Shared and disorder-specific task-positive and default mode network dysfunctions during sustained attention in paediatric Attention-Deficit/Hyperactivity Disorder and obsessive/compulsive disorder

Abstract

Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) share problems with sustained attention, and are proposed to share deficits in switching between default mode and task positive networks. The aim of this study was to investigate shared and disorder-specific brain activation abnormalities during sustained attention in the two disorders. Twenty boys with ADHD, 20 boys with OCD and 20 age-matched healthy controls aged between 12 and 18 years completed a functional magnetic resonance imaging (fMRI) version of a parametrically modulated sustained attention task with a progressively increasing sustained attention load. Performance and brain activation were compared between groups. Only ADHD patients were impaired in performance. Group by sustained attention load interaction effects showed that OCD patients had disorder-specific middle anterior cingulate underactivation relative to controls and ADHD patients, while ADHD patients showed disorder-specific underactivation in left dorsolateral prefrontal cortex/dorsal inferior frontal gyrus (IFG). ADHD and OCD patients shared left insula/ventral IFG underactivation and increased activation in posterior default mode network relative to controls, but had disorder-specific overactivation in anterior default mode regions, in dorsal anterior cingulate for ADHD and in anterior ventromedial prefrontal cortex for OCD. In sum, ADHD and OCD patients showed mostly disorder-specific patterns of brain abnormalities in both task positive salience/ventral attention networks with lateral frontal deficits in ADHD and middle ACC deficits in OCD, as well as in their deactivation patterns in medial frontal DMN regions. The findings suggest that attention performance in the two disorders is underpinned by disorder-specific activation patterns.

An Investigation Into Response Inhibition in Distinct Clinical Groups Within Obsessive-Compulsive Disorder

“…The increased level of omission errors in those with OCD only is indicative of a deficit in sustained attention (50). Whilst the higher level of omission errors reported here contrasts with previous work where OCD (in the absence of comorbidities) was associated with a decrease in omission and an increase in commission errors (22), it is in line with studies showing poorer sustained attention in OCD (51,52).…”

Neural dysfunction during temporal discounting in paediatric Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder

“…Findings of decreased activation in these regions extend previous findings in ADHD during TD ( Ortiz et al, 2015 , Rubia et al, 2009 ), by showing that deficits are shared with patients with OCD during this task. Interestingly, we have previously shown that IFG underactivation is disorder-specific in ADHD relative to OCD during inhibitory and attentional control ( Norman et al, 2016 , Norman et al, 2017 , Rubia et al, 2010 ). Current findings are in line with suggestions that inhibitory control and TD are mediated by neuroanatomically overlapping but functionally dissociable fronto-striatal neural circuits ( Fineberg et al, 2014 ), and suggest that IFG underactivation in ADHD relative to OCD is task-specific to the contexts of inhibitory and attentional control, but not the context of TD.…”

“…In the brain, we hypothesised shared underactivation in both disorders relative to controls in striatal, DLPFC and cerebellar regions previously implicated in ADHD ( Carlisi et al, 2016 , Hart et al, 2013 , Norman et al, 2016 ) and OCD ( Carlisi et al, 2017a , Carlisi et al, 2017b , Carlisi et al, in press ; Norman et al, 2016 ; Rubia et al, 2010 , Rubia et al, 2011 ). We, however, hypothesised more prominent or disorder-specific abnormalities in OCD patients in VMPFC/OFC ( Carlisi et al, 2017b , Menzies et al, 2008 , Norman et al, 2016 , Norman et al, 2017 ), and larger or disorder-specific underactivation in IFG in ADHD patients ( Noreika et al, 2013 , Norman et al, 2016 , Norman et al, 2017 , Rubia et al, 2009 , Rubia et al, 2010 ). Data have been published in other forms elsewhere, although in this paper we provide the novel comparison between controls, patients with ADHD and patients with OCD ( Carlisi et al, 2016 , Carlisi et al, 2017b , Chantiluke et al, 2014 , Christakou et al, 2011 , Rubia et al, 2009 ).…”

“…the poor ability to inhibit inappropriate prepotent responses during response inhibition paradigms ( Benzina et al, 2016 , Lipszyc and Schachar, 2010 , Norman et al, 2016 , Rubia et al, 2010 , Woolley et al, 2008 , Zandt et al, 2009 ). Recent fMRI studies and a large meta-analysis have provided evidence for disorder-specific fronto-insula-striatal activation abnormalities in the two disorders, with lateral inferior prefrontal underactivation being disorder-specific to ADHD ( Norman et al, 2016 , Norman et al, 2017 , Rubia et al, 2010 , Rubia et al, 2011 ), and medial frontal dysfunction being disorder-specific to OCD ( Norman et al, 2016 , Norman et al, 2017 ). However, impulsivity is a multifaceted construct ( Fineberg et al, 2014 ), and much less research has examined the neural basis of other impulsivity domains such as choice impulsivity, defined as the tendency to prefer smaller immediate rewards over larger delayed rewards, which is also a feature of ADHD and OCD ( Noreika et al, 2013 , Patros et al, 2016 , Sohn et al, 2014 ).…”

Error Processing and Inhibitory Control in Obsessive-Compulsive Disorder: A Meta-analysis Using Statistical Parametric Maps

“…, in gray matter structure(3,5,(67)(68)(69), during symptom provocation(63,70,71), and across multiple cognitive and decision-making tasks in OCD(3-5, 72, 73). Moreover, many resting-state, structural and functional abnormalities within these regions are shared with unaffected relatives of patients with OCD (26,64,65,68,71,74,75), and are OCD-specific relative to disorders such as attention deficit/hyperactivity disorder and anxiety disorders(3,42,54,72,73). The current findings provide further evidence for cross-modal abnormalities in cinguloopercular and orbito-striato-thalamic brain networks in OCD(3,6), which may be endophenotypes for the disorder(68).…”