Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent childhood disorder marked by inattention and/or hyperactivity symptoms. ADHD may also relate to impaired executive function (EF), but is often studied in a single EF task per sample. The current study addresses the question of unique vs. overlapping relations in brain activity across multiple EF tasks and ADHD symptom burden. Three in-scanner tasks drawn from distinct EF domains (cognitive flexibility, working memory, and inhibition) were collected from children with and without an ADHD diagnosis (N = 63). Whole-brain activity and 11 regions of interest were correlated with parent reports of inattention and hyperactivity symptoms. Across the three EF domains, brain activity related to ADHD symptom burden, but the direction and location of these associations differed across tasks. Overall, activity in sensory and default mode network regions related to ADHD, and these relations did not consistently overlap across EF domains. We observed both distinct and overlapping patterns for inattention and hyperactivity symptoms. By studying multiple EF tasks in the same sample, we identified a heterogenous neural profile related to attention symptom burden in children. Our results inform ADHD characterization and treatment and explain some of the variable brain results related to EF and ADHD reported in the literature.
Highlights
Attention-deficit/hyperactivity disorder (ADHD) is a neurodeve lopmental disorder diagnosed in an estimated 9% of the school-aged population in the US (Danielson et al, 2018)
Parent ratings of ADHD symptom burden were higher for in dividuals with an ADHD diagnosis; this was true for both inattention (t = 7.12, p < .001) and hyperactivity (t = 6.33, p < .001) symptom ratings, though there was notable overlap (Fig. 2)
We ad dressed two main questions: First, in a large pediatric group with varied ADHD symptom burden, do two facets of ADHD differentially relate to neural activity in three executive function (EF) tasks? We found some overlap between in attention and hyperactivity measures during our working memory task, but otherwise found distinct symptom results, with a notable lack of consistent pattern of ADHD-brain activity correlations across the three EF tasks
Summary
Attention-deficit/hyperactivity disorder (ADHD) is a neurodeve lopmental disorder diagnosed in an estimated 9% of the school-aged population in the US (Danielson et al, 2018). Behavioral models of EF support the idea that while an individual is consistent in their EF abilities, there may be variability across different components or do mains, reflecting both unity and diversity (Miyake and Friedman, 2012) This variability could be relevant to EF impairments in ADHD, which itself is phenotypically heterogenous, with estimates of EF impairments in ADHD ranging from 35 to 80% (Biederman et al, 2004; Happe et al, 2006; Kofler et al, 2018; Nigg et al, 2005; Roberts et al, 2017; Willcutt et al, 2005a)
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