Brain differences between persistent and remitted attention deficit hyperactivity disorder

Abstract

Previous resting state studies examining the brain basis of attention deficit hyperactivity disorder have not distinguished between patients who persist versus those who remit from the diagnosis as adults. To characterize the neurobiological differences and similarities of persistence and remittance, we performed resting state functional magnetic resonance imaging in individuals who had been longitudinally and uniformly characterized as having or not having attention deficit hyperactivity disorder in childhood and again in adulthood (16 years after baseline assessment). Intrinsic functional brain organization was measured in patients who had a persistent diagnosis in childhood and adulthood (n = 13), in patients who met diagnosis in childhood but not in adulthood (n = 22), and in control participants who never had attention deficit hyperactivity disorder (n = 17). A positive functional correlation between posterior cingulate and medial prefrontal cortices, major components of the default-mode network, was reduced only in patients whose diagnosis persisted into adulthood. A negative functional correlation between medial and dorsolateral prefrontal cortices was reduced in both persistent and remitted patients. The neurobiological dissociation between the persistence and remittance of attention deficit hyperactivity disorder may provide a framework for the relation between the clinical diagnosis, which indicates the need for treatment, and additional deficits that are common, such as executive dysfunctions.

Neural Correlates of Symptom Improvement Following Stimulant Treatment in Adults with Attention-Deficit/Hyperactivity Disorder

“…Our results are also in accord with previous resting-state fMRI studies showing stimulant-induced functional segregation between default and salience networks (Sripada et al 2013). Consistent with the default network dysregulation hypothesis of ADHD (Mattfeld et al 2014), decreased synchronization between these networks may represent decreased interference by default network processes in task-positive operations.…”

Neurobiology of Adult ADHD: Emerging Evidence for Network Dysfunctions

“…A study in adults with a childhood diagnosis of ADHD reported that persistent ADHD was associated with reduced connectivity within the DMN (medial PFC and PCC) compared with both controls and remitted ADHD, which did not differ ( Figure 3). 6 However, the expected negative connectivity (anticorrelation) between the dlPFC and medial PFC was present in the control group, but not in either the persistent or remitted ADHD groups. The authors of this study suggested this may indicate executive functioning weakness, as the ADHD groups were similarly impaired on neuropsychological testing.…”

“…The authors of this study suggested this may indicate executive functioning weakness, as the ADHD groups were similarly impaired on neuropsychological testing. 6 Another study that included two groups of medication naïve adults with ADHD reported increased connectivity between the DMN and a small region within left lateral PFC based on independent component analysis ( Figure 3). 7 In addition, higher levels of resting state activity within that area of PFC were associated with lower levels of performance on an attentional tasks.…”

“…A resting state fMRI study in adults with a childhood diagnosis of ADHD reported significantly reduced functional connectivity within the default mode network in persistent ADHD. 6 The areas in which either remitted ADHD (blue) or controls (orange) had greater connectivity from the seed region (black, posterior cingulate cortex) compared with persistent ADHD are approximated on a midline MRI. 6 This study also reported that neither ADHD group exhibited the expected negative functional connectivity between the other default mode network seed region (medial prefrontal cortex) and dorsolateral prefrontal cortex .…”

Creativity in Children with Attention Déficit Hyperactivity Disorder (ADHD)

“…Regarding the way to confront the creative task, there are similarities of functioning between ADHD and creative, both groups show difficulties for the deactivation of the default neural network (DNN) to tasks that require more mental effort, which leads to the maintenance of a dispersed, unfocused mental state (Mattfeld et al, 2014, Sonuga-Barke & Castellanos, 2007, Uddin et al, 2008.…”