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Cited by 50Attention Deficit Hyperactivity DisorderAutism Spectrum Disorder ResearchNeural and Behavioral Psychology Studies

Differentiating neural reward responsiveness in autism versus ADHD

Open access
Kohls, Gregor, Thönessen, Heike, Bartley, Gregory K., Grossheinrich, Nicola, Fink, Gereon R., Herpertz-Dahlmann, Beate, Konrad, Kerstin·2014·Developmental Cognitive Neuroscience
DOI 10.1016/j.dcn.2014.08.003PMC PMC6987952
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Abstract

Although attention deficit hyperactivity disorders (ADHD) and autism spectrum disorders (ASD) share certain neurocognitive characteristics, it has been hypothesized to differentiate the two disorders based on their brain's reward responsiveness to either social or monetary reward. Thus, the present fMRI study investigated neural activation in response to both reward types in age and IQ-matched boys with ADHD versus ASD relative to typically controls (TDC). A significant group by reward type interaction effect emerged in the ventral striatum with greater activation to monetary versus social reward only in TDC, whereas subjects with ADHD responded equally strong to both reward types, and subjects with ASD showed low striatal reactivity across both reward conditions. Moreover, disorder-specific neural abnormalities were revealed, including medial prefrontal hyperactivation in response to social reward in ADHD versus ventral striatal hypoactivation in response to monetary reward in ASD. Shared dysfunction was characterized by fronto-striato-parietal hypoactivation in both clinical groups when money was at stake. Interestingly, lower neural activation within parietal circuitry was associated with higher autistic traits across the entire study sample. In sum, the present findings concur with the assumption that both ASD and ADHD display distinct and shared neural dysfunction in response to reward.

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Written from the paper’s full text.

TL;DR

In an fMRI incentive go/no-go study, boys/adolescents with ASD, ADHD, and typically developing controls showed differential ventral striatal reward responsiveness: ASD had low ventral striatal reactivity to both social and monetary reward, while ADHD had equal reactivity to both plus medial prefrontal overactivation to social reward. Both clinical groups shared fronto-striato-parietal hypoactivation for monetary reward relative to controls.

Key findings

  • Final sample: 16 ADHD, 15 ASD, and 17 TDC. A significant reward-by-group interaction emerged in ventral striatum ROI for SR > NR and MR > NR (F(2,45) = 4.18, p = 0.02, ηp² = 0.16): TDC showed stronger right ventral striatal activation for monetary versus social reward (p = 0.001, Cohen’s d = −0.94), which was absent in ASD (p = 0.71) and ADHD (p = 0.74).
  • ASD showed relatively low ventral striatum reactivity for both reward types (one-sample tests against zero: ps ≥ 0.1 for SR > NR and MR > NR), whereas ADHD responded equally strongly to social and monetary reward (ps ≤ 0.019).
  • Disorder-specific abnormalities: ADHD versus TDC and ASD showed medial prefrontal hyperactivation during social reward, including dorsal anterior cingulate (peak MNI = −2, 50, 16; Z = 3.26) and superior frontal gyrus (peak MNI = 8, 58, 26; Z = 3.74). ASD versus TDC and ADHD showed diminished ventral striatal activation to monetary reward only at a less stringent uncorrected threshold (p < 0.005, extent ≥ 20 voxels; left peak MNI = −8, 6, −6; Z = 3.07), not with FWE correction.
  • Shared abnormalities: both clinical groups versus TDC showed hypoactivation in dorsal striatum/caudate, thalamus, dorsal cingulate, posterior cingulate, and precuneus when money was at stake. Across the whole sample, AQ total score negatively correlated with posterior cingulate (r = −0.45, p = 0.002) and precuneus (r = −0.40, p = 0.006) activation.

Methods

  • Participants were 55 right-handed male children/adolescents aged 9–18; after exclusions, 16 ADHD (13 combined subtype, 3 inattentive), 15 ASD, and 17 TDC remained, all with full-scale IQ ≥ 80. Diagnoses used ICD-10/DSM-IV criteria and K-SADS-PL; ASD diagnoses were confirmed with ADOS-G and ADI-R. ADHD participants taking stimulants (n = 9) discontinued medication at least 48 h before scanning.
  • fMRI task: blocked incentive go/no-go with non-reward, social reward, and monetary reward conditions; 18 go and 18 no-go blocks, 5 trials per block, feedback rewarded with 80% probability. Imaging used a Siemens Trio 3.0 T scanner; analyses used FEAT/FSL, FLAME, whole-brain cluster correction (Z > 2.3, p ≤ 0.05), ventral striatum ROI analysis, and conjunction analyses.
  • Behavioral data used MANOVA/repeated-measures ANOVA; ROI used 2 × 3 reward × group ANOVA with planned contrasts; brain-behavior correlations used Pearson correlations with Bonferroni correction.

Limitations

  • Stated in the paper: the sample size was relatively small and may limit reproducibility; the sample included only males; within-disorder heterogeneity may mean reward circuit dysfunction contributes variably to clinical manifestation; limited range in disorder-specific severity scores may have weakened brain-behavior correlations.
  • Stated in the paper: ADHD participants had a history of MPH treatment, which could bias striatal findings despite 48 h discontinuation; several ASD participants scored high on an ADHD symptom measure though none met ADHD diagnostic criteria; the blocked design cannot reliably disentangle reward anticipation from consumption; the ASD-specific ventral striatal finding for monetary reward was only present at a less stringent threshold and needs caution.
  • Evident from the text: the study is cross-sectional and cannot establish causal direction between neural reward responsiveness and clinical symptoms; no significant no-go condition activation differences were found, so conclusions are limited to go blocks; behavioral performance did not differ by group, leaving the functional significance of activation differences uncertain.

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

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Crossref · 10.1016/j.dcn.2014.08.003

Cites

Statistics

Claims the paper makes

0 of 54 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Compared with typically developing controls, the clinical groups (ASD and ADHD) showed different ventral striatum activation to both social and monetary reward.

    “Clinical groups versus TDC had different ventral striatum activation to both rewards.”
    • Also stated in: § BOLD activation during go blocks · plain
      “We found a significant reward by group interaction effect (F(2, 45) = 4.18, p = 0.02, ηp2 = 0.16), related to stronger striatal activation on the right hemisphere for monetary versus social reward in TDC (p = 0.001, Cohen's d = −0.94), which was absent in both clinical groups (ASD: p = 0.71, ADHD: p = 0.74).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ASD and ADHD groups did not have other psychiatric or neurological conditions (beyond the diagnoses under study) that could affect reward processing.
    • Rests on an assumption: Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.
  • Findingown data

    Medial prefrontal overactivation in response to social reward was specific to ADHD.

    “Medial prefrontal overactivation in response to social reward was ADHD specific.”
    • Also stated in: § BOLD activation during go blocks · plain
      “Relative to TDC and ASD, the ADHD group showed enhanced activation in a medial prefrontal cluster during social reward processing, including dorsal anterior cingulate cortex (right: peak MNI = −2, 50, 16; Z = 3.26) and superior frontal gyrus (right: peak MNI = 8, 58, 26; Z = 3.74).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ASD and ADHD groups did not have other psychiatric or neurological conditions (beyond the diagnoses under study) that could affect reward processing.
    • Rests on an assumption: Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.
  • Findingown data

    Ventral striatal underactivation in response to monetary reward was specific to ASD.

    “Ventral striatal underactivation in response to monetary reward was ASD specific.”
    • Also stated in: § BOLD activation during go blocks · plain
      “However, lowering the threshold to an uncorrected voxel height of p < 0.005 with an extent cluster size of at least 20 voxels (according to Scott-Van Zeeland et al., 2010), which still produces desirable balance between Types I and II errors comparable to false discovery rate (Lieberman and Cunningham, 2009), the ASD group, compared to TDC and ADHD, showed diminished activation in ventral striatum”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ASD and ADHD groups did not have other psychiatric or neurological conditions (beyond the diagnoses under study) that could affect reward processing.
    • Rests on an assumption: Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.
  • Findingown data

    The different reward conditions similarly affected subjective experiences associated with task performance in all groups.

    “The group by reward interaction effect (F(8, 86) = 1.92, ns, ηp2 = 0.15) and the group effect (F(4, 90) = 0.77, ns, ηp2 = 0.03) were found to be non-significant, suggesting that the different reward conditions similarly affected subjective experiences associated with task performance in all groups.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The subjective rating questionnaire validly measures motivation and reward value.
  • Findingown data

    fMRI analyses revealed differential patterns of aberrant reward system reactivity in both clinical groups versus TDC, particularly in ventral striatum.

    “our fMRI analyses revealed the expected differential patterns of aberrant reward system reactivity in both clinical groups versus TDC, particularly in ventral striatum.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.
  • The quote only partly states this claim. 1
  • May combine two claims. 25
  • Classified as probably not a substantial claim. 15

  • The quote only partly states this claim.

    Findingown data

    Fronto-striato-parietal underactivation for monetary reward was shared by both clinical groups (ASD and ADHD) relative to TDC.

    “Fronto-striato-parietal underactivation for money was shared by both clinical groups.”
    • Also stated in: § BOLD activation during go blocks · plain
      “Both clinical groups versus TDC showed hypoactivation in dorsal striatum (left caudate: peak MNI = −18, 18, 16; Z = 3.25), thalamus (right: peak MNI = 8, −20, 10; Z = 3.74), dorsal cingulate (right: peak MNI = 4, 2, 36; Z = 3.86), posterior cingulate (left: peak MNI = −2, −52, 26; Z = 3.86), and precuneus (right: peak MNI = 8, −66, 28; Z = 3.49) when money was at stake (see Fig. 3).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ASD and ADHD groups did not have other psychiatric or neurological conditions (beyond the diagnoses under study) that could affect reward processing.
    • Rests on an assumption: Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.

  • May combine two claims.

    Findingown data

    In both youth with ASD and ADHD, differential striatum reactivity to monetary versus social reward was absent, but the deviant activation pattern was opposite in the two groups.

    “However, in both youth with ASD and ADHD this differential striatum reactivity to monetary versus social reward was absent, but the deviant activation pattern was opposite in the two groups.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.

  • May combine two claims.

    Findingcitation

    The peak of the interaction effect was located in the caudate head, as part of the ventral striatum, but not in the nucleus accumbens proper.

    “Note, though, that the peak of this interaction effect was located in the caudate head, as part of the ventral striatum (Mawlawi et al., 2001), but not in the nucleus accumbens proper (see Fig. 2).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mawlawi et al., 2001 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The two disorder groups showed equal subjective motivation ratings and behavioral task performances as controls.

    “While the two disorder groups showed equal subjective motivation ratings as well as behavioral task performances as controls”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The three groups did not differ in any task performance measures and were similarly affected by the different reward contingencies.

    “Noteworthy, the three groups did not differ in any task performance measures and were similarly affected by the different reward contingencies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Several ASD patients scored high on the ADHD-specific symptom measure (FBB-HKS), although none met diagnostic criteria for ADHD.

    “Concerning ASD, several patients scored high on the ADHD-specific symptom measure (i.e., FBB-HKS (Döpfner and Lehmkuhl, 1998)), although none did meet diagnostic criteria for ADHD.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Döpfner and Lehmkuhl, 1998

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Other studies reported enhanced striatal and medial prefrontal/orbitofrontal reactivity during reward outcome processing in children and adolescents with ADHD relative to TDC.

    “other studies reported enhanced striatal and medial prefrontal/orbitofrontal reactivity during reward outcome processing in children and adolescents with ADHD relative to TDC (Bjork et al., 2010, Gatzke-Kopp et al., 2009, Paloyelis et al., 2012, Rubia et al., 2009a).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bjork et al., 2010 source

      Not checked in the free run.

    • cites Gatzke-Kopp et al., 2009 source

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    • cites Paloyelis et al., 2012 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Deficits within the fronto-striatal reward circuitry have been reported in ADHD for monetary rewards using fMRI, although the direction of deviations is inconsistent.

    “Considering brain function, deficits within the fronto-striatal reward circuitry have been reported in ADHD for monetary rewards using functional magnetic resonance imaging (fMRI), although the direction of the deviations is inconsistent.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    In ADHD, prevailing theories propose that characteristic symptoms may result from dysregulated reward-seeking tendencies, including oversensitivity to reward contingencies and abnormal preference for immediate over delayed rewards, most likely caused by disruptions of the dopaminergic reward pathway including striatum and orbitofrontal cortex.

    “In the case of ADHD, prevailing theories propose that the characteristic symptoms such as inattention, impulsivity and hyperactivity may result from dysregulated reward-seeking tendencies, including oversensitivity to reward contingencies as well as an abnormal preference for immediate over delayed rewards (“delay aversion”). This is most likely caused by disruptions of the dopaminergic reward”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Luman et al., 2005 source

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    • cites Luman et al., 2010 source

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    • cites Sonuga-Barke, 2011 source

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  • May combine two claims.

    Study design and conductown data

    None of the TDC had a history or presence of psychiatric or neurological disorders or was taking psychotropic medications.

    “None of the TDC had a history or the presence of psychiatric or neurological disorders or was taking psychotropic medications.”
    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

    As age and IQ did not correlate with the dependent measures, these variables were not included as covariates in the data analyses.

    “As age and IQ did not correlate with the dependent measures, these variables were not included as covariates in the data analyses.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    ADHD participants used no psychotropic medications other than short- or long-acting stimulants (n=9), which were discontinued at least 48 h prior to scanning.

    “None of the ADHD participants used any psychotropic medications other than short- or long acting stimulants (n = 9; medicated for several years), which were discontinued at least 48 h prior to scanning.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.

  • May combine two claims.

    Study design and conductown data

    None of the included ASD participants had a confirmed comorbid ADHD diagnosis or was taking any psychotropic medication at time of testing, and ADHD participants did not fulfill criteria for ASD.

    “None of the included ASD participants had a confirmed comorbid ADHD diagnosis or was taking any psychotropic medication at time of testing, and ADHD participants did not fulfill criteria for ASD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Money has strong social connotations and exerts substantial impact on pro-social behavior.

    “However, money has strong social connotations and, thus, exerts substantial impact on pro-social behavior (Vohs et al., 2006).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Vohs et al., 2006 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The groups did not differ with respect to age and estimated IQ (all p-values > 0.1).

    “The groups did not differ with respect to age and estimated IQ (all p-values > 0.1; Table 1).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The specificity of reward dysfunction for social rewards in ASD has been questioned given behavioral and neural evidence in support of a more generalized reward processing deficit comprising social and nonsocial types of reward.

    “However, the specificity of reward dysfunction for social rewards has also been questioned given behavioral and neural evidences in support of a more generalized reward processing deficit comprising social as well as nonsocial types of reward (Kohls et al., 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kohls et al., 2012 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Two recent fMRI investigations compared neural responses between children with ADHD and ASD using a sustained attention task and a resting-state paradigm, but without reward contingencies.

    “However, closely related to this question, two recent fMRI investigations compared neural responses between children with ADHD and ASD using a sustained attention task (Christakou et al., 2013) and a resting-state paradigm (Di Martino et al., 2013), but without reward contingencies.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Christakou et al., 2013 source

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    • cites Di Martino et al., 2013 source

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  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    All fMRI studies to date exclusively employed monetary rewards, so it remains unclear to what extent day-to-day social incentives may affect neural reward responsiveness in youth with ADHD.

    “Given that all fMRI studies to date exclusively employed monetary rewards, it remains unclear to what extent day-to-day social incentives may affect neural reward responsiveness in youth with ADHD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisenone given

    No study to date has directly compared brain correlates of reward processing in individuals with ADHD versus ASD, leaving the question unanswered about potential commonalities along with disorder-specific reward deficits, particularly with regard to social reward.

    “Still, no study to date has directly compared brain correlates of reward processing in individuals with ADHD versus ASD, leaving the question unanswered about potential commonalities along with disorder-specific reward deficits, particularly with regard to social reward.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    To ensure that all participants understood the task instructions, the experimental procedure was preceded by 10 practice trials in each reward condition outside the magnet.

    “To ensure that all participants understood the task instructions, the experimental procedure was preceded by 10 practice trials in each reward condition outside the magnet.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    The TDC group was recruited from local schools and underwent an extensive psychiatric examination (K-SADS-PL).

    “The TDC group was recruited from local schools and underwent an extensive psychiatric examination (K-SADS-PL).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    In ASD, core social-communicative symptoms are closely linked to an under-responsiveness to social incentives, apparent as lack of motivation to attend to social stimuli and to seek and enjoy reciprocal social interactions.

    “In the field of ASD, it has been suggested that the core social-communicative symptoms in affected individuals are closely linked to an under-responsiveness to social incentives, apparent as a lack of motivation to attend to social stimuli, and to seek and enjoy reciprocal social interactions and relationships (Chevallier et al., 2012, Dawson et al., 2005, Kohls et al., 2012, Mundy, 1995, Schultz,”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Chevallier et al., 2012 source

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    • cites Dawson et al., 2005 source

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    • cites Kohls et al., 2012 source

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  • May combine two claims.

    Premisecitation

    In those two studies, shared functional abnormalities spanning both disorders were observed in fronto-striatal as well as superior parietal areas including precuneus; atypical neural activation in other brain regions were disorder-specific and included ADHD-related deficits in dorsolateral prefrontal cortex and striatal pallidum, in contrast to ASD-related dysfunction in temporo-limbic and

    “While shared functional abnormalities spanning both disorders were observed in fronto-striatal as well as superior parietal areas including precuneus, atypical neural activation in other brain regions were disorder-specific and included ADHD-related deficits in dorsolateral prefrontal cortex and striatal pallidum, in contrast to ASD-related dysfunction in temporo-limbic and cerebellar nodes.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Diagnoses of ASD were confirmed using ADOS-G and ADI-R conducted by experienced clinicians.

    “In the ASD group, diagnoses were confirmed using the Autism Diagnostic Observation Schedule-Generic (ADOS-G; Lord et al., 2000) and the Autism Diagnostic Interview-Revised (ADI-R; Lord et al., 1994) conducted by experienced clinicians.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Lord et al., 2000 source

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    • cites Lord et al., 1994 source

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  • May combine two claims.

    Interpretationown data

    The motivational manipulations were effective and the detected group differences in brain activation were not confounded by task performance differences.

    “This indicates that the motivational manipulations were effective and that the detected group differences in brain activation were not confounded by task performance differences (Murphy and Garavan, 2004).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Murphy and Garavan, 2004

      Not checked in the free run.

    • Rests on an assumption: BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.

  • May combine two claims.

    Premisecitation

    ADHD symptoms are very common among youth with ASD, making our ASD sample representative for this clinical disorder.

    “However, ADHD symptoms are very common among youth with ASD (Rommelse et al., 2011), making our ASD sample representative for this clinical disorder.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rommelse et al., 2011 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Greater ventral striatum activity for more salient and preferred rewards (e.g., smile versus €0.20) has been reported for healthy adults and holds true for healthy children as demonstrated here.

    “This is most likely reflected in greater ventral striatum activity for more salient and preferred rewards (e.g., smile versus €0.20), which has been reported for healthy adults (Spreckelmeyer et al., 2009), but also holds true for healthy children as demonstrated here.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Spreckelmeyer et al., 2009 source

      Not checked in the free run.

    • Rests on an assumption: BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Medications were discontinued at least 48 h prior to testing.

    “Although medications were discontinued at least 48 h prior to testing”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Disorder-specific dysfunctions likely give rise to the distinct clinical picture of each syndrome, while shared aberrations may underlie the phenotypic overlap and co-occurrence of both disorders, possibly mediated by pleiotropic genes.

    “While disorder-specific dysfunctions likely give rise to the distinct clinical picture of each of the syndromes, shared aberrations may underlie the phenotypic overlap and co-occurrence of both disorders, possibly mediated by pleiotropic genes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Given phenotypic and neural heterogeneity within each disorder group, reward circuit dysfunction likely contributes with variable degree to the clinical manifestation of individuals with ASD and ADHD.

    “Given phenotypic and neural heterogeneity within each of the disorder groups, it is likely that reward circuit dysfunction contributes with variable degree to the clinical manifestation of individuals with ASD and ADHD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The overall sample size was relatively small, which may limit reproducibility of results, but was comparable to other relevant fMRI studies.

    “Overall the sample size was relatively small, which may limit reproducibility of results (Button et al., 2013), but was comparable to other relevant fMRI studies (Christakou et al., 2013, Richey et al., 2012, Rubia et al., 2009b).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Button et al., 2013 source

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    • cites Christakou et al., 2013 source

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    • cites Richey et al., 2012

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

    Premisecitation

    Both ventral striatum and medial prefrontal cortex have critical roles in reward responsiveness.

    “Both ventral striatum and medial prefrontal cortex have critical roles in reward responsiveness (Haber and Knutson, 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haber and Knutson, 2010 source

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  • May combine two claims.

    Interpretationcitation

    The current findings further highlight that fronto-striato-parietal aberrations may underlie the shared ASD-ADHD clinical phenotype, including executive and motivation dysfunction.

    “In sum, the current findings further highlight that fronto-striato-parietal aberrations may underlie the shared ASD-ADHD clinical phenotype, including executive and motivation dysfunction; both domains constitute the most consistent cognitive deficits among the two disorders (Rommelse et al., 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rommelse et al., 2011 source

      Not checked in the free run.

    • Rests on an assumption: BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.

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

    Study design and conductcitation

    Neural activation differences observed between individuals with ASD and TDC or ADHD could be due to differences in neurovascular coupling and/or oxygen consumption that underlie the BOLD signal in fMRI, and thus are artifacts.

    “Another issue of clinical imaging is that neural activation differences observed between individuals with ASD and TDC or ADHD could be due to differences in neurovascular coupling and/or oxygen consumption that underlie the BOLD signal in fMRI, and thus are artifacts (Reynell and Harris, 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Reynell and Harris, 2013

      Not checked in the free run.

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

    Premisecitation

    The ventral striatum signals the anticipatory drive for a motivational incentive, while the medial prefrontal cortex encodes and acts upon reward values.

    “While the ventral striatum signals the anticipatory drive for a motivational incentive, the medial prefrontal cortex encodes and acts upon reward values (Berridge et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Berridge et al., 2009 source

      Not checked in the free run.

35 of 35

  • The paper relies on this without support.

    The ASD and ADHD groups did not have other psychiatric or neurological conditions (beyond the diagnoses under study) that could affect reward processing.

    “None of the included ASD participants had a confirmed comorbid ADHD diagnosis or was taking any psychotropic medication at time of testing, and ADHD participants did not fulfill criteria for ASD.”

  • The paper relies on this without support.

    Discontinuing stimulant medication at least 48 h before scanning is sufficient to eliminate its effects on neural reward responsiveness.

    “None of the ADHD participants used any psychotropic medications other than short- or long acting stimulants (n = 9; medicated for several years), which were discontinued at least 48 h prior to scanning.”

  • The paper relies on this without support.

    The subjective rating questionnaire validly measures motivation and reward value.

    “Following the experimental procedure, participants were asked separately for the three reward conditions (a) how motivating they found the condition, and (b) how rewarding they found the feedback stimuli. The participants were also asked how much they were motivated with regard to doing the task prior to the scan. Participants indicated their answers by marking a 10-cm, horizontal visual-analog”

  • The paper relies on this without support.

    BOLD signal differences between groups reflect true task-related neural activity rather than neurovascular coupling or oxygen-consumption artifacts.

    “Another issue of clinical imaging is that neural activation differences observed between individuals with ASD and TDC or ADHD could be due to differences in neurovascular coupling and/or oxygen consumption that underlie the BOLD signal in fMRI, and thus are artifacts (Reynell and Harris, 2013).”

  • The paper relies on this without support.

    The blocked design allows meaningful interpretation of reward-related activation despite its inability to disentangle reward anticipation from consumption.

    “While the present study applied a blocked design, which does not allow the reliable disentanglement between brain responses for reward anticipation and consumption and, thus, hampers comparisons with prior studies”
5 of 5

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 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.

  • ConsistentF(4, 42) = 36.32reported p < .001 · recomputed p < .001

    “F(4, 42) = 36.32, p < .001”

  • ConsistentF(8, 86) = 1.92reported n.s. · recomputed p = .067

    “F(8, 86) = 1.92, ns”

  • ConsistentF(4, 90) = 0.77reported n.s. · recomputed p = .548

    “F(4, 90) = 0.77, ns”

  • ConsistentF(1, 45) = 0.18reported n.s. · recomputed p = .673

    “F(1, 45) = 0.18, ns”

  • ConsistentF(1, 45) = 2.62reported n.s. · recomputed p = .113

    “F(1, 45) = 2.62, ns”

  • ConsistentF(2, 45) = 0.38reported n.s. · recomputed p = .686

    “F(2, 45) = 0.38, ns”

  • ConsistentF(1, 45) = 8.6reported p = .005 · recomputed p = .005

    “F(1, 45) = 8.60, p = .005”

  • ConsistentF(2, 45) = 1.64reported n.s. · recomputed p = .205

    “F(2, 45) = 1.64, ns”

  • ConsistentF(2, 45) = 1.87reported n.s. · recomputed p = .166

    “F(2, 45) = 1.87, ns”

  • ConsistentF(2, 45) = 4.18reported p = .02 · recomputed p = .022

    “F(2, 45) = 4.18, p = .02”

10 of 10

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.

  • Insula activation is claimed across all groups but not listed for ADHD

    Minor

    The text says the R > NR contrast activated the insula across all three groups, but Table 3 lists no insula activation in its ADHD R > NR results.

1 of 1

The citation lists haven’t been fetched yet

References 85 · Cited by 50

Authors
Kohls, G., Thönessen, H., Bartley, G. K., Grossheinrich, N., Fink, G. R., Herpertz-Dahlmann, B., & Konrad, K.
Affiliations
  • Forschungszentrum Jülich (DE)
  • Children's Hospital of Philadelphia (US)
  • RWTH Aachen University (DE)
Corresponding author
Kohls, Gregor
ORCID
Venue
Developmental Cognitive Neuroscience
Publisher
Elsevier BV
Published
2014-10
Volume
10
Pages
104-116
ISSN
1878-9293 (ISSN-L)
DOI
10.1016/j.dcn.2014.08.003
PMC
PMC6987952
OpenAlex
W2143331647
Cited by
50
References
85
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 9 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 1
FWCI
3.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Developmental Cognitive Neuroscience (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • RWTH Publications (RWTH Aachen) (submittedVersion, other-oa)
Funders
German Research Foundation
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
autism spectrum disorder, attention deficit hyperactivity disorder, reward processing, social reward, monetary rewards, ventral striatum, medial prefrontal cortex, parietal cortex, autistic traits, neural dysfunction, boys
MeSH terms
Adolescent, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Brain Mapping, Child, Child Development Disorders, Pervasive, Humans, Magnetic Resonance Imaging, Male, Parietal Lobe, Reward, Prefrontal Cortex, Ventral Striatum

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 ›

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