Dickstein SG, Bannon K, Castellanos FX, Milham MP. The neural correlates of attention deficit hyperactivity disorder: an ALE meta-analysis. J Child Psychol Psychiatry 47: 1051-1062

NYU Child Study Center, New York, NY 10016, USA.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 10/2006; 47(10):1051-62. DOI: 10.1111/j.1469-7610.2006.01671.x
Source: PubMed


Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent and commonly studied forms of psychopathology in children and adolescents. Causal models of ADHD have long implicated dysfunction in fronto-striatal and frontal-parietal networks supporting executive function, a hypothesis that can now be examined systematically using functional neuroimaging. The present work provides an objective, unbiased statistically-based meta-analysis of published functional neuroimaging studies of ADHD.
A recently developed voxel-wise quantitative meta-analytic technique known as activation likelihood estimation (ALE) was applied to 16 neuroimaging studies examining and contrasting patterns of neural activity in patients with ADHD and healthy controls. Voxel-wise results are reported using a statistical threshold of p < .05, corrected. Given the large number of studies examining response inhibition, additional meta-analyses focusing specifically on group differences in the neural correlates of inhibition were included.
Across studies, significant patterns of frontal hypoactivity were detected in patients with ADHD, affecting anterior cingulate, dorsolateral prefrontal, and inferior prefrontal cortices, as well as related regions including basal ganglia, thalamus, and portions of parietal cortex. When focusing on studies of response inhibition alone, a more limited set of group differences were observed, including inferior prefrontal cortex, medial wall regions, and the precentral gyrus. In contrast, analyses focusing on studies of constructs other than response inhibition revealed a more extensive pattern of hypofunction in patients with ADHD than those of response inhibition.
To date, the most consistent findings in the neuroimaging literature of ADHD are deficits in neural activity within fronto-striatal and fronto-parietal circuits. The distributed nature of these results fails to support models emphasizing dysfunction in any one frontal sub-region. While our findings are suggestive of the primacy of deficits in frontal-based neural circuitry underlying ADHD, we discuss potential biases in the literature that need to be addressed before such a conclusion can be fully embraced.

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Available from: Francisco Xavier Castellanos
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    • "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. "
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    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 Broca's area in adolescents with ADHD: resting-state fMRI ". PSiCL
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    • "Cherkasova y Hechtman han mostrado que hay anomalías estructurales en otras regiones del cerebro, sobre todo en el cerebelo y los lóbulos parietales. Además, los estudios de imágenes funcionales, han encontrado déficits en la actividad neuronal en los circuitos fronto-parietales, fronto-estriados y, especialmente en el corteza cingulada anterior, la corteza prefrontal dorsolateral y la corteza prefrontal inferior (Dickstein, Bannon, Castellanos & Milham, 2006). Los estudios de imágenes funcionales mostraron anomalías no sólo durante el reposo sino también durante condiciones activas. "
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    • "The growing interest in computerbased cognitive training programs also coincides with the recent reconceptualization of ADHD as a neurocognitive disorder (American Psychiatric Association , 2013) and emergence of new theories that implicate deficient EFs as either underlying causes or associated features of ADHD (Barkley, 1997; Nigg, Willcutt, Doyle, & Sonuga-Barke, 2005; Rapport et al., 2008). Meta-analytic and factor analytic studies consistently identify three primary EFs—working memory, behavioral inhibition, and set shifting—two of which (working memory , set shifting) show developmental stability throughout the lifespan and have a strong independent genetic basis (Dickstein et al., 2006; Friedman et al., 2008; Huizingua, Dolan, & van der Molen, 2006; Miyake et al., 2000). All three have been targeted in recent cognitive training studies for children with ADHD; however, only working memory , set shifting, and some attention processes appear to be promising treatment targets as discussed below. "

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