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Cited by 147Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesDevelopmental and Educational Neuropsychology

Attentional Control Activation Relates to Working Memory in Attention-Deficit/Hyperactivity Disorder

Open access
Burgess, Gregory C., Depue, Brendan E., Ruzic, Luka, Willcutt, Erik G., Du, Yiping P., Banich, Marie T.·2010·Biological Psychiatry
DOI 10.1016/j.biopsych.2009.10.036PMC PMC2953472
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Abstract

Background Attentional control difficulties in individuals with attention-deficit/hyperactivity disorder (ADHD) might reflect poor working memory (WM) ability, especially because WM ability and attentional control rely on similar brain regions. The current study examined whether WM ability might explain group differences in brain activation between adults with ADHD and normal control subjects during attentional demand.Methods Participants were 20 adults with ADHD combined subtype with no comorbid psychiatric or learning disorders and 23 control subjects similar in age, IQ, and gender. The WM measures were obtained from the Wechsler Adult Intelligence Scale-III and Wechsler Memory Scale-Revised. Brain activation was assessed with functional magnetic resonance imaging (fMRI) while performing a Color-Word Stroop task.Results Group differences in WM ability explained a portion of the activation in left dorsolateral prefrontal cortex (DLPFC), which has been related to the creation and maintenance of an attentional set for task-relevant information. In addition, greater WM ability predicted increased activation of brain regions related to stimulus-driven attention and response selection processes in the ADHD group but not in the control group.Conclusions The inability to maintain an appropriate task set in young adults with combined type ADHD, associated with decreased activity in left DLPFC, might in part be due to poor WM ability. Furthermore, in individuals with ADHD, higher WM ability might relate to increased recruitment of stimulus-driven attention and response selection processes, perhaps as a compensatory strategy.

Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2009.10.036

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

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

Claims the paper makes

0 of 57 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The incongruent-NI contrast yielded greater activation for controls than for the ADHD group in right dACC.

    “The event-related contrast of incongruent-NI yielded significantly greater activation for controls versus ADHD in right dACC.”
    Quote in the paperSubstantial claim
  • Findingown data

    The group difference in the working memory correlation was in the opposite direction within three other regions, including ventromedial PFC (BA10).

    “In contrast, the group difference in the WM correlation was in the opposite direction within three other regions. These regions included ventromedial PFC (BA10), which has been implicated in “default mode” processing (38).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [38] Castellanos, 2008, Cingulate-precuneus interactions: a new locus of dysfunction in adult attention-deficit/hyperactivity disorder, Biol Psychiatry source

      Not checked in the free run.

  • Findingown data

    The ADHD group showed reduced reaction-time interference relative to controls.

    “an unpaired samples t-test revealed that proportion RT interference scores [(mean RT for incongruent trials - mean RT for NI trials) / mean RT for NI trials] were reduced for the ADHD group relative to controls, t(41)=-2.329, p = .025.”
    Quote in the paperSubstantial claim
  • Findingown data

    High working memory individuals with ADHD deactivated ventromedial PFC transiently for more difficult incongruent trials relative to neutral trials.

    “Instead, high WM individuals with ADHD deactivated this region in a transient manner for more-difficult incongruent trials relative to neutral trials (i.e., inc-NI contrast).”
    Quote in the paperSubstantial claim
  • Findingown data

    These event-related activation effects remained significant after adding working memory ability as a covariate.

    “After adding WM ability as a covariate, these effects remained significant (Table 3).”
    Quote in the paperSubstantial claim
  • May combine two claims. 14
  • Classified as probably not a substantial claim. 17

  • May combine two claims.

    Findingown data

    The control group deactivated ventromedial PFC during task relative to rest, but the ADHD group did not show this sustained deactivation.

    “The control group deactivated this region during task relative to rest (i.e., I, C, and N blocked contrasts), but the ADHD group did not show this sustained deactivation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    This difference arose from a positive correlation in the ADHD group and a non-significant correlation in the control group.

    “Again, this difference arose from a positive correlation in the ADHD group and a non-significant correlation in the control group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The control group activated left angular gyrus and right DLPFC, whereas the ADHD group did not.

    “The control group activated these regions, but the ADHD group did not.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Higher working memory ability was related to greater reaction-time facilitation in the ADHD group but not in the control group.

    “Increased WM ability was related to increased RT facilitation in the ADHD group, r(20)=.468, p = .038, but not for the control group, r(23)=.111, p > .60, suggesting that WM ability increased task-irrelevant processing in the ADHD group, but not in the control group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In each case, greater working memory ability was associated with greater activation in the ADHD group, whereas the control group relationship was negative or non-significant.

    “In each case, greater WM ability was associated with greater activation in the ADHD group, whereas in the control group, the relationship between WM ability and blocked activity was either negative (i.e. greater WM, less activity) or non-significant (cf. Figure 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The groups did not differ on accuracy interference scores or on the correlation between working memory ability and behavioral interference scores.

    “The groups did not differ on accuracy interference scores, or on the correlation between WM ability and behavioral interference scores.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Left DLPFC activity was reduced for the ADHD group versus controls during congruent and neutral blocks, but not during incongruent blocks.

    “Consistent with this, left DLPFC activity was reduced for the ADHD group versus controls during C and N blocks, but not during I blocks.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisereasoning

    For response selection, attentional demands are greater for incongruent trials than for congruent and neutral trials.

    “For response selection, attentional demands will be greater for incongruent than congruent and neutral trials, because the two sources of color information in incongruent trials relate to potential responses that conflict.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    ADHD is defined by difficulty in controlling, maintaining, and directing attention.

    “A defining characteristic of attention-deficit/hyperactivity disorder (ADHD) is a difficulty in controlling, maintaining, and directing attention (1).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] 2000

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The groups did not differ in IQ, reading and spelling performance, or math performance, and were similar in overall age.

    “Groups did not differ in IQ, reading and spelling performance, or math performance, and were consistent in overall age.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The demands of task-set maintenance vary across different Stroop task conditions.

    “Others have argued that the demands of task set maintenance vary across different Stroop task conditions (9).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Kane, 2003, Working-memory capacity and the control of attention: The contributions of goal neglect, response competition, and task set to Stroop interference, J Exp Psychol Gen source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Three ADHD individuals were identified as working memory outliers and excluded before analyses to avoid spurious correlations.

    “Furthermore, three individuals with ADHD were identified as outliers on WM measures. These individuals were excluded prior to subsequent analyses, to avoid spurious correlations between WM ability and brain activity.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The search space was restricted to regions that had shown Stroop effects in previous studies from the authors' laboratory.

    “To simultaneously increase our sensitivity and avoid spurious results, we constrained our search space to regions that have shown Stroop effects in previous studies conducted in our lab (23-25, 32, 33).”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [23] Milham, 2005, Anterior cingulate cortex: An fMRI analysis of conflict specificity and functional differentiation, Hum Brain Mapp source

      Not checked in the free run.

    • cites [24] Banich, 2000, FMRI studies of Stroop tasks reveal unique roles of anterior and posterior brain systems in attentional selection, J Cogn Neurosci source

      Not checked in the free run.

    • cites [25] Milham, 2003, Competition for priority in processing increases prefrontal cortex's involvement in top-down control: An event-related fMRI study of the Stroop task, Cogn Brain Res source

      Not checked in the free run.

    • cites [32] Banich, 2001, Attentional selection and the processing of task-irrelevant information: Insights from fMRI examinations of the Stroop task, Prog Brain Res source

      Not checked in the free run.

    • cites [33] Liu, 2006, Functional dissociation of attentional selection within PFC: Response and non-response related aspects of attentional selection as ascertained by fMRI, Cereb Cortex source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The ADHD and control groups differed in number of ADHD symptoms and real-world impairment.

    “As expected, however, the ADHD and control groups differed in the number of ADHD symptoms and impairment in real-world functioning (Table 1).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Reduced working memory ability in ADHD contributes to deficits in attentional control and executive function.

    “Some theories suggest that reduced WM ability in individuals with ADHD contributes to their deficits in attentional control and executive function (5, 6).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5] Pennington, 1996, Executive functions and developmental psychopathology, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [6] Rapport, 2008, Working memory deficits in boys with attention-deficit/hyperactivity disorder (ADHD): The contribution of central executive and subsystem processes, J Abnorm Child Psychol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Attentional control and working memory depend on a shared set of neural structures, many of which are dysfunctional in ADHD.

    “Attentional control and WM rely on a common set of neural structures, many of which have been implicated as dysfunctional in ADHD.”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [14] Nee, 2007, Interference resolution: Insights from a meta-analysis of neuroimaging tasks, Cogn Affect Behav Neurosci source

      Not checked in the free run.

    • cites [15] Neumann, 2008, Model-based clustering of meta-analytic functional imaging data, Hum Brain Mapp source

      Not checked in the free run.

    • cites [16] Owen, 2005, N-back working memory paradigm: A meta-analysis of normative functional neuroimaging studies, Hum Brain Mapp source

      Not checked in the free run.

    • cites [17] Wager, 2003, Neuroimaging studies of working memory: A meta-analysis, Cogn Affect Behav Neurosci source

      Not checked in the free run.

    • cites [18] Dickstein, 2006, The neural correlates of attention deficit hyperactivity disorder: An ALE meta-analysis, J Child Psychol Psychiatry source

      Not checked in the free run.

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

    Premisecitation

    ADHD affects executive function more broadly, including response inhibition and planning.

    “However, ADHD affects executive function more widely, compromising processes such as response inhibition and planning (2).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Willcutt, 2005, Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review, Biol Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The ADHD group had no comorbid psychiatric disorders or learning disabilities.

    “The ADHD group was not comorbid for other psychiatric disorders or learning disabilities.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    In non-ADHD individuals, lower working memory ability is associated with poorer cognitive ability.

    “Indeed, lower WM ability in non-ADHD individuals is associated with poorer cognitive ability (7) and increased mind-wandering away from challenging activities in real-life settings (8).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Engle, 1999, Working memory, short-term memory, and general fluid intelligence: A latent-variable approach, J Exp Psychol Gen source

      Not checked in the free run.

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

    Study design and conductown data

    Data from five individuals were unusable because of excessive movement during scanning.

    “Data from 5 individuals (4 ADHD, 1 control) were unusable due to excessive movement (i.e., greater than 2mm) during scanning.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    For selecting the task-relevant stimulus dimension, attentional demands are lower for neutral trials than for incongruent and congruent trials.

    “For selecting the task-relevant stimulus dimension, attentional demands will be less for neutral trials than for incongruent and congruent trials, when two sources of color information must be disambiguated (i.e., the ink color and the word identity; 23, 29).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [23] Milham, 2005, Anterior cingulate cortex: An fMRI analysis of conflict specificity and functional differentiation, Hum Brain Mapp source

      Not checked in the free run.

    • cites [29] Posner, 1998, Executive attention: Conflict, target detection, and cognitive control

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    On congruent and neutral trials, the word name does not conflict with the ink color, so there is no reminder to identify the ink color, resulting in goal neglect.

    “In contrast, on congruent and neutral trials, the word name does not conflict with the ink color, resulting in no reminder of the need to identify the ink color (i.e., “goal neglect”; 9).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Kane, 2003, Working-memory capacity and the control of attention: The contributions of goal neglect, response competition, and task set to Stroop interference, J Exp Psychol Gen source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Sustained deactivation of default mode is dysfunctional in ADHD, but high working memory individuals with ADHD attempt to overcome this by deactivating the region transiently.

    “This suggests that sustained deactivation of default mode is dysfunctional in individuals with ADHD (39), but high WM individuals with ADHD attempt to overcome this dysfunction by deactivating this region transiently.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] Braver, 2009, Flexible neural mechanisms of cognitive control within human prefrontal cortex, Proc Natl Acad Sci U S A source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationown data

    This pattern was unexpected if interference reduces task-set maintenance.

    “This pattern was unexpected if interference (which is present in both incongruent and congruent conditions) reduces task-set maintenance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Attentional control depended on task-set maintenance during congruent and neutral blocks, but not during incongruent blocks.

    “This pattern suggests that attentional control depended upon task-set maintenance during the C and N blocks, but not during the I blocks.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Monte Carlo simulations were used to estimate cluster-wise false positive rates of alpha equal to .05 within the a priori search space.

    “We used the AlphaSim algorithm within AFNI (34) to conduct Monte Carlo simulations to estimate cluster-wise false positive rates of alpha=.05 within this a priori search space.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34] Ward

      Not checked in the free run.

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

    Premisecitation

    dACC has not been strongly implicated in working memory function.

    “Unlike other regions discussed above (e.g., DLPFC), dACC has not been not strongly implicated in WM function (17).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Wager, 2003, Neuroimaging studies of working memory: A meta-analysis, Cogn Affect Behav Neurosci source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The Cascade-of-Control model proposes that when earlier-stage attentional control processes are ineffective, individuals direct performance using later-stage attentional control processes.

    “The Cascade-of-Control model (20) suggests that, when earlier-stage attentional control processes are ineffective, individuals direct performance using later-stage attentional control processes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Banich, 2009, Executive function: The search for an integrated account, Curr Dir Psychol Sci source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Regions were considered statistically significant if they exceeded a voxelwise threshold of z equal to 2.58 and a cluster size of 69 voxels.

    “Regions were considered statistically significant, correcting for multiple comparisons, if they surpassed a voxelwise threshold of z=2.58 (one-tailed p = .005) and a cluster size of 69 voxels.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Working memory ability in ADHD might relate to attentional control processes other than task-set maintenance, such as stimulus-driven attention and response selection.

    “Furthermore, WM ability in individuals with ADHD might relate to attentional control processes other than task-set maintenance, such as stimulus-driven attention and response selection.”
    Quote in the paperSubstantial claim
30 of 30

  • The paper relies on this without support.

    No prior studies have directly examined how the neural substrates supporting both working memory and attentional control, namely DLPFC, might be altered in young adults with ADHD.

    “Despite these similarities, no studies have investigated directly how the neural substrates that support both WM ability and attentional control, namely DLPFC, might be altered in young adults with ADHD.”

  • The authors state this as an assumption.

    Working memory networks maintain representations of task sets, producing a relationship between working memory ability and task-set maintenance.

    “We propose that WM networks may maintain representations of task sets, resulting in a relationship between WM ability and task-set maintenance.”

  • The paper relies on this without support.

    The Stroop task contains at least three levels of attentional demand: task-set selection and maintenance, task-relevant stimulus-dimension selection, and response selection.

    “The Stroop task contains at least three levels of attentional demand: selection and maintenance of a task set for task-relevant information (i.e., attend to chromatic color), selection of the task-relevant stimulus dimension (i.e. the chromatic color blue, not the semantic meaning “RED”), and response selection (the response associated with blue versus with red).”
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: r(20)=.468, p = .038

    Minor

    The paper reports p = .038 here; recomputing from the test statistic and its degrees of freedom gives p = .028 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .038 · recomputed p = .028

  • Inconsistent p-value: r(23)=.111, p > .60

    Minor

    The paper reports p > .6 here; recomputing from the test statistic and its degrees of freedom gives p = .597 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p > .6 · recomputed p = .597

2 of 2

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 upr(20) = 0.468reported p = .038 · recomputed p = .028

    “r(20)=.468, p = .038”

  • Doesn’t add upr(23) = 0.111reported p > .6 · recomputed p = .597

    “r(23)=.111, p > .60”

  • Consistentt(41) = -3.26reported p = .002 · recomputed p = .002

    “t(41) = -3.260, p = .002”

  • Consistentt(41) = -2.131reported p = .039 · recomputed p = .039

    “t(41) = -2.131, p = .039”

  • Consistentt(41) = -3.313reported p = .002 · recomputed p = .002

    “t(41) = -3.313, p = .002”

  • Consistentt(41) = -1.922reported p = .062 · recomputed p = .062

    “t(41) = -1.922, p = .062”

  • Consistentt(41) = -3.804reported p = .0005 · recomputed p < .001

    “t(41) = -3.804, p = .0005”

  • Consistentt(41) = 2.385reported p = .022 · recomputed p = .022

    “t(41)=2.385, p = .022”

  • Consistentt(40) = 2.51reported p = .016 · recomputed p = .016

    “t(40)=2.510, p = .016”

  • Consistentt(41) = -2.329reported p = .025 · recomputed p = .025

    “t(41)=-2.329, p = .025”

  • Consistentt(40) = -2.356reported p = .023 · recomputed p = .023

    “t(40)=-2.356, p = .023”

11 of 11

Self-check

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

Self-check results appear here once an independent check has confirmed them.

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Related

Authors
Burgess, G. C., Depue, B. E., Ruzic, L., Willcutt, E. G., Du, Y. P., & Banich, M. T.
Affiliations
  • University of Colorado Boulder (US)
  • University of Colorado Denver (US)
Corresponding author
Burgess, Gregory C.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2010-04
Volume
67
Issue
7
Pages
632-640
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2009.10.036
PMC
PMC2953472
OpenAlex
W2089842948
Cited by
147
References
44
Citations by year
2026: 7 · 2025: 6 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 10 · 2020: 11 · 2019: 4 · 2018: 11 · 2017: 11 · 2016: 3 · 2015: 13 · 2014: 14 · 2013: 21 · 2012: 7
FWCI
8.75
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01 MH70037, P50 MH079485)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
attention deficit hyperactivity disorder, working memory, attentional control, dorsolateral prefrontal cortex, Stroop task, task set maintenance, bottom-up attention, response selection, adult ADHD
MeSH terms
Attention, Attention Deficit Disorder with Hyperactivity, Female, Humans, Magnetic Resonance Imaging, Male, Memory, Short-Term, Reaction Time, Wechsler Scales, Young Adult

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