditory processing deficit might be present as a
part of ADHD-I, and not as a separate developmental disorder (Bamiou et al. 2001),
which could explain the lower fALFF in ADHD-I. A previous study on the size of BA
45 in ADHD showed that the length of BA 45 is predictive of poor expressive
language ability, phonological awareness, and semantic processing (Kibby et al.
2009). However, the study did not differentiate between the ADHD-I and ADHD-C
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
subtypes; thus, it is impossible to relate the findings to our results. Nevertheless, it
suggests that functional and structural abnormalities in Broca's area in ADHD may be
connected.
Figure 1. fALFF in BA 44 across groups. The graph shows the median value, lower and upper quartiles
and the range.
A significant correlation between fALFF and age in TDC and ADHD-I, and a
significant difference in age means between these groups, might suggest that the
difference visible in BA 44 might be driven by the age variable. However, it does not
have to be the case, as the difference in fALFF in BA 45 between TDC and ADHD-C
is also significant, while there is no significant difference between the age means and
no correlation between the age and fALFF in ADHD-C. It suggests that ADHD has a
stronger effect on fALFF than the age variable.
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
Figure 2. fALFF in BA 45 across groups. The graph shows the median value, lower and upper quartiles
and the range.
Limitations
As the detailed literature on the relationship between specific language deficits and
ADHD subtypes is practically non-existent, the results of this study should be
approached with caution. Nevertheless, they show a trend of decreased spontaneous
brain activity in Broca’s area in a large sample, which might be connected to language
deficits that are found in patients with ADHD. As the phenotypic data for the studied
sample is limited, there is a need for future studies, which will integrate language
performance testing alongside other diagnostic information in order to provide more
comprehensive results. As we lacked sufficient information on the handedness of the
participants included in the dataset, our analysis of the left BA 44 and 45 might not
reflect the effect of atypical language lateralization in left handers. As such, this study
should be treated as an exploratory one. What is more, the high ratio of males to
females in the ADHD groups might be explained by the fact that ADHD is in fact
threefold more prevalent in males than in females (Barkley 2006; Gaub and Carlson
1997). It is shown, however, that the difference between males and females in the
diagnosis does not lie in the symptoms per se, but rather in self-expression of these
Pikusa, M. and R. Jończyk. In press. Functional abnormalities in Brocas area in adolescents
with ADHD: resting-state fMRI. PSiCL
symptoms (Skogli et al. 2013; Barkley 2013). What is more, no gender differences
were identified in executive functioning as measured by cognitive tests, with both
genders being more impaired than control samples on such measures (Barkley et al.,
2008). Thus, we analyzed both males and females as a homogenous group, finding the
gender difference insignificant for the study.
Conclusions
Our results contribute to previous studies exploring the relationship between brain
functions and cognitive performance in clinical populations. As the growing body of
literature on neural correlates of ADHD seems to omit the issue of linguistic
difficulties associated with the disorder, the results of the present study give insight
into possible underlying causes of these difficulties. We have shown that particular
linguistic deficits in ADHD might be related to the functioning of language areas in
the brain, and that ADHD subtypes might manifest in different linguistic deficits.
Thus, the contribution of our results presented in the paper might help stress the fact
that ADHD should not be treated as a single disorder in experimental studies, and that
linguistic difficulties associated with the subtypes of ADHD might be traced to the
functioning of the components of the language network in the brain.
Acknowledgments
We would like to thank the two anonymous reviewers for their valuable and
constructive suggestions concerning the manuscript.
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... Overall, seven studies were available to review which have used fMRI to examine functional activation and connectivity differences between the ADHD-C and ADHD-I subtypes. Of these seven studies, two utilized task-based fMRI (Solanto et al., 2009;Orinstein and Stevens, 2014) and five were rs-fMRI studies (Fair et al., 2012;dos Santos Siqueira et al., 2014;Ahn et al., 2015;Pikusa and Jonczyk, 2015;Sanefuji et al., 2016). Various task-based paradigms were utilized in the two studies reviewed, which involved a three-stimulus auditory oddball attention task (Orinstein and Stevens, 2014), and the Go/No-Go response inhibition task (Solanto et al., 2009). ...
... Overall, the five rs-fMRI studies available to review, all utilized data from the "ADHD-200 database" (Bellec et al., 2017), demonstrated significant differences between the ADHD-C and ADHD-I subtypes (Fair et al., 2012;dos Santos Siqueira et al., 2014;Ahn et al., 2015;Pikusa and Jonczyk, 2015;Sanefuji et al., 2016). Consistent with the findings of taskbased fMRI studies (see above), patterns of aberrant connectivity within the CFP attention and DMN networks between the two subtypes are reported in rs-fMRI studies, which further support the role of the CFP attention and DMN as key networks in ADHD pathophysiology. ...
... Based on a sample of 80 ADHD-I, and 112 ADHD-C participants, and 455 neuro-typical controls, aged 7-14 years, the authors also found alterations of the DMN and the insular cortex in ADHD-C and aberrant network properties for the dorsolateral prefrontal cortex and cerebellum in ADHD-I. Deficits in language and communication processing are often associated in ADHD and were examined in a study by Pikusa and Jonczyk (2015) using fractional amplitude low-frequency fluctuations (fALFF) using rs-fMRI, between 158 ADHD-I, 109 ADHD-C, and 478 controls. While no significant differences between subtypes were found, ADHD-I had lower fALFF in Brodmann area 44, while ADHD-C had lower fALFF in area 45, both relative to controls (Pikusa and Jonczyk, 2015). ...
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Objective: Insights to underlying neural mechanisms in attention deficit hyperactivity disorder (ADHD) have emerged from neuroimaging research; however, the neural mechanisms that distinguish ADHD subtypes remain inconclusive. Method: We reviewed 19 studies integrating magnetic resonance imaging [MRI; structural (sMRI), diffusion, functional MRI (fMRI)] findings into a framework exploring pathophysiological mechanisms underlying the combined (ADHD-C) and predominantly inattentive (ADHD-I) ADHD subtypes. Results: Despite equivocal structural MRI results, findings from fMRI and DTI imaging modalities consistently implicate disrupted connectivity in regions and tracts involving frontal striatal thalamic in ADHD-C and frontoparietal neural networks in ADHD-I. Alterations of the default mode, cerebellum, and motor networks in ADHD-C and cingulo-frontoparietal attention and visual networks in ADHD-I highlight network organization differences between subtypes. Conclusion: Growing evidence from neuroimaging studies highlight neurobiological differences between ADHD clinical subtypes, particularly from a network perspective. Understanding brain network organization and connectivity may help us to better conceptualize the ADHD types and their symptom variability.
... Experimental pragmatics is a novel approach which has been under development since early 2000s in Europe under such initiatives as euro-exprag and the Poznań School of Pragmatics under Roman Kopytko . The latter has increased its output in recent years, with research on a variety of topics related to affective pragmatics, such as irony processing (Bromberek-Dyzman 2012, neuropragmatics of emotion (Jończyk 2015;Pikusa and Jończyk 2015;Jończyk et al. 2016), as well as emotional prosody processing (Bąk 2013). The empirical vein in pragmatics remains, however, in its nascent stage and it is its venerable theoretical tradition that can facilitate emotion research more reliably. ...
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This volume provides the first systematic and data-driven exploration of English emotional prosody processing in the minds of non-native speakers of the language. Over the past few decades emotional prosody has attracted the interest of researchers from a variety of disciplines such as psychiatry, neuropsychology, psycholinguistics, and linguistics. Although a considerable collective body of empirical evidence exists regarding emotional prosody processing in native speakers of various languages, non-native speakers have been virtually ignored. This constitutes a knowledge gap of increasing relevance, as we approach 2050, the year when the global population of non-native speakers of English is estimated to overtake that of native speakers of the language. This volume aims to fill this gap and provide insights into how emotions are processed on multiple levels while also presenting novel methodological solutions. Crucially, Emotional Prosody Processing for Non-Native English Speakers: Towards an Integrative Emotion Paradigm begins by providing a conceptual background of emotion research, and then demonstrates a novel, workable, completely integrative paradigm for emotion research. This integrative approach reconciles theories such as the dimensional view of emotions, the standard basic emotions view, and the appraisal view of emotions. Following this theoretical section is an empirical exploration of the topic: the volume explores those views via experimental tasks. The insight into overall processing such a multiple-level approach allows a comprehensive answer to the question of how non native speakers of English process emotional prosody in their second language. By offering a critical, data-driven, integrative approach to investigating emotions in the minds of non-native English speakers, this volume is a significant and timely contribution to the literature on emotion prosody processing, bilingual research, and broadly understood emotion research.
... Experimental pragmatics is a novel approach which has been under development since early 2000s in Europe under such initiatives as euro-exprag and the Poznań School of Pragmatics under Roman Kopytko (Kopytko 2002). The latter has increased its output in recent years, with research on a variety of topics related to affective pragmatics, such as irony processing (Bromberek-Dyzman 2012, neuropragmatics of emotion (Jończyk 2015;Pikusa and Jończyk 2015;Jończyk et al. 2016), as well as emotional prosody processing (Bąk 2013). The empirical vein in pragmatics remains, however, in its nascent stage and it is its venerable theoretical tradition that can facilitate emotion research more reliably. ...
Chapter
Throughout the history of emotion research psychologists have been deeply uncomfortable with the idea that language may have a significant influence on emotion processing. The discomfort came largely from the long antagonism toward the anthropological principle of linguistic relativity. However, the conspicuous lack of competent and meaningful linguistic expertise in psycholinguistic research on emotions was also partially the result of the Chomskyan Revolution in mainstream linguistics, which turned it away from applied approaches. Thus psychologists felt no need to delve into language of emotions because for them emotions were primarily nonverbal phenomena and linguists were largely focused on arguments over finer points of Universal Grammar. Still, a few fields in applied linguistics continued to grow, develop new theories and tools which have a wide application in all subjects pertaining especially to word meanings, their use and functional distributions. These fields are semiotics, semantics, lexicography, corpus linguistics, and pragmatics. Although none of these disciplines are dedicated to investigating the language of emotions, they can be applied to such enterprise. This chapter focuses on the way these disciplines of applied linguistics can complement emotion research and allow for a rigorous and systematic research of the language of emotions.
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ADHD is diagnosed and treated more often in males than in females. Research on gender differences suggests that girls may be consistently underidentified and underdiagnosed because of differences in the expression of the disorder among boys and girls. One aim of the present study was to assess in a clinical sample of medication naive boys and girls with ADHD, whether there were significant gender x diagnosis interactions in co-existing symptom severity and executive function (EF) impairment. The second aim was to delineate specific symptom ratings and measures of EF that were most important in distinguishing ADHD from healthy controls (HC) of the same gender. Thirty-seven females with ADHD, 43 males with ADHD, 18 HC females and 32 HC males between 8 and 17 years were included. Co-existing symptoms were assessed with self-report scales and parent ratings. EF was assessed with parent ratings of executive skills in everyday situations (BRIEF), and neuropsychological tests. The three measurement domains (co-existing symptoms, BRIEF, neuropsychological EF tests) were investigated using analysis of variance (ANOVA) and random forest classification. ANOVAs revealed only one significant diagnosis x gender interaction, with higher rates of self-reported anxiety symptoms in females with ADHD. Random forest classification indicated that co-existing symptom ratings was substantially better in distinguishing subjects with ADHD from HC in females (93% accuracy) than in males (86% accuracy). The most important distinguishing variable was self-reported anxiety in females, and parent ratings of rule breaking in males. Parent ratings of EF skills were better in distinguishing subjects with ADHD from HC in males (96% accuracy) than in females (92% accuracy). Neuropsychological EF tests had only a modest ability to categorize subjects as ADHD or HC in males (73% accuracy) and females (79% accuracy). Our findings emphasize the combination of self-report and parent rating scales for the identification of different comorbid symptom expression in boys and girls already diagnosed with ADHD. Self-report scales may increase awareness of internalizing problems particularly salient in females with ADHD.
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The purpose of the present investigation was to examine the language skills of a group of 38 mildly to moderately behavior-disordered students. At issue was whether such students suffer from language disorders as has been reported for Children with more severe behavior disorders such as autism. The results from the Test of Language Development-Intermediate (TOLD-I) (Hammill & Newcomer, 1982) revealed that 37 of the children (97%) fell a minimum of one standard deviation below the normative mean on one or more of the TOLD-I subtests. These findings are offered in support of the notion that the mildly to moderately behavior-disordered child is at risk for language disorders.
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In recent years, a change in perspective in etiological models of attention deficit hyperactivity disorder (ADHD) has occurred in concordance with emerging concepts in other neuropsychiatric disorders such as schizophrenia and autism. These models shift the focus of the assumed pathology from regional brain abnormalities to dysfunction in distributed network organization. In the current contribution, we report findings from functional connectivity studies during resting and task states, as well as from studies on structural connectivity using diffusion tensor imaging, in subjects with ADHD. Although major methodological limitations in analyzing connectivity measures derived from noninvasive in vivo neuroimaging still exist, there is convergent evidence for white matter pathology and disrupted anatomical connectivity in ADHD. In addition, dysfunctional connectivity during rest and during cognitive tasks has been demonstrated. However, the causality between disturbed white matter architecture and cortical dysfunction remains to be evaluated. Both genetic and environmental factors might contribute to disruptions in interactions between different brain regions. Stimulant medication not only modulates regionally specific activation strength but also normalizes dysfunctional connectivity, pointing to a predominant network dysfunction in ADHD. By combining a longitudinal approach with a systems perspective in ADHD in the future, it might be possible to identify at which stage during development disruptions in neural networks emerge and to delineate possible new endophenotypes of ADHD. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.
Article
Psychopathology is increasingly viewed from a circuit perspective in which a disorder stems not from circumscribed anomalies in discrete brain regions, but rather from impairments in distributed neural networks. This focus on neural circuitry has rendered resting state functional connectivity MRI (rs-fcMRI) an increasingly important role in the elucidation of pathophysiology including attention-deficit/hyperactivity disorder (ADHD). Unlike many other MRI techniques that focus on the properties of discrete brain regions, rs-fcMRI measures the coherence of neural activity across anatomically disparate brain regions, examining the connectivity and organization of neural circuits. In this review, we explore the methods available to investigators using rs-fcMRI techniques, including a discussion of their relative merits and limitations. We then review findings from extant rs-fcMRI studies of ADHD focusing on neural circuits implicated in the disorder, especially the default mode network, cognitive control network, and cortico-striato-thalamo-cortical loops. We conclude by suggesting future directions that may help advance subsequent rs-fcMRI research in ADHD.
Book
Recent years have seen tremendous advances in understanding and treating Attention-Deficit/Hyperactivity Disorder (ADHD). Now in a revised and expanded third edition, this authoritative handbook brings the field up to date with current, practical information on nearly every aspect of the disorder. Drawing on his own and others' ongoing, influential research - and the wisdom gleaned from decades of front-line clinical experience - Russell A. Barkley provides insights and tools for professionals working with children, adolescents, or adults. Part I presents foundational knowledge about the nature and developmental course of ADHD and its neurological, genetic, and environmental underpinnings. The symptoms and subtypes of the disorder are discussed, as are associated cognitive and developmental challenges and psychiatric comorbidities. In Parts II and III, Barkley is joined by other leading experts who offer state-of-the-art guidelines for clinical management. Assessment instruments and procedures are described in detail, with expanded coverage of adult assessment. Treatment chapters then review the full array of available approaches - parent training programs, family-focused intervention for teens, school- and classroom-based approaches, psychological counseling, and pharmacotherapy - integrating findings from hundreds of new studies. The volume also addresses such developments as once-daily sustained delivery systems for stimulant medications and a new medication, atomoxetine. Of special note, a new chapter has been added on combined therapies. Chapters in the third edition now conclude with user-friendly Key Clinical Points. This comprehensive volume is intended for a broad range of professionals, including child and adult clinical psychologists and psychiatrists, school psychologists, and pediatricians. It serves as a scholarly yet accessible text for graduate-level courses. Note: Practitioners wishing to implement the assessment and treatment recommendations in the Handbook are advised to purchase the companion Workbook, which contains a complete set of forms, questionnaires, and handouts, in a large-size format with permission to photocopy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(jacket)
Article
Concurring with the shift from linking functions to specific brain areas towards studying network integration, resting state FMRI (R-FMRI) has become an important tool for delineating the functional network architecture of the brain. Fueled by straightforward data collection, R-FMRI analysis methods as well as studies reporting on R-FMRI have flourished, and already impact research on child- and adolescent psychiatric disorders. Here, we review R-FMRI analysis techniques and outline current methodological debates. Furthermore, we provide an overview of the main R-FMRI findings related to child- and adolescent psychiatric disorders. R-FMRI research has contributed significantly to our understanding of brain function in child and adolescent psychiatry: existing hypotheses based on task-based FMRI were confirmed and new insights into the brain's functional architecture of disorders were established. However, results were not always consistent. While resting state networks are robust and reproducible, neuroimaging research in psychiatric disorders is especially complicated by tremendous phenotypic heterogeneity. It is imperative that we overcome this heterogeneity when integrating neuroimaging into the diagnostic and treatment process. As R-FMRI allows investigating the richness of the human functional connectome and can be easily collected and aggregated into large-scale datasets, it is clear that R-FMRI can be a powerful tool in our quest to understand psychiatric pathology.