Cited by 854Attention Deficit Hyperactivity DisorderFunctional Brain Connectivity StudiesNeural and Behavioral Psychology Studies

The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index; none of the 32 sources its claims cite is checked for support yet.

Cingulate-Precuneus Interactions: A New Locus of Dysfunction in Adult Attention-Deficit/Hyperactivity Disorder

Open access

Abstract

Background Pathophysiologic models of attention-deficit/hyperactivity disorder (ADHD) have focused on frontal-striatal circuitry with alternative hypotheses relatively unexplored. On the basis of evidence that negative interactions between frontal foci involved in cognitive control and the non-goal-directed "default-mode" network prevent attentional lapses, we hypothesized abnormalities in functional connectivity of these circuits in ADHD.Methods Resting-state blood oxygen level-dependent functional magnetic resonance imaging (fMRI) scans were obtained at 3.0-Tesla in 20 adults with ADHD and 20 age- and sex-matched healthy volunteers.Results Examination of healthy control subjects verified presence of an antiphasic or negative relationship between activity in dorsal anterior cingulate cortex (centered at x = 8, y = 7, z = 38) and in default-mode network components. Group analyses revealed ADHD-related compromises in this relationship, with decreases in the functional connectivity between the anterior cingulate and precuneus/posterior cingulate cortex regions (p < .0004, corrected). Secondary analyses revealed an extensive pattern of ADHD-related decreases in connectivity between precuneus and other default-mode network components, including ventromedial prefrontal cortex (p < 3 x 10(-11), corrected) and portions of posterior cingulate (p < .02, corrected).Conclusions Together with prior unbiased anatomic evidence of posterior volumetric abnormalities, our findings suggest that the long-range connections linking dorsal anterior cingulate to posterior cingulate and precuneus should be considered as a candidate locus of dysfunction in ADHD.

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TL;DR

Resting-state functional connectivity in adults with ADHD showed reduced negative coupling between dorsal anterior cingulate cortex and posterior default-mode regions, especially precuneus/posterior cingulate cortex. The authors propose cingulate–precuneus long-range connections as a candidate locus of dysfunction in ADHD.

Key findings

  • Healthy controls showed an antiphasic/negative relationship between dorsal anterior cingulate cortex (dACC; centered at x=8, y=7, z=38) and default-mode network components.
  • ADHD participants had significantly less negative dACC–precuneus/PCC connectivity (p<.0004, corrected; cluster = 13,436 mm³).
  • Secondary analyses found ADHD-related decreases between precuneus and other default-mode components, including ventromedial prefrontal cortex (p<3×10⁻¹¹, corrected) and portions of posterior cingulate (p<.02, corrected).
  • Regression parameter estimates for the negative dACC–PCC/precuneus relationship were −0.23 ± 0.12 in healthy controls and −0.01 ± 0.15 in ADHD (t(38)=5.10, p=9.6×10⁻⁶; d=1.61, 95% CI 0.79–2.43), and across the whole sample correlated with ADHD symptoms (Pearson r between −0.61 and −0.54, n=38, p<.001).

Methods

  • Resting-state BOLD fMRI at 3.0 Tesla in 20 adults with ADHD and 20 age- and sex-matched healthy volunteers; 9 ADHD patients were currently treated with stimulants, discontinued for at least one day before scanning.
  • Seed-based functional connectivity analyses used three frontal ROIs (dACC, right inferior frontal gyrus, right medial frontal gyrus), GLM in FEAT, nuisance covariates, and mixed-effects group analyses in FSL/FLAME with cluster-level correction.
  • A study-specific template was created for spatial normalization; secondary analyses used the precuneus/PCC region as a seed, and exploratory correlations examined symptom severity.

Limitations

  • The paper states that no significant relationship was detected between connectivity estimates and inattention severity within the ADHD group, possibly because symptom ranges were restricted and inattentive/hyperactive symptoms were highly correlated (r=0.68).
  • The authors note that undiagnosed learning disorders in ADHD participants may have contributed, though high educational attainment diminishes this concern; they also note divergence from a prior adolescent ADHD connectivity report and suggest differences in seed ROI, anti-correlations, and age group as possible explanations.
  • Evident from the text: the sample was small (20 per group), cross-sectional, and did not directly assess attentional lapses, working memory, response variability, medication response, or effective connectivity.

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Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2007.06.025

Cites

13 of 13 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

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Show all 20 claims

  • Probably not a substantial claim. 20
  • It may state two separate claims as one. 7
23 of 23
  • The authors state this as an assumption.

    Cortical connectivity should be reciprocal.

    “Based on the assumption that cortical connectivity should be reciprocal (29), we used the timeseries corresponding to the”
    “Based on the assumption that cortical connectivity should be reciprocal (29), we used the timeseries corresponding to the region which differed significantly between groups in our primary analyses, and derived the corresponding positively and negatively predicted networks and their significant group differences.”
  • The paper relies on this without support.

    Standard task-based functional imaging studies depend on the precise specification of underlying neuropsychological deficits.

    “Additionally, standard task-based functional imaging studies depend on the precise specification of underlying neuropsychological deficits.”
2 of 2

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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.

  • Reported symptom-correlation direction conflicts with group data

    Major

    ADHD participants have much higher symptom counts in Table 1 and higher regression parameter estimates than controls. Given the reported within-group standard deviations, the stated negative correlation across the combined sample is incompatible with those group data.

  • Table 3 labels positive-network differences as negatively correlated

    Minor

    The Results describe the medial prefrontal and PCC/precuneus differences as involving positively correlated default-mode regions, but the corresponding portion of Table 3 is headed as decreases in negatively correlated connectivity.

  • Frontal seed labels are swapped in the supplement

    Minor

    The Methods assign the seed near x=34, y=45 to rIFG and the seed near x=49, y=19 to rMFG. The supplementary description assigns those locations to rMFG and rIFG, respectively.

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Citations

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Show all 13 references

Research works printed but not linked: 25

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  2. Sonuga-Barke, 2005, Causal models of ADHD: from common simple deficits to multiple developmental pathways, Biol Psychiatry, 57, 1231, 10.1016/j.biopsych.2004.09.008 · DOI · Paper page
  3. Friston, 1994, Functional and effective connectivity in neuroimaging: A synthesis, Hum Brain Mapp, 2, 56, 10.1002/hbm.460020107 · DOI · Paper page
  4. Margulies, 2007, Mapping the functional connectivity of anterior cingulate cortex, Neuroimage, 10.1016/j.neuroimage.2007.05.019 · DOI
  5. Fransson, 2005, Spontaneous low-frequency BOLD signal fluctuations: An fMRI investigation of the resting-state default mode of brain function hypothesis, Hum Brain Mapp, 26, 15, 10.1002/hbm.20113 · DOI · Paper page
  6. Raichle, 2007, A default mode of brain function: A brief history of an evolving idea, Neuroimage, 10.1016/j.neuroimage.2007.02.041 · DOI · Paper page
  7. Tian, 2006, Altered resting-state functional connectivity patterns of anterior cingulate cortex in adolescents with attention deficit hyperactivity disorder, Neurosci Lett, 400, 39, 10.1016/j.neulet.2006.02.022 · DOI · Paper page
  8. Zang, 2007, Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI, Brain Dev, 29, 83, 10.1016/j.braindev.2006.07.002 · DOI · Paper page
  9. Greicius, 2004, Default-mode network activity distinguishes Alzheimer’s disease from healthy aging: Evidence from functional MRI, Proc Natl Acad Sci U S A, 101, 4637, 10.1073/pnas.0308627101 · DOI · Paper page
  10. Kennedy, 2006, Failing to deactivate: Resting functional abnormalities in autism, Proc Natl Acad Sci U S A, 103, 8275, 10.1073/pnas.0600674103 · DOI · Paper page
  11. Liang, 2006, Widespread functional disconnectivity in schizophrenia with resting-state functional magnetic resonance imaging, NeuroReport, 17, 209, 10.1097/01.wnr.0000198434.06518.b8 · DOI
  12. Greicius, 2007, Resting-state functional connectivity in major depression: Abnormally increased contributions from subgenual cingulate cortex and thalamus, Biol Psychiatry, 10.1016/j.biopsych.2006.09.020 · DOI · Paper page
  13. Fox, 2005, The human brain is intrinsically organized into dynamic, anticorrelated functional networks, Proc Natl Acad Sci U S A, 102, 9673, 10.1073/pnas.0504136102 · DOI · Paper page
  14. Adler, 2004, Diagnosis and evaluation of adult ADHD, Psychiatr Clin North Am, 27, 187, 10.1016/j.psc.2003.12.003 · DOI · Paper page
  15. Kessler, 2006, The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication, Am J Psychiatry, 163, 716, 10.1176/ajp.2006.163.4.716 · DOI · Paper page
  16. Sporns, 2000, Connectivity and complexity: The relationship between neuroanatomy and brain dynamics, Neural Netw, 13, 909, 10.1016/S0893-6080(00)00053-8 · DOI
  17. Overmeyer, 2001, Distributed grey and white matter deficits in hyperkinetic disorder: MRI evidence for anatomical abnormality in an attentional network, Psychol Med, 31, 1425, 10.1017/S0033291701004706 · DOI · Paper page
  18. Carmona, 2005, Global and regional gray matter reductions in ADHD: A voxel-based morphometric study, Neurosci Lett, 389, 88, 10.1016/j.neulet.2005.07.020 · DOI · Paper page
  19. Makris, 2007, Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder, Cereb Cortex, 17, 1364, 10.1093/cercor/bhl047 · DOI · Paper page
  20. Hampson, 2006, Brain connectivity related to working memory performance, J Neurosci, 26, 13338, 10.1523/JNEUROSCI.3408-06.2006 · DOI · Paper page
  21. Bush, 2000, Cognitive and emotional influences in anterior cingulate cortex, Trends Cogn Sci, 4, 215, 10.1016/S1364-6613(00)01483-2 · DOI · Paper page
  22. Simmonds, 2007, Functional brain correlates of response time variability in children, Neuropsychologia, 10.1016/j.neuropsychologia.2007.01.013 · DOI · Paper page
  23. Shaw, 2006, Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder, Arch Gen Psychiatry, 63, 540, 10.1001/archpsyc.63.5.540 · DOI · Paper page
  24. Cavanna, 2006, The precuneus: A review of its functional anatomy and behavioural correlates, Brain, 129, 564, 10.1093/brain/awl004 · DOI · Paper page
  25. Bassett, 2006, Small-world brain networks, Neuroscientist, 12, 512, 10.1177/1073858406293182 · DOI · Paper page

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Metadata

Authors
Castellanos, F. X., Margulies, D. S., Kelly, C., Uddin, L. Q., Ghaffari, M., Kirsch, A., Shaw, D., Shehzad, Z., Di Martino, A., Biswal, B., Sonuga-Barke, E. J. S., Rotrosen, J., Adler, L. A., & Milham, M. P.
Affiliations
  • Nathan Kline Institute for Psychiatric Research (US)
  • New York University (US)
  • University of Medicine and Dentistry of New Jersey (US)
  • King's College London (GB)
Corresponding author
Castellanos, F. Xavier
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2008-02
Volume
63
Issue
3
Pages
332-337
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2023981958
Cited by
854
References
13
Citations by year
2026: 13 · 2025: 28 · 2024: 25 · 2023: 33 · 2022: 24 · 2021: 38 · 2020: 41 · 2019: 48 · 2018: 42 · 2017: 43 · 2016: 55 · 2015: 66 · 2014: 63 · 2013: 66 · 2012: 72
FWCI
26.58
Type
journal article
Language
en
Open access
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • Max Planck Digital Library (submittedVersion)
  • UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • MPG.PuRe (Max Planck Society) (submittedVersion)
Funders
  • National Institutes of Health (5r21mh066393-03, 5t32mh067763-10)
  • National Institute of Mental Health (5T32MH067763, 5R21MH066393, R01MH083246, R21-MH066393, T32MH-067763)
  • National Institute on Drug Abuse (R01DA016979)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
attention deficit hyperactivity disorder, dorsal anterior cingulate cortex, precuneus, posterior cingulate cortex, default mode network, functional connectivity, resting-state functional connectivity, ventromedial prefrontal cortex, cognitive control, adult ADHD
MeSH terms
Adult, Attention Deficit Disorder with Hyperactivity, Brain Mapping, Female, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen, Case-Control Studies, Prefrontal Cortex

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