Default mode network activity and neuropsychological profile in male children and adolescents with attention deficit hyperactivity disorder and conduct disorder

Abstract

It is known that patients with Attention Deficit and Hyperactivity disorder (ADHD) and Conduct disorder (CD) commonly shows greater symptom severity than those with ADHD alone and worse outcomes. This study researches whether Default mode network (DMN) is altered in adolescents with ADHD + CD, relative to ADHD alone and controls or not. Ten medication-naïve boys with ADHD + CD, ten medication-naïve boys with ADHD and 10-age-matched typically developing (TD) controls underwent functional magnetic resonance imaging (fMRI) scans in the resting state and neuropsychological tasks such as the Wisconsin Card Sorting Test (WCST), Stroop Test TBAG Form (STP), Auditory Verbal learning Test (AVLT), Visual Auditory Digit Span B (VADS B) were applied to all the subjects included. fMRI scans can be used only nine patients in each groups. The findings revealed group differences between cingulate cortex and primary mortor cortex; cingulate cortex and somatosensory association cortex; angular gyrus (AG) and dorsal posterior cingulate cortex, in these networks increased activity was observed in participants with ADHD + CD compared with the ADHD. We found that lower resting state (rs)-activity was observed between left AG and dorsal posterior cingulate cortex, whereas higher rs-activity connectivity were detected between right AG and somatosensory association cortex in ADHD relative to the ones with ADHD + CD. In neuropsyhcological tasks, ADHD + CD group showed poor performance in WISC-R, WCST, Stroop, AVLT tasks compared to TDs. The ADHD + CD group displayed rs-functional abnormalities in DMN. Our results suggest that abnormalities in the intrinsic activity of resting state networks may contribute to the etiology of CD and poor prognosis of ADHD + CD.

Development of Psychopathy from Childhood

“…Cikili-Uytun et al found that increased DMN activity in ADHD+CD group compared to ADHD and in the ADHD group compared to controls in several DMN regions. This result is consistent with rs-fMRI studies, which showed that the increased DMN with ADHD but diferent from the study which showed decreased DMN activity with CD adolescents [91]. Increased activity in the DMN was present in some previous studies, and this study is consistent with the hypothesis that ADHD individuals may have increased disturbances during task performance and that relect faulty deactivation of the DMN [92].…”

Aggression Subtypes Relate to Distinct Resting State Functional Connectivity in Disruptive Children and Adolescents

“…Other recent studies have also reported reduced DMN rsFC in male adolescents with CD compared to healthy controls (Zhou et al, 2016). Higher ADHD scores, however, related to increased rsFC density and alterations (Lu, Zhou, Zhang, et al, 2017;Pu et al, 2017;Uytun et al, 2016) in DMN areas. Critically, these rs-fMRI studies were mostly limited to male adolescents with CD, and further distinct manifestations of aggression including reactive and proactive aggression (RA/PA) (Dodge & Coie, 1987) largely neglected.…”

“…After Fisher's transformation to normally distributed z-scores, general linear model (GLM) analyses were computed. Second-level analysis included random-effects analysis of covariance for group comparisons, with further analyses adding ADHD symptoms as additional covariates of no interest based on previous reports on the importance of considering ADHD symptoms to differentiate rsFC of cases and controls (Broulidakis et al, 2016;Uytun et al, 2016). Linear regressions separately tested the association between RA and PA and CU total score and dimensions on rsFC within cases.…”

“…We applied a frequently used seed-based approach (Aghajani et al, 2016(Aghajani et al, , 2017Pujol et Werhahn et al 7 al., 2012;Uytun et al, 2016). Based on the findings of altered rsFC of the DMN (Broulidakis et al, 2016;Lu et al, 2015;Zhou et al, 2016) and SN (Aghajani et al, 2016(Aghajani et al, , 2017, we defined regions of interest (ROIs) in these brain areas and expected to find reduced rsFC in aggressive cases compared to healthy controls.…”

Regional Dysregulation and Aberrant Functional Connectivity in ADHD

“…It has been found that abnormalities in the intrinsic activity of resting state networks may contribute to the etiology of conduct disorder and poor prognosis of ADHD in combination with conduct disorder (Uytun et al, 2016) [15]; whereas reduced default mode functional connectivity is associated with expressions of conduct disorder (Broulidakis et al, 2016) [16], individuals presenting ADHD present disproportionately high expressions of default mode network activity related to goal-directed tasks accompanied by 'switch-specificity alterations in the right insula region (Sidlauskaite et al, 2016) [17]. Moreover, adult ADHD patients demonstrated markedly stronger resting-state functional connectivity in the anterior cingulate gyrus of the executive control network, as well as in the cerebellar network, than healthy control adults (Moster et al, 2016) [18].…”