Abstract
Aerobic exercise can improve cognitive functions in healthy individuals and in various clinical groups, which might be particularly relevant for patients with ADHD. This study investigated the effects of a single bout of aerobic exercise on attention and executive functions in adult patients with ADHD, including functional MRI to examine the underlying neural mechanisms. On two different days, 23 adult patients with ADHD and 23 matched healthy controls performed in a flanker task, while functional MR images were collected, following 30 min of continuous stationary cycling with moderate intensity as well as after a control condition (watching a movie). Behavioral performance and brain activation were tested for differences between groups and conditions and for interactions to investigate whether exercise improves executive function to a greater extent in patients compared to healthy controls. Exercise significantly improved reaction times in congruent and incongruent trials of the flanker task in patients with ADHD but not in healthy controls. We found no changes in brain activation between the two conditions for either group. However, a subgroup analysis of ADHD patients with a higher degree of cardiorespiratory fitness revealed decreased activation in premotor areas during congruent trials and in premotor and medial frontal cortex during incongruent trials in the exercise compared to the control condition. Our results indicate exercise-induced improvements in attention and processing speed in patients with ADHD, demonstrating that adult patients with ADHD may benefit from an acute bout of exercise. These findings could be of high relevance for developing alternative treatment approaches for ADHD. In addition, results of the current study contribute to elucidate the neurophysiological mechanisms underlying the beneficial effects of exercise on cognition and to better understand the role of cardiorespiratory fitness on these effects.
Highlights
Attention deficit hyperactivity disorder (ADHD) is well-known as a disorder affecting children, even though symptoms often persist until adulthood [1]
Patients and healthy controls did not differ with respect to age, gender, and BMI, but patients scored higher than controls in ADHD symptoms as well as in depression scores
We found interaction effects between group and condition for reaction times in congruent and incongruent trials [congruent: F(1, 22) = 14.78, p = 0.001, η2 = 0.40; incongruent: F(1, 22) = 7.47, p = 0.012, η2 = 0.25], which were due to enhanced performance in patients in the exercise compared to the control condition
Summary
Attention deficit hyperactivity disorder (ADHD) is well-known as a disorder affecting children, even though symptoms often persist until adulthood [1]. Impairments in executive function, e.g., difficulties to sustain attention, increased distractibility, or reduced control of response interference are common among patients with ADHD [2], affecting various areas of daily life. Adult patients often report difficulties at work or in social communication, situations in which attentional and interference control are crucial [3]. There are numerous studies demonstrating that patients with ADHD show impaired performance in these tasks compared to healthy participants [4,5,6,7]. Neuroimaging studies have further reported abnormal brain activation in patients during executive function tasks, mainly affecting fronto-striatal and parietal regions, and temporal and subcortical structures [8,9,10,11,12]. There is no consensus on the direction of activation differences [11,12,13,14]
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