Abstract

Significance: It has been reported that children with attention-deficit hyperactivity disorder (ADHD) have impairment in the recognition of angry but not of happy facial expressions, and they show atypical cortical activation patterns in response to facial expressions. However, little is known about neural mechanisms underlying the impaired recognition of facial expressions in school-aged children with ADHD and the effects of acute medication on their processing of facial expressions.Aim: We aimed to investigate the possibility that acute administration of methylphenidate (MPH) affects processing of facial expressions in ADHD children.Approach: We measured the hemodynamic changes in the bilateral temporo-occipital areas of ADHD children observing the happy and angry facial expressions before and 1.5 h after MPH or placebo administration in a randomized, double-blind, placebo-controlled, crossover design study.Results: We found that, regardless of medication, happy expressions induced increased oxyhemoglobin (oxy-Hb) responses in the right inferior occipital region but not in the superior temporal region. For angry expressions, oxy-Hb responses increased after MPH administration, but not after placebo administration, in the left inferior occipital area, whereas there was no significant activation before MPH administration.Conclusions: Our results suggest that (1) ADHD children consistently recruit the right inferior occipital regions to process happy expressions and (2) MPH administration to ADHD children enhances cortical activation in the left inferior occipital regions when they process angry expressions.

Highlights

  • Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric developmental disorders, and it affects ∼10% of school-aged children in the United States.[1]

  • We found that happy facial expressions induced significant increases in oxygenated hemodynamic responses compared with baseline in the right inferior occipital area before and after administration of either a placebo or MPH

  • In contrast to our prediction that MPH administration would induce activation in the right temporal area when observing angry expressions, which was based on previous findings showing a significant activation in the right temporal area in typically developing (TD) children,[18] we found that MPH, but not a placebo, induced increases of oxygenated hemoglobin (oxy-Hb) concentrations in the left inferior occipital area

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Summary

Introduction

Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric developmental disorders, and it affects ∼10% of school-aged children in the United States.[1]. It has been reported that 37% of school-aged ADHD children have impairment of emotion recognition.[3] Atypical processing of facial expressions, especially negative expressions, such as anger, fear, and sadness, has been reported for children with ADHD4–14 and for schoolaged children at risk of ADHD,[15] as well as for adult ADHD patients.[16,17] Some previous studies revealed that ADHD children had poor performance in the recognition of angry facial expressions compared with typically developing (TD) children, whereas that of happy facial expressions was not significantly different between ADHD and TD children.[5,8,13] In accordance with this behavioral evidence, neuroimaging studies with ADHD children have found atypical patterns of brain activation during recognition of facial expressions in the temporal areas, which are reported to be crucial for face processing.[5,18] Williams et al.[5] measured event-related potentials (ERPs) while ADHD children observed facial expressions and found that neural responses in ADHD children were significantly different from those in TD children for angry expressions but not for happy expressions. Previous behavioral and neuroimaging findings suggest that the impaired ability to process facial expressions in ADHD children could be related to an atypical neural processing of facial expressions

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