Frontostriatal Dysfunction During Decision Making in Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder

Abstract

BackgroundThe aim of the current paper is to provide the first comparison of computational mechanisms and neurofunctional substrates in adolescents with attention-deficit/hyperactivity disorder (ADHD) and adolescents with obsessive-compulsive disorder (OCD) during decision making under ambiguity.MethodsSixteen boys with ADHD, 20 boys with OCD, and 20 matched control subjects (12–18 years of age) completed a functional magnetic resonance imaging version of the Iowa Gambling Task. Brain activation was compared between groups using three-way analysis of covariance. Hierarchical Bayesian analysis was used to compare computational modeling parameters between groups.ResultsPatient groups shared reduced choice consistency and relied less on reinforcement learning during decision making relative to control subjects, while adolescents with ADHD alone demonstrated increased reward sensitivity. During advantageous choices, both disorders shared underactivation in ventral striatum, while OCD patients showed disorder-specific underactivation in the ventromedial orbitofrontal cortex. During outcome evaluation, shared underactivation to losses in patients relative to control subjects was found in the medial prefrontal cortex and shared underactivation to wins was found in the left putamen/caudate. ADHD boys showed disorder-specific dysfunction in the right putamen/caudate, which was activated more to losses in patients with ADHD but more to wins in control subjects.ConclusionsThe findings suggest shared deficits in using learned reward expectancies to guide decision making, as well as shared dysfunction in medio-fronto-striato-limbic brain regions. However, findings of unique dysfunction in the ventromedial orbitofrontal cortex in OCD and in the right putamen in ADHD indicate additional, disorder-specific abnormalities and extend similar findings from inhibitory control tasks in the disorders to the domain of decision making under ambiguity.

Low self-control and aggression exert serial mediation between inattention/hyperactivity problems and severity of internet gaming disorder features longitudinally among adolescents

“…IHPs may contribute importantly to IGD via low levels of self-control and high levels of aggressive behavior. Neurodevelopmental mismatches in the frontostriatal system or dysfunctional neurotransmission may be the neurobiological mechanisms underlying these observations (Norman et al, 2018).…”

Association of Affected Neurocircuitry With Deficit of Response Inhibition and Delayed Gratification in Attention Deficit Hyperactivity Disorder: A Narrative Review

“…The frontostriatal functional connectivity takes the responsibility for how information is processed by permitting transmission of signal downstream from cortex, and getting a feedback simultaneously from striatum to cortex. Many fMRI researchers have found out that these impairments can be caused by decreased neurons within prefrontal cortex and striatum of ADHD (Ortiz et al, 2015; Hauser et al, 2016; Szekely et al, 2017; Norman et al, 2018). Compared to normal controls, many statistical evidences of ADHD neuroimaging have been provided for neuropsychological deficits owing to these regions.…”

Localized Connectivity in Obsessive-Compulsive Disorder: An Investigation Combining Univariate and Multivariate Pattern Analyses

“…Meanwhile, aberrant structural connectivity of left superior longitudinal fasciculus and the body of corpus callosum has been identified in patients with OCD, which was associated with executive control function (Spalletta et al, 2014). For functional MRI (fMRI) researches in OCD, patients show abnormal activation in several brain regions, which are essential for some domains of neuropsychological function such as decision making [ventromedial orbitofrontal cortex (OFC)] (Norman et al, 2018), error monitoring [amygdala, presupplementary motor area (preSMA), and subgenual anterior cingulate cortex] (Grützmann et al, 2016), response inhibition [inferior parietal gyrus (IPG), inferior frontal gyrus, and preSMA] (de Wit et al, 2012), reward-based learning (hippocampus, putamen, and amygdala; Marsh et al, 2015), fear conditioning (caudate and hippocampus) and extinction recall (cerebellum, posterior cingulate cortex, and putamen; Milad et al, 2013), cognitive flexibility [caudate and ventrolateral prefrontal cortex (PFC)], as well as goal-directed planning (putamen and dorsolateral PFC; Vaghi et al, 2017). The results obtained from these functional neuroimaging researches appear to be highly inconsistent, which might be attributed to clinical heterogeneity (e.g., symptom severity, onset age, illness duration, medication exposure, and comorbidity profiles) of OCD participants.…”