Increased Neural Responses to Reward in Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder and Their Unaffected Siblings

Abstract

Objective Attention-deficit/hyperactivity disorder (ADHD) is a heritable neuropsychiatric disorder associated with abnormal reward processing. Limited and inconsistent data exist about the neural mechanisms underlying this abnormality. Furthermore, it is unknown whether reward processing is abnormal in unaffected siblings of participants with ADHD. Method We used event-related functional magnetic resonance imaging (fMRI) to investigate brain responses during reward anticipation and receipt with an adapted monetary incentive delay task in a large sample of adolescents and young adults with ADHD (n=150), their unaffected siblings (n=92), and control participants (n=108), all of the same age. Results Participants with ADHD showed, relative to control participants, increased responses in the anterior cingulate, anterior frontal cortex, and cerebellum during reward anticipation, and in the orbitofrontal, occipital cortex, and ventral striatum during reward receipt. Responses of unaffected siblings were increased in these regions as well, except for the cerebellum during anticipation and the orbitofrontal cortex during receipt. Conclusion ADHD in adolescents and young adults is associated with enhanced neural responses in frontostriatal circuitry to anticipation and receipt of reward. The findings support models emphasizing aberrant reward processing in ADHD and suggest that processing of reward is subject to familial influences. Future studies using standard monetary incentive delay task parameters have to replicate our findings.

Prevalence and Treatment Outcomes of Persistent Negative Mood Among Children with Attention-Deficit/Hyperactivity Disorder and Aggressive Behavior

“…Moreover, there is increasing evidence that children and adults with ADHD show differences in blood oxygenation level dependent (BOLD) signal in functional magnetic resonance imaging (fMRI) during paradigms that assess reward and general affective processing (von Rhein et al 2015). There is certainly a need to better define these effects in light of task and sample differences.…”

Measuring the Neural Basis of Reward Anticipation and Reward Receipt in Attention-Deficit/Hyperactivity Disorder: The Importance of Task Design

“…1 We observed faster reaction times in rewarded compared with neutral trials 1 ( Figure 1 of the original article). Reward anticipation for the contrast rewarded versus neutral cue was associated with increased responses in the basal ganglia, including the VS, anterior cingulate cortex, insular cortex, visual cortex, and cerebellum 1 (Figure 2 of the original article).…”

“…Plichta and Scheres have provided a thoughtful comment on our article about increased neural responses to reward in adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD) and their unaffected siblings. 1 In their commentary, the authors express concerns about the interpretability of our findings in light of the specific version of the Monetary Incentive Delay (MID) task that we administered. Specifically, in our version of the MID task, we opted for a smaller gain amount per trial and a lower hit rate (i.e., probability for success) compared with the original version as described by Knutson et al 2 We had a clear rationale for these modifications.…”

“…I n the May 2015 issue of the Journal, von Rhein et al 1 investigated ventral-striatal (VS) response during monetary reward anticipation and receipt using an impressively large sample (N ¼ 350) of adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD), their unaffected siblings, and typically functioning controls. The goal was to resolve putative inconsistent findings in previous studies by using a statistically well-powered, multicenter, large-scale functional magnetic resonance imaging study.…”

And the best task is …? Using Task potency to infer task specificity

“…In the current analyses we included data from healthy control participants only (initial N=385) who each performed at least one of the following tasks during fMRI scanning: response inhibition (Stop Signal Task (STOP), (Logan et al, 1984;Rhein et al, 2015;van Rooij et al, 2015)), reward processing (REWARD, (Hoogman et al, 2011;Knutson et al, 2001;Rhein et al, 2015;von Rhein et al, 2015)), spatial working memory (WM, (van Ewijk et al, 2015;Klingberg et al, 2002;McNab et al, 2008;Rhein et al, 2015)) (see supplementary table 1). In addition, to the task-based MRI scans each participant completed a task-free resting state fMRI sca.…”