Emotion Processing Influences Working Memory Circuits in Pediatric Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder
Open accessAbstract
Objective This functional magnetic resonance imaging (fMRI) study examined how working memory circuits are affected by face emotion processing in pediatric bipolar disorder (PBD) and attention-deficit/hyperactivity disorder (ADHD).Methods A total of 23 patients with PBD, 14 patients with ADHD, and 19 healthy control (HC) subjects (mean age, 13.36 ± 2.55 years) underwent an affective, two-back fMRI task with blocks of happy, angry, and neutral faces.Results For angry versus neutral faces PBD patients, relative to ADHD patients, exhibited increased activation in the subgenual anterior cingulate cortex (ACC) and orbitofrontal cortex, and reduced activation in the dorsolateral prefrontal cortex (DLPFC) and premotor cortex. Relative to the HC group, the PBD group showed no increased activation and reduced activation at the junction of DLPFC and ventrolateral prefrontal cortex (VLPFC). Relative to HC, the ADHD patients exhibited greater activation in the DLPFC and reduced activation in the ventral and medial PFC, pregenual ACC, striatum, and temporo-parietal regions. For happy versus neutral faces, relative to the ADHD group, the PBD group exhibited greater activation in the bilateral caudate, and relative to the HC group the ADHD group showed increased activation in the DLPFC, striatal, and parietal regions, and no reduced activation. The ADHD group, compared with the HC group, showed no reduced activation and increased activation in regions that were underactive for the angry face condition.Conclusions Relative to the ADHD group, the PBD group exhibited greater deployment of the emotion-processing circuitry and reduced deployment of working memory circuitry. Commonalities across PBD and ADHD patients, relative to the HC individuals, entailed cortico-subcortical activity that was reduced under negative emotional challenge and increased under positive emotional challenge.
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Emotional Stroop task manipulation exacerbates performance deficits already evident in ADHD, suggesting performance drops off more steeply than in typical individuals under emotional challenge.
“This manipulation exacerbates the performance deficits already evident in ADHD suggesting that performance drops off more steeply than it does in typical individuals under emotional challenge (91, 92).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [91]
The Behavioral Performance Results (page not available) report that angry faces slowed responses across groups, with no significant group-by-emotion effect; ADHD accuracy was only nonsignificantly lower than healthy controls. The Discussion likewise describes slower responses in all groups, not a steeper performance drop in ADHD. This study used an affective n-back task rather than an emotional Stroop task. (LLM, conf=0.84)
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Experimental — accuracy not yet measuredDuring positive emotional distractors, ADHD patients showed greater activation in DLPFC, left temporal and occipital, and vmPFC/subgenual ACC, striatum, and temporo-parietal regions.
“but greater activation in dorsolateral prefrontal cortex (DLPFC; Passarotti et al., 2010), in left temporal and occipital (Hwang et al., 2015) and in vmPFC/subgenual ACC, striatum, and temporo-parietal regions (Passarotti et al., 2010; Posner et al., 2011a) during positive emotional distractors.”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Passarotti et al., 2010
The Results section on happy versus neutral faces (Table 3, Fig. 2b; page not provided) reports greater activation in ADHD than healthy controls in bilateral DLPFC, right caudate, and bilateral inferior parietal lobule. It reports dorsal ACC activation, but not greater vmPFC or subgenual ACC activation for this condition. The left temporal and occipital regions are cited to Hwang et al., not to this source. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThese patterns are partly lost in ADHD; when negative stimuli are added to a working memory task, performance deficits in ADHD are associated with hypoactivation in prefrontal control regions, but when positive stimuli are used, ADHD subjects show hyperactivation in these regions.
“Specifically, when negative stimuli are added to a working memory task, performance deficits in ADHD are associated with hypoactivation in prefrontal ‘control’ regions, including ventrolateral, orbitofrontal and medial prefrontal cortices. However, when positive stimuli are used, ADHD subjects show hyperactivation in these regions (91).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [91]
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Experimental — accuracy not yet measuredDuring negative valenced emotional distractors in emotional Stroop and WM tasks, two fMRI studies found reduced activation in ADHD patients in ventral and mPFC, subgenual ACC, striatum and temporo-parietal regions.
“Thus, during emotional distractors in the emotional Stroop and a WM task, two fMRI studies found reduced activation in ADHD patients during negative valenced stimuli in ventral and mPFC, subgenual ACC, striatum and temporo-parietal regions (Passarotti et al., 2010; Posner et al., 2011a)”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Passarotti et al., 2010
On average, neural activity is most commonly decreased in the DLPFC and increased in the left amygdala, the fusiform gyrus and the inferior frontal gyrus in patients with mood disorders.
“On average, neural activityis most commonly decreased in the DLPFC 30,59,68,76 and increased in the left amygdala, 55,74,76,79,98,99 the fusiform gyrus 82,93,98 and the inferior frontal gyrus 82,90,98 in patients with mood disorders.”
From Systematic review of the neural basis of social cognition in patients with mood disorders (2012) · cites this paper as [98]
The anterior cingulate cortex is involved in attentional processing in ADHD.
“Given that this region is also involved with attentional processing in ADHD (e.g., Cubillo, Halari, Smith, Taylor, & Rubia, 2012; Passarotti, Sweeney, & Pavuluri, 2010)”
From Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions (2015) · cites this paper as Passarotti, Sweeney, & Pavuluri, 2010
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Self-citationWhat do ADHD Neuroimaging Studies Reveal for Teachers, Teacher Educators and Inclusive Education?
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Response Patterns to Emotional Faces Among Adolescents Diagnosed With ADHD
Dan, O., & Raz, S. (2015) · Journal of Attention Disorders · doi:10.1177/1087054715606215 · Cited by 12 · see citing works
Neural Correlates of Reactive Aggression in Adult Attention-Deficit/Hyperactivity Disorder
Jakobi, B., Vásquez, A. A., Hermans, E. J., Vlaming, P., Buitelaar, J. K., Franke, B., Hoogman, M., & van Rooij, D. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.840095 · Cited by 11 · see citing works
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Neuromonitoring-guided working memory intervention in children with ADHD
Jounghani, A. R., Gozdas, E., Dacorro, L., Avelar‐Pereira, B., Reitmaier, S., Fingerhut, H., Hong, D. S., Elliott, G. R., Hardan, A. Y., Hinshaw, S. P., et al. (2024) · iScience · doi:10.1016/j.isci.2024.111087 · Cited by 10 · see citing works
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Emotion processing difficulties in ADHD: a Bayesian meta-analysis study
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Brain response to facial expressions in adults with adolescent ADHD
Lindholm, P., Lieslehto, J., Nikkinen, J., Moilanen, I. K., Hurtig, T. M., Veijola, J. M., Miettunen, J., Kiviniemi, V. J., & Ebeling, H. E. (2019) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2019.09.003 · Cited by 8 · see citing works
- Authors
- Passarotti, A. M., Sweeney, J. A., & Pavuluri, M. N.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Passarotti, Alessandra M.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 49
- Issue
- 10
- Pages
- 1064-1080
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC2957818
- OpenAlex
- W1964377208
- Cited by
- 137
- References
- 91
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 9 · 2021: 4 · 2020: 11 · 2019: 6 · 2018: 8 · 2017: 5 · 2016: 9 · 2015: 12 · 2014: 20 · 2013: 11 · 2012: 14
- FWCI
- 8.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Eli Lilly and Company
- AstraZeneca
- GlaxoSmithKline
- National Alliance for Research on Schizophrenia and Depression
- National Institutes of Health
- University of Illinois at Urbana-Champaign
- National Institute of Child Health and Human Development
- National Center for Research Resources (K23RR018638, K23 RR 18638-01)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- pediatric bipolar disorder, attention deficit hyperactivity disorder, working memory, subgenual anterior cingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, caudate nucleus, cortico-subcortical circuits
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Bipolar Disorder, Brain, Brain Mapping, Caudate Nucleus, Child, Corpus Striatum, Dominance, Cerebral, Emotions, Facial Expression, Female, Frontal Lobe, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Memory, Short-Term, Nerve Net, Parietal Lobe, Prefrontal Cortex
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