Neural Correlates of Reactive Aggression in Adult Attention-Deficit/Hyperactivity Disorder

Abstract

Despite not being part of the core diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD), emotion dysregulation is a highly prevalent and clinically important component of (adult) ADHD. Emotionally dysregulated behaviors such as reactive aggression have a significant impact on the functional outcome in ADHD. However, little is known about the mechanisms underlying reactive aggression in ADHD. In this study, we aimed to identify the neural correlates of reactive aggression as a measure of emotionally dysregulated behavior in adults with persistent ADHD during implicit emotion regulation processes. We analyzed associations of magnetic resonance imaging-based whole-brain activity during a dynamic facial expression task with levels of reactive aggression in 78 adults with and 78 adults without ADHD, and also investigated relationships of reactive aggression with symptoms and impairments. While participants with ADHD had higher reactive aggression scores than controls, the neural activation patterns of both groups to processing of emotional faces were similar. However, investigating the brain activities associated with reactive aggression in individuals with and without ADHD showed an interaction of diagnosis and reactive aggression scores. We found high levels of activity in the right insula, the hippocampus, and middle and superior frontal areas to be particularly associated with high reactive aggression scores within the ADHD group. Furthermore, the limbic activity was associated with more hyperactivity/impulsivity symptoms. These results suggest a partly differential mechanism associated with reactive aggression in ADHD as compared to controls. Emotional hyper-reactivity in the salience network as well as more effortful top–down regulation from the self-regulation network might contribute to emotionally dysregulated behavior as measured by reactive aggression.

The gut-microbiome in adult Attention-deficit/hyperactivity disorder - A Meta-analysis

“…We requested data from all ADHD case-control studies that included 16S fecal gut-microbiome samples, identified in two recent systematic reviews 13, 16 , see Supplementary Section 1.1, Table 1 and Supplementary Figure 15. We received clinical information and raw sequencing data from four adult cohorts (comprising the three articles including adults published to date: the NeuroIMAGE cohort 20, 21 and the Mental-Cat cohort from the Vall d’Hebron Research Institute in Barcelona (VHIR) 19 ; and unpublished data from the MIND-Set cohort 27 and our own cohort IMpACT2-NL 28 .…”

Aberrant Functional Connectivity of the Salience Network in Adult Patients with Tic Disorders: A Resting-State fMRI Study

“…Remarkably, these neuropsychological functions are closely related to salience-based information processing in the brain ( Seeley, 2019 ; Lugrin et al, 2023 ). Dysfunctional alterations in the salience network (SN) have been observed in various psychiatric disorders, including ADHD, OCD, post-traumatic stress disorder, and schizophrenia ( Berg et al, 2021 ; Huang et al, 2022 ; Jakobi et al, 2022 ; Tomiyama et al, 2022 ). In TD, the non-tic symptoms may rely on abnormalities of the cortical hubs within the SN, such as the anterior cingulate cortex (ACC), the ventral anterior insular cortex, and the temporoparietal junction (TPJ; Kucyi et al, 2012 ; Seeley, 2019 ; Uddin et al, 2019 ).…”