Activity In Medial Frontal Cortex Research Articles

Comparison of quantitative FDG-PET and MRI in anti-LGI1 autoimmune encephalitis

ObjectivesAnti-leucine glioma-inactivated protein 1 (anti-LGI1) autoimmune encephalitis (AE) presents as subacute memory loss, behavioral changes, and seizures. Diagnosis and treatment delays can result in long term sequelae, including cognitive impairment. 18F-FDG PET/CT may be more sensitive than MRI in patients with AE. Our objective was to determine if anti-LGI1 is associated with a distinct pattern of FDG uptake and whether this pattern persists following treatment.MethodsNineteen18F-FDG PET/CT brain scans (13 pre-treatment, 6 convalescent phase) for 13 patients with anti-LGI1 were studied using NeuroQ™ and CortexID™. The sensitivity of the PET images was compared to MRI. The Z scores of 47 brain regions between the pre-treatment and next available follow-up images during convalescence were compared.ResultsAll 18F-FDG PET/CT scans demonstrated abnormal FDG uptake, while only 6 (42.9%) pre-treatment brain MRIs were abnormal. The pre-treatment scans demonstrated hypermetabolism in the bilateral medial temporal cortices, basal ganglia, brain stem, and cerebellum and hypometabolism in bilateral medial and mid frontal, cingulate, and parietotemporal cortices. Overall, the brain uptake during convalescence showed improvement of the Z scores towards 0 or normalization of previous hypometabolic activity in medial frontal cortex, inferior frontal cortex, Broca’s region, parietotemporal cortex, and posterior cingulate cortex and previous hypermetabolic activity in medial temporal cortices, caudate, midbrain, pons and cerebellum.ConclusionsBrain FDG uptake was more commonly abnormal than MRI in the pre-treatment phase of anti-LGI1, and patterns of dysmetabolism differed in the pre-treatment and convalescent phases. These findings may expedite the diagnosis, treatment, and monitoring of anti-LGI1 patients.

The neural determinants of abstract beauty.

We have enquired into the neural activity which correlates with the experience of beauty aroused by abstract paintings consisting of arbitrary assemblies of lines and colours. During the brain imaging experiments, subjects rated abstract paintings according to aesthetic appeal. There was low agreement on the aesthetic classification of these paintings among participants. Univariate analyses revealed higher activity with higher declared aesthetic appeal in both the visual areas and the medial frontal cortex. Additionally, representational similarity analysis (RSA) revealed that the experience of beauty correlated with decodable patterns of activity in visual areas. These results are broadly similar to those obtained in previous studies on facial beauty. With abstract art, it was the involvement of visual areas implicated in the processing of lines and colours while with faces it was of visual areas implicated in the processing of faces. Both categories of aesthetic experience correlated with increased activity in medial frontal cortex. We conclude that the sensory areas participate in the selection of stimuli according to aesthetic appeal and that it is the co-operative activity between the sensory areas and the medial frontal cortex that is the basis for the experience of abstract visual beauty. Further, this co-operation is enabled by "experience dependent" functional connections, in the sense that currently the existence and high specificity of these connections can only be demonstrated during certain experiences.

Stay or Go? Neuronal Activity in Medial Frontal Cortex During a Voluntary Tactile Preference Task in Head-fixed Mice

The decision to move is influenced by sensory, attentional, and motivational cues. One such cue is the quality of the tactile input, with noxious or unpleasant sensations causing an animal to move away from the cue. Processing of painful and unpleasant sensation in the cortex involves multiple brain regions, although the specific role of the brain areas involved in voluntary, rather than reflexive movement away from unpleasant stimuli is not well understood. Here, we focused on the medial subdivision of secondary motor cortex, which is proposed to link sensory and contextual cues to motor action, and tested its role in controlling voluntary movement in the context of an aversive tactile cue. We designed a novel, 3D-printed tactile platform consisting of innocuous (grid) and mildly noxious (spiked) surfaces (50:50 % of total area), which enabled monitoring neuronal activity in the medial frontal cortex by two-photon imaging during a sensory preference task in head-fixed mice. We found that freely moving mice spent significantly less time on a spiked-surface, and that this preference was eliminated by administration of a local anesthetic. At the neuronal level, individual neurons were differentially modulated specific to the tactile surface encountered. At the population level, the neuronal activity was analyzed in relation to the events where mice chose to "stop-on" or "go-from" a specific tactile surface and when they "switched" surfaces without stopping. Notably, each of these three scenarios showed population activity that differed significantly between the grid and spiked tactile surfaces. Collectively, these data provide evidence that tactile quality is encoded within medial frontal cortex. The task pioneered in this study provides a valuable tool to better evaluate mouse models of nociception and pain, using a voluntary task that allows simultaneous recording of preference and choice. Grant support from NS109287 (G.A.), NS096246 (Y.U.), DK116624 (Y.U.) and NS113189 (Y.U.), the Iowa Neuroscience Institute, and the Williams- Cannon faculty fellowship (G.A). A.K. was supported by a predoctoral fellowship through NIH T32 Grant GM067795.

Medial Frontal Cortex Activity Predicts Information Sampling in Economic Choice.

Decision-making not only requires agents to decide what to choose but also how much information to sample before committing to a choice. Previously established frameworks for economic choice argue for a deliberative process of evidence accumulation across time. These tacitly acknowledge a role of information sampling in that decisions are only made once sufficient evidence is acquired, yet few experiments have explicitly placed information sampling under the participant's control. Here, we use fMRI to investigate the neural basis of information sampling in economic choice by allowing participants (n = 30, sex not recorded) to actively sample information in a multistep decision task. We show that medial frontal cortex (MFC) activity is predictive of further information sampling before choice. Choice difficulty (inverse value difference, keeping sensory difficulty constant) was also encoded in MFC, but this effect was explained away by the inclusion of information sampling as a coregressor in the general linear model. A distributed network of regions across the prefrontal cortex encoded key features of the sampled information at the time it was presented. We propose that MFC is an important controller of the extent to which information is gathered before committing to an economic choice. This role may explain why MFC activity has been associated with evidence accumulation in previous studies in which information sampling was an implicit rather than explicit feature of the decision.SIGNIFICANCE STATEMENT The decisions we make are determined by the information we have sampled before committing to a choice. Accumulator frameworks of decision-making tacitly acknowledge the need to sample further information during the evidence accumulation process until a decision boundary is reached. However, relatively few studies explicitly place this decision to sample further information under the participant's control. In this fMRI study, we find that MFC activity is related to information sampling decisions in a multistep economic choice task. This suggests that an important role of evidence representations within MFC may be to guide adaptive sequential decisions to sample further information before committing to a final decision.

Stay or go? Neuronal activity in medial frontal cortex during a voluntary tactile preference task in head-fixed mice

The decision to move is influenced by sensory, attentional, and motivational cues. One such cue is the quality of the tactile input, with noxious or unpleasant sensations causing an animal to move away from the cue. Processing of painful and unpleasant sensation in the cortex involves multiple brain regions, although the specific role of the brain areas involved in voluntary, rather than reflexive movement away from unpleasant stimuli is not well understood. Here, we focused on the medial subdivision of secondary motor cortex, which is proposed to link sensory and contextual cues to motor action, and tested its role in controlling voluntary movement in the context of an aversive tactile cue. We designed a novel, 3D-printed tactile platform consisting of innocuous (grid) and mildly noxious (spiked) surfaces (50:50 % of total area), which enabled monitoring neuronal activity in the medial frontal cortex by two-photon imaging during a sensory preference task in head-fixed mice. We found that freely moving mice spent significantly less time on a spiked-surface, and that this preference was eliminated by administration of a local anesthetic. At the neuronal level, individual neurons were differentially modulated specific to the tactile surface encountered. At the population level, the neuronal activity was analyzed in relation to the events where mice chose to “stop-on” or “go-from” a specific tactile surface and when they “switched” surfaces without stopping. Notably, each of these three scenarios showed population activity that differed significantly between the grid and spiked tactile surfaces. Collectively, these data provide evidence that tactile quality is encoded within medial frontal cortex. The task pioneered in this study provides a valuable tool to better evaluate mouse models of nociception and pain, using a voluntary task that allows simultaneous recording of preference and choice.

Modeling neural and self-reported factors of affective distress in the relationship between pain and working memory in healthy individuals

The relationship between pain and cognition has primarily been investigated in patients with chronic pain and healthy participants undergoing experimental pain. Recently, there has been interest in understanding the disruptive effects of non-experimental pain in otherwise healthy individuals. Recent studies suggest that healthy individuals reporting pain also demonstrate decrements in working memory (WM) performance, however factors contributing to this relationship remain poorly understood. The present study examined the association between pain and WM in a large community-based sample of healthy individuals and investigated whether self-reported affective distress and medial frontal cortex activity might help to explain this relationship. To address these research questions, a large publicly available dataset from the Human Connectome Project (N = 416) was sourced and structural equation modeling was utilized to examine relationships between pain intensity experienced over the past 7 days, self-reported affective distress, performance on a WM (n-back) task, and task-related activation in the medial frontal cortex. Examining participants who reported non-zero pain intensity in the past 7 days (n = 228), we found a direct negative association between pain intensity and performance on the WM n-back task, consistent with prior findings. Self-reported affective distress was not associated with WM performance. Additionally, pain intensity was indirectly associated with WM performance via WM task-related activity in the ventromedial prefrontal cortex (vmPFC). Our findings suggest that pain experienced in everyday life by otherwise healthy individuals may directly impact WM performance. Furthermore, WM task-related increases in vmPFC activity may be a factor contributing to this relationship.

Activation and disruption of a neural mechanism for novel choice in monkeys.

Neural mechanisms that mediate the ability to make value-guided decisions have received substantial attention in humans and animals1-6. Experiments in animals typically involve long training periods. By contrast, choices in the real world often need to be made between new options spontaneously. It is therefore possible that the neural mechanisms targeted in animal studies differ from those required for new decisions, which are typical of human imaging studies. Here we show that the primate medial frontal cortex (MFC)7 is involved in making new inferential choices when the options have not been previously experienced. Macaques spontaneously inferred the values of new options via similarities with the component parts of previously encountered options. Functional magnetic resonance imaging (fMRI) suggested that this ability was mediated by the MFC, which is rarely investigated in monkeys3; MFC activity reflected different processes of comparison for unfamiliar and familiar options. Multidimensional representations of options in the MFC used a coding scheme resembling that of grid cells, which is well known in spatial navigation8,9, to integrate dimensions in this non-physical space10 during novel decision-making. By contrast, the orbitofrontal cortex held specific object-based value representations1,11. In addition, minimally invasive ultrasonic disruption12 of MFC, but not adjacent tissue, altered the estimation of novel choice values.

The effect of ethnicity and team membership on face processing: a cultural neuroscience perspective.

In-ethnicity bias, as one of the in-group biases, is widespread in different cultures, interfering with cross-ethnicity communication. Recent studies have revealed that an in-ethnicity bias can be reduced by an in-team bias caused by the membership in a mixed-ethnicity team. However, the neural correlates of different in-group biases are still not clear, especially regarding possible cultural differences. A total of 44 participants (20 Chinese and 24 Germans) were recruited and completed a social categorization fMRI-task, categorizing faces according to their ethnicity and a learned team membership. Our behavioral results revealed both in-ethnicity and in-team bias in German participants, but not in Chinese participants. Our imaging results, however, showed both biases across all participants, as reflected in increased dorsal medial frontal cortex (MFC) activation for in-ethnicity, as well as in-team categorizations, while activation in ventral MFC was higher for in-ethnicity faces in Chinese participants than in the German participants. Our results highlight the importance of the dorsal MFC for in-group categorization across cultures and suggest that cultures might modulate in-group biases.

Decoding Changes of Mind in Voluntary Action-Dynamics of Intentional Choice Representations.

Voluntary actions rely on appropriate flexibility of intentions. Usually, we should pursue our goals, but sometimes we should change goals if they become too costly to achieve. Using functional magnetic resonance imaging, we investigated the neural dynamics underlying the capacity to change one's mind based on new information after action onset. Multivariate pattern analyses revealed that in visual areas, neural representations of intentional choice between 2 visual stimuli were unchanged by additional decision-relevant information. However, in fronto-parietal cortex, representations changed dynamically as decisions evolved. Precuneus, angular gyrus, and dorsolateral prefrontal cortex encoded new externally cued rewards/costs that guided subsequent changes of mind. Activity in medial frontal cortex predicted changes of mind when participants detached from externally cued evidence, suggesting a role in endogenous decision updates. Finally, trials with changes of mind were associated with an increase in functional connectivity between fronto-parietal areas, allowing for integration of various endogenous and exogenous decision components to generate a distributed consensus about whether to pursue or abandon an initial intention. In conclusion, local and global dynamics of choice representations in fronto-parietal cortex allow agents to maintain the balance between adapting to changing environments versus pursuing internal goals.

Medial Frontal Theta Is Entrained to Rewarded Actions.

Rodents lick to consume fluids. The reward value of ingested fluids is likely to be encoded by neuronal activity entrained to the lick cycle. Here, we investigated relationships between licking and reward signaling by the medial frontal cortex (MFC), a key cortical region for reward-guided learning and decision-making. Multielectrode recordings of spike activity and field potentials were made in male rats as they performed an incentive contrast licking task. Rats received access to higher- and lower-value sucrose rewards over alternating 30 s periods. They learned to lick persistently when higher-value rewards were available and to suppress licking when lower-value rewards were available. Spectral analysis of spikes and fields revealed evidence for reward value being encoded by the strength of phase-locking of a 6-12 Hz theta rhythm to the rats' lick cycle. Recordings during the initial acquisition of the task found that the strength of phase-locking to the lick cycle was strengthened with experience. A modification of the task, with a temporal gap of 2 s added between reward deliveries, found that the rhythmic signals persisted during periods of dry licking, a finding that suggests the MFC encodes either the value of the currently available reward or the vigor with which rats act to consume it. Finally, we found that reversible inactivations of the MFC in the opposite hemisphere eliminated the encoding of reward information. Together, our findings establish that a 6-12 Hz theta rhythm, generated by the rodent MFC, is synchronized to rewarded actions.SIGNIFICANCE STATEMENT The cellular and behavioral mechanisms of reward signaling by the medial frontal cortex (MFC) have not been resolved. We report evidence for a 6-12 Hz theta rhythm that is generated by the MFC and synchronized with ongoing consummatory actions. Previous studies of MFC reward signaling have inferred value coding upon temporally sustained activity during the period of reward consumption. Our findings suggest that MFC activity is temporally sustained due to the consumption of the rewarding fluids, and not necessarily the abstract properties of the rewarding fluid. Two other major findings were that the MFC reward signals persist beyond the period of fluid delivery and are generated by neurons within the MFC.

FMRI activity during associative encoding is correlated with cardiorespiratory fitness and source memory performance in older adults

Older adults (OA), relative to young adults (YA), exhibit age-related alterations in functional Magnetic Resonance Imaging (fMRI) activity during associative encoding, which contributes to deficits in source memory. Yet, there are remarkable individual differences in brain health and memory performance among OA. Cardiorespiratory fitness (CRF) is one individual difference factor that may attenuate brain aging, and thereby contribute to enhanced source memory in OA. To examine this possibility, 26 OA and 31 YA completed a treadmill-based exercise test to evaluate CRF (peak VO2) and fMRI to examine brain activation during a face-name associative encoding task. Our results indicated that in OA, peak VO2 was positively associated with fMRI activity during associative encoding in multiple regions including bilateral prefrontal cortex, medial frontal cortex, bilateral thalamus and left hippocampus. Next, a conjunction analysis was conducted to assess whether CRF influenced age-related differences in fMRI activation. We classified OA as high or low CRF and compared their activation to YA. High fit OA (HFOA) showed fMRI activation more similar to YA than low fit OA (LFOA) (i.e., reduced age-related differences) in multiple regions including thalamus, posterior and prefrontal cortex. Conversely, in other regions, primarily in prefrontal cortex, HFOA, but not LFOA, demonstrated greater activation than YA (i.e., increased age-related differences). Further, fMRI activity in these brain regions was positively associated with source memory among OA, with a mediation model demonstrating that associative encoding activation in medial frontal cortex indirectly influenced the relationship between peak VO2 and subsequent source memory performance. These results indicate that CRF may contribute to neuroplasticity among OA, reducing age-related differences in some brain regions, consistent with the brain maintenance hypothesis, but accentuating age-differences in other regions, consistent with the brain compensation hypothesis.

Startle Habituation and Midfrontal Theta Activity in Parkinson Disease

The ability to adapt to aversive stimuli is critical for mental health. Here, we investigate the relationship between habituation to startling stimuli and startle-related activity in medial frontal cortex as measured by EEG in both healthy control participants and patients with Parkinson disease (PD). We report three findings. First, patients with PD exhibited normal initial startle responses but reduced startle habituation relative to demographically matched controls. Second, control participants had midfrontal EEG theta activity in response to startling stimuli, and this activity was attenuated in patients with PD. Finally, startle-related midfrontal theta activity was correlated with the rate of startle habituation. These data indicate that impaired startle habituation in PD is a result of attenuated midfrontal cognitive control signals. Our findings could provide insight into the frontal regulation of startle habituation.

Corticostriatal Field Potentials Are Modulated at Delta and Theta Frequencies during Interval-Timing Task in Rodents.

Organizing movements in time is a critical and highly conserved feature of mammalian behavior. Temporal control of action requires corticostriatal networks. We investigate these networks in rodents using a two-interval timing task while recording LFPs in medial frontal cortex (MFC) or dorsomedial striatum. Consistent with prior work, we found cue-triggered delta (1–4 Hz) and theta activity (4–8 Hz) primarily in rodent MFC. We observed delta activity across temporal intervals in MFC and dorsomedial striatum. Rewarded responses were associated with increased delta activity in MFC. Activity in theta bands in MFC and delta bands in the striatum was linked with the timing of responses. These data suggest both delta and theta activity in frontostriatal networks are modulated during interval timing and that activity in these bands may be involved in the temporal control of action.

Neural Mechanisms of Credit Assignment in a Multicue Environment.

Learners should infer which features of environments are predictive of significant events, such as rewards. This "credit assignment" problem is particularly challenging when any of several cues might be predictive. We show that human subjects solve the credit assignment problem by implicitly "hypothesizing" which cue is relevant for predicting subsequent outcomes, and then credit is assigned according to this hypothesis. This process is associated with a distinctive pattern of activity in a part of medial frontal cortex. By contrast, when unexpected outcomes occur, hypotheses are redirected toward alternative cues, and this process is associated with activity in lateral orbitofrontal cortex.

Uncertainty-dependent activity within the ventral striatum predicts task-related changes in response strategy.

Recent neuroimaging work has demonstrated that the ventral striatum (VS) encodes confidence in perceptual decisions. However, it remains unclear whether perceptual uncertainty can signal the need to adapt behavior (such as by responding more cautiously) and whether such behavioral changes are related to uncertainty-dependent activity within the VS. Changes in response strategy have previously been observed following errors and are associated with both medial frontal cortex (MFC) and VS, two components of the performance-monitoring network. If uncertainty can elicit changes in response strategy (slowing), then one might hypothesize that these changes rely on the performance-monitoring network. In the present study, we investigated the link between perceptual uncertainty and task-related behavioral adaptations (response slowing and accuracy increases), as well as how such behavioral changes relate to uncertainty-dependent activity within MFC and VS. Our participants performed a two-choice perceptual decision-making task in which perceptual uncertainty was reported on each trial while behavioral and event-related functional magnetic resonance imaging data were collected. Analysis of the behavioral data revealed that uncertain (but correct) responses led to slowing on subsequent trials, a phenomenon that was positively correlated with increased accuracy. Critically, post-uncertainty slowing was negatively correlated with the VS activity elicited by uncertain responses. In agreement with previous reports, increases in MFC activation were observed for uncertain responses, although MFC activity was not correlated with post-uncertainty slowing. These results suggest that perceptual uncertainty can serve as a signal to adapt one's response strategy and that such behavioral changes are closely tied to the VS, a key node in the performance-monitoring network.

Unique functional abnormalities in youth with combined marijuana use and depression: an FMRI study.

Prior research has shown a relationship between early onset marijuana (MJ) use and depression; however, this relationship is complex and poorly understood. Here, we utilized passive music listening and fMRI to examine functional brain activation to a rewarding stimulus in 75 participants [healthy controls (HC), patients with major depressive disorder (MDD), frequent MJ users, and the combination of MDD and MJ (MDD + MJ)]. For each participant, a preferred and neutral piece of instrumental music was determined (utilizing ratings on a standardized scale), and each completed two 6-min fMRI scans of a passive music listening task. Data underwent pre-processing and 61 participants were carried forward for analysis (17 HC, 15 MDD, 15 MJ, 14 MDD + MJ). Two statistical analyses were performed using SPM8, an analysis of covariance with two factors (group × music type) and a whole brain, multiple regression analysis incorporating two predictors of interest [MJ use in past 28 days; and Beck Depression Inventory (BDI) score]. We identified a significant group × music type interaction. Post hoc comparisons showed that the preferred music had significantly greater activation in the MDD + MJ group in areas including the right middle and inferior frontal gyri extending into the claustrum and putamen and the anterior cingulate. No significant differences were identified in MDD, MJ, or HC groups. Multiple regression analysis showed that activation in medial frontal cortex was positively correlated with amount of MJ use, and activation in areas including the insula was negatively correlated with BDI score. Results showed modulation in brain activation during passive music listening specific to MDD, frequent MJ users. This supports the suggestion that frequent MJ use, when combined with MDD, is associated with changes in neurocircuitry involved in reward processing in ways that are absent with either frequent MJ use or MDD alone. This could help inform clinical recommendations for youth with MDD.

Updating Expected Action Outcome in the Medial Frontal Cortex Involves an Evaluation of Error Type

Forming expectations about the outcome of an action is an important prerequisite for action control and reinforcement learning in the human brain. The medial frontal cortex (MFC) has been shown to play an important role in the representation of outcome expectations, particularly when an update of expected outcome becomes necessary because an error is detected. However, error detection alone is not always sufficient to compute expected outcome because errors can occur in various ways and different types of errors may be associated with different outcomes. In the present study, we therefore investigate whether updating expected outcome in the human MFC is based on an evaluation of error type. Our approach was to consider an electrophysiological correlate of MFC activity on errors, the error-related negativity (Ne/ERN), in a task in which two types of errors could occur. Because the two error types were associated with different amounts of monetary loss, updating expected outcomes on error trials required an evaluation of error type. Our data revealed a pattern of Ne/ERN amplitudes that closely mirrored the amount of monetary loss associated with each error type, suggesting that outcome expectations are updated based on an evaluation of error type. We propose that this is achieved by a proactive evaluation process that anticipates error types by continuously monitoring error sources or by dynamically representing possible response-outcome relations.

Topographic analysis of the development of individual activation patterns during performance monitoring in medial frontal cortex

Age-related improvements in human performance monitoring have been linked to maturation of medial frontal cortex (MFC) in healthy youth, however, imaging studies conflict regarding age-related changes in MFC activation patterns. Topographical analysis of single-subject activation enables measurement of variation in location of MFC activation by age, as well as other potentially influential factors (e.g., performance on task). In this study, 22 youth (ages 8–17 years) and 21 adults (ages 23–51 years) underwent functional magnetic resonance imaging during a performance monitoring task examining interference and errors. Single-subject factors (extent of MFC activation, age and accuracy) were entered into a three-level hierarchical linear model to test the influence of these characteristics on location of MFC activation. Activation shifted from a rostral/anterior to a more dorsal/posterior location with increasing age and accuracy during interference. Inclusion of age and accuracy accounted for almost all of the unexplained variance in location of interference-related activation within MFC. This pattern links improvement of performance-monitoring capacity to age-related increases in posterior MFC and decreases in anterior MFC activation. Taken together, these results show the maturation of performance monitoring capacity to depend on more focal engagement of posterior MFC substrate for cognitive control.

The neural correlates of cognitive control in bipolar I disorder: An fMRI study of medial frontal cortex activation during a Go/No-go task

In addition to dysregulation of mood, bipolar I disorder (BD I) is characterized by abnormalities in the execution of cognitive control. Hypoactivation of a specific sub-region in the cognitive control network, located in the medial frontal cortex, has been described among BD I patients. The aim of this study was to investigate whether patients with BD I showed decreased activation in this brain region as compared to healthy controls when performing a cognitive control task. Twenty-four BD I patients and 24 healthy controls performed a Go/No-go task during a functional magnetic resonance imaging (fMRI) session. Performance and response times were recorded. The BD I subjects had significantly slower response times and more patients made errors of omission compared to the healthy controls during the task. Both BD I subjects and healthy controls demonstrated activations in the brain region of interest during the task, but analyses revealed no statistically significant differences between groups. Although the patients display some deviances in behavioural measures, this study reveals no significant differences between BD I subjects and healthy controls in recruitment of the medial frontal cortex during a Go/No-go task.

Identifying a consistent pattern of neural function in attention deficit hyperactivity disorder: a meta-analysis

The neurobiological underpinnings of attention deficit hyperactivity disorder (ADHD) are inconclusive. Activation abnormalities across brain regions in ADHD compared with healthy controls highlighted in task-based functional magnetic resonance imaging (fMRI) studies are heterogeneous. To identify a consistent pattern of neural dysfunction in ADHD, a meta-analysis of fMRI studies using Go/no-go, Stop and N-back tasks was undertaken. Several databases were searched using the key words: 'ADHD and fMRI' and 'ADHD and fMRI task'. In all, 20 studies met inclusion criteria comprising 334 patients with ADHD and 372 healthy controls and were split into N-back, Stop task and Go/no-go case-control groups. Using Signed Differential Mapping each batch was meta-analysed individually and meta-regression analyses were used to examine the effects of exposure to methylphenidate (MPH), length of MPH wash-out period, ADHD subtype, age and intelligence quotient (IQ) differences upon neural dysfunction in ADHD. Across all tasks less activity in frontal lobe regions compared with controls was detected. Less exposure to treatment and lengthier wash-out times resulted in less left medial frontal cortex activation in N-back and Go/no-go studies. Higher percentage of combined-type ADHD resulted in less superior and inferior frontal gyrus activation. Different IQ scores between groups were linked to reduced right caudate activity in ADHD. Consistent frontal deficits imply homogeneous cognitive strategies involved in ADHD behavioural control. Our findings suggest a link between fMRI results and the potentially normalizing effect of treatment and signify a need for segregated examination and contrast of differences in sample characteristics in future studies.