Brain activation patterns in medicated versus medication-na\xefve adults with attention-deficit hyperactivity disorder during fMRI tasks of motor inhibition and cognitive switching

Jatta Berberat,Hanspeter E Killer,Ruth Huggenberger,Luca Remonda,Margherita Montali,Achmed Pircher,Philipp Gruber,Karl-Olof Lövblad

doi:10.1186/s12880-021-00579-3

Jatta Berberat, Hanspeter E Killer + Show 6 more

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https://doi.org/10.1186/s12880-021-00579-3

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Abstract

BackgroundAdult-attention-deficit-hyperactive-disorder (ADHD) is often unrecognized condition. FMRI examination along with neuropsychological testing might strengthen the diagnosis. We hypothesized that ADHD-adults with and without medication would show different fMRI pattern compared to healthy controls while testing tasks of motor inhibition and cognitive switching.Methods45 subjects in three age-matched groups: (1) controls, (2) ADHD-adults under medication (ADHD+) and (3) medication-naïve adults with ADHD (ADHD−) underwent fMRI and neuropsychological testing. Group analysis and population-based statistics were performed.ResultsDTVP-A, intellectual ability as well as attention capability, visual-perceptual and visual-motor abilities showed no significant differences between the groups. However, fMRI revealed statistically significant differences between the ADHD+, ADHD− and control groups on tasks of motor inhibition and cognitive switching on adults in bilateral fronto-striatal brain regions, inferior fronto-frontal, fronto-cingulate and fronto-parietal networks as well as in the parietal lobe (p < 0.05).ConclusionsfMRI offers the potential to differentiate between the ADHD+, ADHD− and control groups. FMRI possibly opens a new window for monitoring the therapeutic effect of ADHD medication.Trial registrationNCT02578342, registered at August 2015 to clinical trial registry (https://ichgcp.net/clinical-trials-registry/NCT02578342).

Highlights

IntroductionWe hypothesized that ADHD-adults with and without medication would show different functional MRI (fMRI) pattern compared to healthy controls while testing tasks of motor inhibition and cognitive switching
Recent meta-analyses of task-based on functional MRI studies show domain-specific brain dysfunctions in ADHD based on motor response (Go/No-Go task, Stop task and Switch task) bilateral frontal- and frontoparietal areas, occipital, parietal and temporal areas as well as insula when compared to controls [8, 18, 28, 30, 35]
Since the stimulant medication history is a major confounder in imaging studies [10], all ADHD participants under medication were only included in the study if they had achieved a stable phase with the medication doses]

Summary

Introduction

We hypothesized that ADHD-adults with and without medication would show different fMRI pattern compared to healthy controls while testing tasks of motor inhibition and cognitive switching. ADHD is characterized by age-inappropriate symptoms of inattention, impulsiveness and hyperactivity [27] It affects academic and social development and is associated with significant psychiatric comorbidities and Berberat et al BMC Med Imaging (2021) 21:53 mental health problems in adult life [3, 40]. Most of these adults live with the symptoms and suffer the often devastating effects of ADHD in their lives without identifying the source of their struggles. Recent meta-analyses of task-based on functional MRI (fMRI) studies show domain-specific brain dysfunctions in ADHD based on motor response (Go/No-Go task, Stop task and Switch task) bilateral frontal- and frontoparietal areas, occipital, parietal and temporal areas as well as insula when compared to controls [8, 18, 28, 30, 35]

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