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Cited by 137Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesAutism Spectrum Disorder Research

Abnormal Amygdalar Activation and Connectivity in Adolescents With Attention-Deficit/Hyperactivity Disorder

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Posner, Jonathan, Nagel, Bonnie J., Maia, Tiago V., Mechling, Anna, Oh, Milim, Wang, Zhishun, Peterson, Bradley S.·2011·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1016/j.jaac.2011.05.010PMC PMC3155780
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Abstract

Objective Emotional reactivity is one of the most disabling symptoms associated with attention-deficit/hyperactivity disorder (ADHD). We aimed to identify neural substrates associated with emotional reactivity and to assess the effects of stimulants on those substrates. Method We used functional magnetic resonance imaging (fMRI) to assess neural activity in adolescents with (n = 15) and without (n = 15) ADHD while they performed a task involving the subliminal presentation of fearful faces. Using dynamic causal modeling, we also examined the effective connectivity of two regions associated with emotional reactivity, i.e., the amygdala and the lateral prefrontal cortex (LPFC). The participants with ADHD underwent scanning both on and off stimulant medication in a counterbalanced fashion. Results During the task, we found that activity in the right amygdala was greater in adolescents with ADHD than in control subjects. In addition, in adolescents with ADHD, greater connectivity was detected between the amygdala and LPFC. Stimulants had a normalizing effect on both the activity in the right amygdala and the connectivity between the amygdala and LPFC. Conclusions Our findings demonstrate that in adolescents with ADHD, a neural substrate of fear processing is atypical, as is the connectivity between the amygdala and LPFC. These findings suggest possible neural substrates for the emotional reactivity that is often present in youths with ADHD, and provide putative neural targets for the development of novel therapeutic interventions for this condition.

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  • Larger studies find amygdala hyperactivation in ADHD during both subliminal perception of fearful expressions and while subjects rated their fear of neutral faces, although results are mixed.

    “The larger studies find amygdala hyperactivation in ADHD, during both the subliminal perception of fearful expressions and while subjects rated their fear of neutral faces, although results are mixed (24, 29, 95-98)-Table 2 and Supplemental Material.”

    From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [97]

    The Discussion reports amygdalar hyperactivation during subliminal fearful-face presentation in unmedicated youths with ADHD and describes a separate study finding hyperactivation when participants rated fear in neutral faces. But this paper calls its own sample small (15 ADHD participants), so it does not support describing it as a larger study; it also does not establish that results across studies were mixed. (LLM, conf=0.87)

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  • Recent neuropsychological studies have found demonstrable, consistent impairments in sustained focus difficult to demonstrate in ADHD, at least in the laboratory setting.

    “The central role of an attentional deficit in ADHD has been questioned by recent neuropsychological studies [21, 26] in which demonstrable, consistent impairments in sustained focus have been difficult to demonstrate, at least in the laboratory setting.”

    From Using Stimulants to Treat ADHD-Related Emotional Lability (2014) · cites this paper as [26]

    The Introduction discusses inattention as a characteristic of ADHD and says the fearful-face task was designed to limit attention differences as a confound. The Method describes an fMRI task, not a test of sustained focus. Searches for sustained-focus impairments and neuropsychological attention findings found no passage addressing whether such impairments are difficult to demonstrate in laboratory studies. (LLM, conf=0.75)

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Cited by

Sorted by citations

Authors
Posner, J., Nagel, B. J., Maia, T. V., Mechling, A., Oh, M., Wang, Z., & Peterson, B. S.
Affiliations
  • New York State Psychiatric Institute (US)
  • Oregon Health & Science University (US)
Corresponding author
Posner, Jonathan
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2011-08
Volume
50
Issue
8
Pages
828-837.e3
ISSN
0890-8567 (ISSN-L)
DOI
10.1016/j.jaac.2011.05.010
PMC
PMC3155780
OpenAlex
W2089152995
Cited by
137
References
4
Citations by year
2026: 2 · 2025: 2 · 2024: 10 · 2023: 6 · 2022: 8 · 2021: 11 · 2020: 10 · 2019: 6 · 2018: 15 · 2017: 8 · 2016: 15 · 2015: 9 · 2014: 14 · 2013: 13 · 2012: 6
FWCI
7.48
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5k02mh074677-05)
  • National Institute on Alcohol Abuse and Alcoholism (P60AA010760)
  • National Institute of Mental Health (K23MH091249, K02-MH-074677)
  • National Institute of Neurological Disorders and Stroke (K08 NS52147, K08NS052147)
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 › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, adolescents, amygdala, lateral prefrontal cortex, emotional reactivity, fear processing, stimulant medication, neural correlates
MeSH terms
Adolescent, Affective Symptoms, Amygdala, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Fear, Female, Humans, Magnetic Resonance Imaging, Male, Models, Neurological, Neural Conduction, Subliminal Stimulation, Case-Control Studies, Prefrontal Cortex

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