CoChat
Sign Up
Cited by 66Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesNeurotransmitter Receptor Influence on Behavior

Hypoactivation in right inferior frontal cortex is specifically associated with motor response inhibition in adult ADHD

Open access
Morein‐Zamir, Sharon, Dodds, Chris, van Hartevelt, Tim J., Schwarzkopf, Wolfgang, Sahakian, Barbara, Müller, Ulrich, Robbins, Trevor·2014·Human Brain Mapping
DOI 10.1002/hbm.22539PMC PMC4336557
Open this paper in CoChat — free accountOpen PDF

Abstract

Adult ADHD has been linked to impaired motor response inhibition and reduced associated activation in the right inferior frontal cortex (IFC). However, it is unclear whether abnormal inferior frontal activation in adult ADHD is specifically related to a response inhibition deficit or reflects a more general deficit in attentional processing. Using functional magnetic resonance imaging, we tested a group of 19 ADHD patients with no comorbidities and a group of 19 healthy control volunteers on a modified go/no‐go task that has been shown previously to distinguish between cortical responses related to response inhibition and attentional shifting. Relative to the healthy controls, ADHD patients showed increased commission errors and reduced activation in inferior frontal cortex during response inhibition. Crucially, this reduced activation was observed when controlling for attentional processing, suggesting that hypoactivation in right IFC in ADHD is specifically related to impaired response inhibition. The results are consistent with the notion of a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation. Hum Brain Mapp 35:5141–5152, 2014 . © 2014 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc.

AI snapshot

Written from the paper’s full text.

TL;DR

In adults with ADHD and no comorbidities, right inferior frontal cortex activation during response inhibition (stopping vs. shifting) was reduced relative to matched healthy controls, and this reduction correlated with ADHD symptom severity. The findings suggest a selective motor response inhibition deficit in adult ADHD rather than a general attentional or executive-control difference.

Key findings

  • ADHD patients made more commission errors than controls (34.56% vs. 23.81%; F(1,36)=4.95, P=0.032, d=0.72), more omission errors (4.21% vs. 1.67%; F(1,36)=4.61, P=0.039, d=0.70), and had slower correct go RTs (610 vs. 577 msec; F(1,36)=4.59, P=0.039, d=0.70).
  • Across all participants, the direct contrast of stopping versus shifting revealed a right inferior frontal cortex cluster (peak [32, 16, −10], P=0.016 FWE-corrected, Z=5.13). The functional ROI analysis showed a significant group difference in this region (t(36)=2.24, P=0.03; contrast values 1.531 for controls vs. 0.513 for ADHD), which remained significant when co-varying for depression and go/stop performance.
  • In the ADHD group, CAARS scores were negatively associated with activation during stopping in this right IFC ROI (t(17)=−2.57, P=0.021, r=−0.540).
  • There were no significant group differences for shifting-versus-stopping ROIs (P>0.16 for all), and no evidence for slower switching in ADHD versus controls (F(1,36)=0.054, P=0.818).

Methods

  • fMRI study comparing 19 adults diagnosed with ADHD (no comorbidities) individually matched for age and gender with 19 healthy controls; medicated patients discontinued medication at least 24 h before scanning.
  • Participants performed a modified go/no-go task with simple and complex blocks; complex blocks included infrequent shift trials, allowing stopping to be contrasted with attentional shifting. Scanning used a 3 T Siemens Tim Trio; fMRI data were analyzed in SPM8 using GLM, whole-brain FWE-corrected analyses, functional ROIs around peak coordinates, anatomical AAL ROIs, conjunction analyses, and correlations with ADHD severity.
  • Behavioral analyses used repeated-measures ANOVAs for commission errors, omission errors, and correct go reaction times, with Cohen’s d where group effects were significant.

Limitations

  • Stated: the study had sufficient power to detect task-related activations in patients, but additional group differences might emerge with increased power; higher-than-average IQ may have mitigated functional abnormalities; greater task demands might reveal more widespread differences; the paradigm lacked control events for go trials; not all patients had a confirmed childhood diagnosis; just over half were taking psychostimulants, and longer-term medication effects cannot be excluded.
  • Stated: both male and female subjects were included, and although right IFC effect sizes were similar across gender, potential gender differences in adult ADHD remain important for future research.
  • Evident from the text: the sample was small (19 per group), comorbidity-free, and clinically referred, which may limit generalizability; medication status and prior stimulant exposure were not fully controlled beyond the 24-h washout.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/hbm.22539

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

29 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 45 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    This group difference remained significant when co-varying for depression levels and go and stop performance.

    “This remained significant when co‐varying for depression levels and go and stop performance.”
    Quote in the paperSubstantial claim
  • Findingown data

    The direct contrast of stop minus shift across all participants revealed a single cluster at whole brain FWE corrected level with the peak in the right IFC (P=0.016, peak coordinate [32,16,-10], cluster extent KE=5, Z=5.13).

    “The direct contrast of stop minus shift across all participants revealed a single cluster at whole brain FWE corrected level with the peak in the right IFC (P = 0.016, peak coordinate = [32, 16, −10], cluster extent (KE) = 5, Z = 5.13).”
    Quote in the paperSubstantial claim
  • Findingown data

    There was no group by difficulty interaction for commission errors (P=0.346).

    “Although there was an effect of task difficulty (F (1,36) = 44.13, P < 0.001), with increased commission errors in the complex (35.27%) compared with the simple task (23.09%), there was no group by difficulty interaction (P = 0.346).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Mean correct go RTs were slower in ADHD versus control participants overall: 610 vs 577 msec, F(1,36)=4.59, P=0.039, D=0.70.

    “Mean RTs were slower in ADHD versus control participants overall: 610 versus 577 msec, respectively (F (1,36) = 4.59, P = 0.039, D = 0.70), and group did not interact with any other factor (P > 0.481).”
    Quote in the paperNot a substantial claim
  • Findingown data

    ADHD patients had more omission errors on go trials (4.21%) compared with controls (1.67%), F(1,36)=4.61, P=0.039, D=0.70.

    “Additionally, ADHD patients had more omission errors on go trials (4.21%) compared with controls (1.67%), (F (1,36) = 4.61, P = 0.039, D = 0.70).”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 27
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Group did not interact with any other factor for correct go RTs (P>0.481).

    “Mean RTs were slower in ADHD versus control participants overall: 610 versus 577 msec, respectively (F (1,36) = 4.59, P = 0.039, D = 0.70), and group did not interact with any other factor (P > 0.481).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Responses were slower to houses (599 msec) than faces (588 msec), F(1,36)=16.21, P<0.001.

    “Responses were slower to houses (599 msec) than faces (588 msec) (F (1,36) = 16.21, P < 0.001), but stimuli interacted with task (F (2,72) = 6.96, P = 0.002) as latencies to houses were slower than faces in the complex task (F (1,36) = 37.96, P < 0.001) but not in the simple task (P > 0.5).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Latencies to houses were slower than faces in the complex task but not in the simple task.

    “Responses were slower to houses (599 msec) than faces (588 msec) (F (1,36) = 16.21, P < 0.001), but stimuli interacted with task (F (2,72) = 6.96, P = 0.002) as latencies to houses were slower than faces in the complex task (F (1,36) = 37.96, P < 0.001) but not in the simple task (P > 0.5).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    There was no effect of difficulty on omission errors, nor a group by difficulty interaction (P>0.5).

    “There was no effect of difficulty on omission errors, nor was there a group by difficulty interaction (P > 0.5).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Between group comparisons of the anatomical ROIs indicated reduced activation in the ADHD patients in stopping compared with shifting in the anterior insula bilaterally and the anterior cingulate (P<0.05 for all), but none of these comparisons survived correction for multiple comparisons.

    “Although between group comparisons of the anatomical ROIs indicated reduced activation in the ADHD patients in stopping compared with shifting in the anterior insula bilaterally and the anterior cingulate (P < 0.05 for all), none of these comparisons survived correction for multiple comparisons.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In all participants, shifting compared with stopping was associated with activation in the left precuneus.

    “| L | 5.11 | −6 | −66 | 50 | 20 | Precuneus”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In all participants, shifting compared with stopping was associated with activation in the left cuneus.

    “| L | 5.31 | −10 | −74 | 32 | 9 | Cuneus”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There were significant group differences in stopping relative to go trials in the right precuneus (t(36)=3.23, P=0.001) and left cuneus (t(36)=2.242, P=0.016) ROIs, with a marginal difference in the left precuneus (t(36)=1.322, P=0.09).

    “To complement this, there were significant group differences in stopping relative to go trials in the right precuneus (t (36) = 3.23, P = 0.001) and left cuneus (t (36) = 2.242, P = 0.016) ROIs, with a marginal difference in the left precuneus (t (36) = 1.322, P = 0.09).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Significant activation associated with stopping versus go was seen only in controls (P<0.05 for all) but not patients (P>0.19 for all).

    “Whilst significant activation was associated with shifting versus stopping in both the controls and patients (P < 0.001 for all ROIs), significant activation associated with stopping versus go was seen only in controls (P < 0.05 for all) but not patients (P > 0.19 for all).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no significant group differences in the shifting relative to go trials in the ROIs and both groups demonstrated significant activation when examined individually (all P values <0.002).

    “There were no significant group differences in the shifting relative to go trials in the ROIs and both groups demonstrated significant activation when examined individually (all P values <0.002).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no significant group differences in overall average activation in the areas activated in the conjunction analysis, either for stopping (t(36) = 0.840, P = 0.406) or for shifting (t(36) = 0.544, P = 0.590).

    “There were no significant group differences in overall average activation in the areas activated in the conjunction analysis, either for stopping (t (36) = 0.840, P = 0.406) or for shifting (t (36) = 0.544, P = 0.590).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The contrast of shift minus stop across all participants revealed several activations in the left and right precuneus, and the left cuneus as well as several activations in the cerebellum.

    “The contrast of shift minus stop across all participants revealed several activations in the left and right precuneus, and the left cuneus as well as several activations in the cerebellum (see Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Conjunction analyses indicated ADHD patients appeared to engage broadly the same brain regions as controls whilst performing the task and in particular frontoparietal areas, albeit with reduced extent.

    “Similarly, conjunction analyses indicated ADHD patients appeared to engage broadly the same brain regions as controls whilst performing the task and in particular frontoparietal areas, albeit with reduced extent, a finding common in patient groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no significant group differences in average activation in the areas activated in the conjunction analysis, both for complex (t(36) = 0.819, P = 0.207) and for simple stopping (t(36) = 0.451, P = 0.673).

    “There were no significant group differences in the average activation in the areas activated in the conjunction analysis, both for complex (t (36) = 0.819, P = 0.207) and for simple stopping (t (36) = 0.451, P = 0.673).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Despite clear evidence for right side dominance in stopping as indicated by the conjunction analyses, left IFC involvement specifically in stopping was noted at more liberal thresholds, with preliminary evidence of reduced activation in the ADHD group.

    “Despite clear evidence for right side dominance in stopping as indicated by the conjunction analyses, we also noted left IFC involvement specifically in stopping at more liberal thresholds, with preliminary evidence of reduced activation in the ADHD group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Despite engaging frontoparietal regions, behavioral impairments and reduced activation in specific control regions were found in the patients.

    “Nevertheless, despite engaging frontoparietal regions, behavioral impairments and reduced activation in specific control regions were found in the patients.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Despite group differences in the right IFC associated with stopping compared with shifting, activation in this area was noted in both groups separately.

    “Despite group differences in the right IFC associated with stopping compared with shifting, activation in this area was noted in both groups separately.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    There were no significant group or group by motion effects in the extent of three-dimensional motion in x, y, and z translations and rotations (P>0.5 for all comparisons).

    “There were no significant group or group by motion effects in the extent of three‐dimensional motion in x, y, and z translations and rotations (P > 0.5 for all comparisons).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Participants successfully shifted their attention on later trials, with no difference in magnitude between complex go and shift trials.

    “Planned comparisons confirmed that latencies to houses were slower than to faces both on complex go trials (F (1,36) = 73.18, P < 0.001) and shift trials (F (1,36) = 15.70, P < 0.001), thus, indicating participants successfully shifted their attention on the later trials, with no difference in the magnitude of this effect between complex go and shift trials (F (1,36) = 1.15, P = 0.291).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premiseown data

    Adult ADHD has been linked to impaired motor response inhibition and reduced activation in the right inferior frontal cortex.

    “Adult ADHD has been linked to impaired motor response inhibition and reduced associated activation in the right inferior frontal cortex (IFC).”
    • Also stated in: § INTRODUCTION · plain
      “Inhibitory dysfunction in ADHD, particularly in response inhibition as measured by go/no‐go and stop signal tasks, has been observed, in combination with atypical activation in frontostriatal and frontoparietal regions [Dickstein et al., 2006; Hart et al., 2013; Lijffijt et al., 2005; Willcutt et al., 2005].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Dickstein et al., 2006

      Not checked in the free run.

    • cites Hart et al., 2013

      Not checked in the free run.

    • cites Lijffijt et al., 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted).

    Premisenone given

    It is unclear whether abnormal inferior frontal activation in adult ADHD is specifically related to a response inhibition deficit or reflects a more general deficit in attentional processing.

    “However, it is unclear whether abnormal inferior frontal activation in adult ADHD is specifically related to a response inhibition deficit or reflects a more general deficit in attentional processing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In healthy adults, the modified go/no-go task has previously revealed greater activation in right IFC during inhibition relative to shifting and greater activation in left IPC during shifting relative to inhibition.

    “In healthy adults, this task has previously revealed greater activation in the right IFC during inhibition relative to shifting and greater activation in the left inferior parietal cortex (IPC) during shifting relative to inhibition [Dodds et al., 2011].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Dodds et al., 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Neuroimaging evidence in adult ADHD suggests functional abnormalities in a range of executive functions including response inhibition, working memory and task switching.

    “Similarly, neuroimaging evidence in adult ADHD suggests functional abnormalities in a range of executive functions including response inhibition, working memory and task switching [Cortese et al., 2012; Cubillo et al., 2012].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cortese et al., 2012

      Not checked in the free run.

    • cites Cubillo et al., 2012

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The groups were matched for age, gender, and verbal IQ, with ADHD patients reporting increased ADHD symptom severity levels and slightly elevated depression though not in the clinical range.

    “The groups were matched for age, gender, and verbal IQ, with ADHD patients reporting increased ADHD symptom severity levels and slightly elevated depression though not in the clinical range (see Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There is also evidence for widespread executive impairments in adult ADHD, consistent with the notion that inhibitory deficits may exist as part of a more general pattern of executive dysfunction.

    “However, as in children, there is also evidence for widespread executive impairments [Biederman et al., 2011; Boonstra et al., 2005; Hervey et al., 2004; McLean et al., 2004] consistent with the notion that inhibitory deficits may exist as part of a more general pattern of executive dysfunction [Nigg, 2001].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Biederman et al., 2011

      Not checked in the free run.

    • cites Boonstra et al., 2005

      Not checked in the free run.

    • cites Nigg, 2001

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The right IFC appears to play an important role in response inhibition and response control in general.

    “The right IFC appears to play an important role in response inhibition and response control in general [Aron et al., 2003; Dodds et al., 2011], but as noted above is also associated with multiple task demands such as attention, orienting and switching [Levy and Wagner, 2011; Wager et al., 2004].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Aron et al., 2003

      Not checked in the free run.

    • cites Dodds et al., 2011

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    ADHD patients did not satisfy DSM-IV criteria for any other disorders.

    “The patients did not satisfy DSM‐IV criteria for any other disorders and exclusion criteria included prior diagnosis of schizophrenia, psychotic disorders, or bipolar disorder; in addition to major depressive disorder, Obsessive Compulsive Disorder or substance abuse in the last 3 months.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Additional inconsistent results have been reported in the cerebellum and parietal cortex.

    “Additional inconsistent results have been reported in the cerebellum and parietal cortex [Dillo et al., 2010; Epstein et al., 2009; Hale et al., 2007].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Dillo et al., 2010

      Not checked in the free run.

    • cites Epstein et al., 2009

      Not checked in the free run.

    • cites Hale et al., 2007

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Varied results whilst comparing control and patient groups have been noted in the inferior frontal cortex.

    “Moreover, varied results whilst comparing control and patient groups have been noted in the inferior frontal cortex (IFC) [Carmona et al., 2012].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Carmona et al., 2012

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Medicated patients discontinued their medication at least 24 h before scanning.

    “To minimize the impact of psychotropic medication, medicated patients discontinued their medication at least 24 h before scanning [Gualtieri et al., 1982].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gualtieri et al., 1982

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In adults, behavioral evidence for inhibitory deficits appears robust, with some support for its specificity compared with other functions.

    “While there has been considerably less research into adult ADHD, the behavioral evidence for inhibitory deficits appears robust, with some support for its specificity compared with other functions [Bekker et al., 2005; Boonstra et al., 2010].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bekker et al., 2005

      Not checked in the free run.

    • cites Boonstra et al., 2010

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The results are consistent with a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation.

    “The results are consistent with the notion of a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Group differences in arousal and motivation do not account for the observed differences in inferior frontal activation during response inhibition.
    • Rests on an assumption: The sample of 19 ADHD patients with no comorbidities is representative of adult ADHD for generalizing the selective response inhibition deficit.

  • Classified as probably not a substantial claim.

    Premisecitation

    Results are mixed, with adult patients showing reduced, increased or no difference in activation in fronto-striatal substrates during task performance.

    “However results are mixed, with adult patients showing reduced, increased or no difference in activation in fronto‐striatal substrates during task performance [Carmona et al., 2012; Cubillo et al., 2010; Dibbets et al., 2010, 2009; Dillo et al., 2010; Epstein et al., 2007; Kooistra et al., 2010; Mulligan et al., 2011].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Carmona et al., 2012

      Not checked in the free run.

    • cites Cubillo et al., 2010

      Not checked in the free run.

    • cites Dibbets et al., 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Patients' levels of sustained attention, motivation and arousal likely fluctuate between studies and differ from healthy controls.

    “These are exacerbated even further by differences compared with healthy controls in patients' levels of sustained attention, motivation and arousal, which also likely fluctuate between studies. All three factors are believed to play a pivotal role in ADHD [Castellanos et al., 2006; Sergeant, 2005].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Castellanos et al., 2006

      Not checked in the free run.

    • cites Sergeant, 2005

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Our results are in line with ACC but not SMA abnormalities, as being specific to motor inhibition and response control in the present task, though the analysis did not survive correction for multiple comparisons.

    “Our results are in line with ACC but not SMA abnormalities, as being specific to motor inhibition and response control in the present task, though the analysis did not survive correction for multiple comparisons.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Hart et al., 2013

      Not checked in the free run.

    • cites Bush et al., 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The strength and novelty of the present study is in demonstrating right IFC hypoactivity in ADHD whilst avoiding such potential confounds.

    “Thus, the strength and novelty of the present study is in demonstrating right IFC hypoactivity in ADHD whilst avoiding such potential confounds.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The results demonstrate a source of variability in posterior regions of the brain, which is of interest as different studies employ different versions of response inhibition tasks, varying widely in task demands such as working memory.

    “They also demonstrate a source of variability in posterior regions of the brain, which is of interest as different studies employ different versions of response inhibition tasks, varying widely in task demands such as working memory.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    The effect sizes in the right IFC suggest a similar pattern of results across gender in the present case.

    “Though the effect sizes in the right IFC suggest a similar pattern of results across gender in the present case, potential gender differences in adult ADHD remain an important avenue for future research [Valera et al., 2010].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Valera et al., 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    It cannot be excluded that with increased power, additional group differences would be detected.

    “Whilst there was sufficient power to detect task related activations in the patient group, it cannot be excluded that with increased power, additional group differences would be detected.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    It is possible that longer-term effects of the stimulants influenced present results.

    “Just over half the patients were taking psychostimulants and although medication was discontinued 24 h before testing, it is also possible that longer‐term effects of the stimulants influenced present results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    As evidenced by the conjunction analysis, both stopping and shifting recruit adaptive online control activating frontoparietal regions in both groups.

    “In any case, as evidenced by the conjunction analysis both stopping and shifting recruit adaptive online control activating frontoparietal regions in both groups.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The results support impaired response control as a core deficit in adult ADHD with associated abnormal functional activation in the IFC.

    “The results support impaired response control as a core deficit in adult ADHD with associated abnormal functional activation in the IFC.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The adult ADHD patients with no comorbidities in this sample are representative of adult ADHD generally.

  • The quote only partly states this claim.

    Interpretationown data

    Current results suggest that with the simple task, as compared with the more complex task, posterior hyperactivation or compensatory activity is indeed the case.

    “Current results suggest that with the simple task, as compared with the more complex task, this is indeed the case.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Dillo et al., 2010

      Not checked in the free run.

    • cites Epstein et al., 2007

      Not checked in the free run.

    • cites Dibbets et al., 2009

      Not checked in the free run.

43 of 43

  • The paper relies on this without support.

    Group differences in arousal and motivation do not account for the observed differences in inferior frontal activation during response inhibition.

    “whilst ruling out likely group differences in attentional orienting, arousal and motivation.”
    “whilst controlling for general attentional and motivational differences.”

  • The paper relies on this without support.

    The sample of 19 ADHD patients with no comorbidities is representative of adult ADHD for generalizing the selective response inhibition deficit.

    “The results are consistent with the notion of a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation.”

  • The paper relies on this without support.

    The adult ADHD patients with no comorbidities in this sample are representative of adult ADHD generally.

    “The results support impaired response control as a core deficit in adult ADHD with associated abnormal functional activation in the IFC.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: t (18) = 2.316, p = .013

    Minor

    The paper reports p = .013 here; recomputing from the test statistic and its degrees of freedom gives p = .033 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .013 · recomputed p = .033

  • p-value fits an unstated one-tailed test: t (36) = 1.71, p = .0476

    Minor

    The paper reports p = .0476 here; recomputing from the test statistic and its degrees of freedom gives p = .096 (two-tailed). The reported value is what a one-tailed test gives, but the paper does not say near this result that a one-tailed test was used.

    Reported p = .0476 · recomputed p = .096

  • Inconsistent p-value: t (17) = −2.57, p = .021

    Minor

    The paper reports p = .021 here; recomputing from the test statistic and its degrees of freedom gives p = .020 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .021 · recomputed p = .020

  • Inconsistent p-value: t (18) = 2.556, p = .007

    Minor

    The paper reports p = .007 here; recomputing from the test statistic and its degrees of freedom gives p = .020 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .007 · recomputed p = .020

  • Inconsistent p-value: t (18) = 3.309, p = .001

    Minor

    The paper reports p = .001 here; recomputing from the test statistic and its degrees of freedom gives p = .004 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .001 · recomputed p = .004

  • Inconsistent p-value: t (18) = 3.527, p < .001

    Minor

    The paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .002 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p < .001 · recomputed p = .002

6 of 6

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upt(17) = -2.57reported p = .021 · recomputed p = .020

    “t (17) = −2.57, p = .021”

  • Doesn’t add upt(36) = 1.71reported p = .0476 · recomputed p = .096

    “t (36) = 1.71, p = .0476”

  • Doesn’t add upt(18) = 3.527reported p < .001 · recomputed p = .002

    “t (18) = 3.527, p < .001”

  • Doesn’t add upt(18) = 2.556reported p = .007 · recomputed p = .020

    “t (18) = 2.556, p = .007”

  • Doesn’t add upt(18) = 2.316reported p = .013 · recomputed p = .033

    “t (18) = 2.316, p = .013”

  • Doesn’t add upt(18) = 3.309reported p = .001 · recomputed p = .004

    “t (18) = 3.309, p = .001”

  • Not confirmedt(18) = 1.61reported p = .057 · recomputed p = .125

    “t (18) = 1.61, p = .057”

  • Not confirmedt(18) = 1.537reported p = .066 · recomputed p = .142

    “t (18) = 1.537, p = .066”

  • Not confirmedt(36) = 3.23reported p = .001 · recomputed p = .003

    “t (36) = 3.23, p = .001”

  • Not confirmedt(36) = 2.242reported p = .016 · recomputed p = .031

    “t (36) = 2.242, p = .016”

  • Not confirmedt(36) = 1.322reported p = .09 · recomputed p = .195

    “t (36) = 1.322, p = .09”

  • Not confirmedt(18) = 1.579reported p = .062 · recomputed p = .132

    “t (18) = 1.579, p = .062”

  • Not confirmedt(36) = 0.819reported p = .207 · recomputed p = .418

    “t (36) = 0.819, p = .207”

  • ConsistentF(1, 36) = 4.95reported p = .032 · recomputed p = .032

    “F (1,36) = 4.95, p = .032”

  • ConsistentF(1, 36) = 44.13reported p < .001 · recomputed p < .001

    “F (1,36) = 44.13, p < .001”

  • ConsistentF(1, 36) = 4.61reported p = .039 · recomputed p = .039

    “F (1,36) = 4.61, p = .039”

  • ConsistentF(1, 36) = 4.59reported p = .039 · recomputed p = .039

    “F (1,36) = 4.59, p = .039”

  • ConsistentF(1, 36) = 16.21reported p < .001 · recomputed p < .001

    “F (1,36) = 16.21, p < .001”

  • ConsistentF(2, 72) = 6.96reported p = .002 · recomputed p = .002

    “F (2,72) = 6.96, p = .002”

  • ConsistentF(1, 36) = 37.96reported p < .001 · recomputed p < .001

    “F (1,36) = 37.96, p < .001”

  • ConsistentF(1, 36) = 73.18reported p < .001 · recomputed p < .001

    “F (1,36) = 73.18, p < .001”

  • ConsistentF(1, 36) = 15.7reported p < .001 · recomputed p < .001

    “F (1,36) = 15.70, p < .001”

  • ConsistentF(1, 36) = 1.15reported p = .291 · recomputed p = .291

    “F (1,36) = 1.15, p = .291”

  • ConsistentF(1, 36) = 0.054reported p = .818 · recomputed p = .818

    “F (1,36) = 0.054, p = .818”

  • Consistentt(36) = 2.24reported p = .03 · recomputed p = .031

    “t (36) = 2.24, p = .03”

  • Consistentt(18) = 4.794reported p < .001 · recomputed p < .001

    “t (18) = 4.794, p < .001”

  • Consistentt(36) = 0.84reported p = .406 · recomputed p = .406

    “t (36) = 0.840, p = .406”

  • Consistentt(36) = 0.544reported p = .59 · recomputed p = .590

    “t (36) = 0.544, p = .590”

  • Consistentt(36) = 0.451reported p = .673 · recomputed p = .655

    “t (36) = 0.451, p = .673”

    The paper states a correction for multiple tests

29 of 29

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Peak Z-score differs between text and Table 2

    Minor

    For the stopping-versus-shifting peak at [32, 16, −10] with a cluster extent of 5, the text reports Z = 5.13, while Table 2 reports 5.15.

  • Complex-block trial ratio is 1:6, not 1:7

    Minor

    The complex version has 240 go trials and 40 trials of each infrequent type, giving six go trials per stop or shift trial. The stated 1:7 ratio applies to the simple version, not the complex version.

    Reported 7 · recomputed 6

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Nelson HE, 1982, The National Adult Reading Test Manual

Cited by

Sorted by citations

Related

Authors
Morein‐Zamir, S., Dodds, C., van Hartevelt, T. J., Schwarzkopf, W., Sahakian, B., Müller, U., & Robbins, T.
Affiliations
  • University of Cambridge (GB)
  • University of Exeter (GB)
  • Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge United Kingdom
Corresponding author
Morein‐Zamir, Sharon
ORCID
Venue
Human Brain Mapping
Publisher
Wiley
Published
2014-05-13
Volume
35
Issue
10
Pages
5141-5152
ISSN
  • 1065-9471 (ISSN-L)
  • 1097-0193
DOI
10.1002/hbm.22539
PMC
PMC4336557
OpenAlex
W1606851799
Semantic Scholar
3444fc2389e1e8b14bf1c843f793bd44daefe5c5
Cited by
65
References
67
Citations by year
2026: 5 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 10 · 2020: 7 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 6 · 2015: 10 · 2014: 2
FWCI
5.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Human Brain Mapping (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Anglia Ruskin Research Online (Anglia Ruskin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Wellcome Trust Grant (089589/Z/09/Z; PI TWR)
  • Medical Research Council and Wellcome Trust (G00001354)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
adult ADHD, response inhibition, right inferior frontal cortex, hypoactivation, go/no-go task, commission errors, attentional shift, prefrontal cortex, attentional processes
MeSH terms
Adult, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Brain Mapping, Decision Making, Female, Frontal Lobe, Humans, Image Processing, Computer-Assisted, Inhibition, Psychological, Functional Laterality, Magnetic Resonance Imaging, Male, Oxygen, Sex Factors, Echo-Planar Imaging, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review