Abnormal amygdala functional connectivity associated with emotional lability in children with attention-deficit/hyperactivity disorder
Open accessAbstract
Objective A substantial proportion of children with attention-deficit/hyperactivity disorder (ADHD) also display emotion regulation deficits manifesting as chronic irritability, severe temper outbursts, and aggression. The amygdala is implicated in emotion regulation, but its connectivity and relation to emotion regulation in ADHD has yet to be explored. The purpose of this study was to examine the relationship between intrinsic functional connectivity (iFC) of amygdala circuits and emotion regulation deficits in youth with ADHD. Method Bilateral amygdala iFC was examined using functional magnetic resonance imaging in 63 children with ADHD, aged 6 to 13 years. First, we examined the relationship between amygdala IFC and parent ratings of emotional lability (EL) in children with ADHD. Second, we compared amygdala iFC across subgroups of children with ADHD and high EL (n = 18), ADHD and low EL (n = 20), and typically developing children (TDC), all with low EL (n = 19). Results Higher EL ratings were associated with greater positive iFC between the amygdala and rostral anterior cingulate cortex in youth with ADHD. EL scores were also negatively associated with iFC between bilateral amygdala and posterior insula/superior temporal gyrus. Patterns of amygdala-cortical iFC in ADHD participants with low EL were not different from the comparison group, and the effect sizes for these comparisons were smaller than those for the trend-level differences observed between the high-EL and TDC groups. Conclusions In children with ADHD and a range of EL, deficits in emotion regulation were associated with altered amygdala-cortical iFC. When comparing groups that differed on ADHD status but not EL, differences in amygdala iFC were small and nonsignificant, highlighting the specificity of this finding to emotional deficits, independent of other ADHD symptoms.
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Recent functional neuroimaging studies suggest that anomalies within frontolimbic circuits, which are not typically associated with executive functions, may underlie emotional lability in children with ADHD.
“These studies have consisted of relatively small samples and require replication, but nonetheless, suggest that anomalies within frontolimbic circuits, which are not typically associated with executive functions, may underlie emotional lability in children with ADHD.”
From Using Stimulants to Treat ADHD-Related Emotional Lability (2014) · cites this paper as [23]
The Results (Amygdala IFC and Emotional Lability in ADHD; page unavailable) associate emotional lability in children with ADHD with altered connectivity between the amygdala and prefrontal and other cortical regions. The Discussion suggests that disruptions in these networks may underlie emotion-regulation difficulties. The paper does not establish that the implicated circuits are not typically associated with executive functions; its introductory passage instead describes prefrontal regions as involved in both cognitive and emotional control. (LLM, conf=0.83)
Experimental — accuracy not yet measuredA study on the high ED group revealed enhanced intrinsic functional connectivity patterns between the amygdala and the ACC/insula/STG in the high ED group.
“revealing an enhanced intrinsic functional connectivity patterns between the amygdala–ACC/insula/STG in the high ED group (15).”
From Abnormal functional connectivity associated with emotional dysregulation in children with attention-deficit/hyperactivity disorder (2025) · cites this paper as [15]
The Results (Group Amygdala iFC Comparisons) report a trend toward greater positive amygdala–ACC connectivity in the high-EL group. But connectivity between the amygdala and insula/STG trended lower, not higher, so the claimed enhancement across all three regions is not supported. The paper calls the group differences trends rather than significant findings. (LLM, conf=0.90)
Experimental — accuracy not yet measuredOnly one study has subdivided ADHD patients into groups with high and low ED to explore their unique functional connectivity characteristics, and found that the effect sizes for the patterns of amygdala-cortical FC in ADHD participants with low ED were smaller than ADHD participants with the high ED and TDC groups.
“only one study has subdivided ADHD patients into groups with high and low ED to explore their unique functional connectivity characteristics, and found that the effect sizes for the patterns of amygdala-cortical FC in ADHD participants with low ED were smaller than ADHD participants with the high ED and TDC groups (15).”
From Abnormal functional connectivity associated with emotional dysregulation in children with attention-deficit/hyperactivity disorder (2025) · cites this paper as [15]
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Self-citation
- Authors
- Hulvershorn, L. A., Mennes, M., Castellanos, F. X., Di Martino, A., Milham, M. P., Hummer, T. A., & Roy, A. K.
- Affiliations
- Riley Hospital for Children (US)
- Radboud University Medical Center (NL)
- Nathan Kline Institute for Psychiatric Research (US)
- Fordham University (US)
- Corresponding author
- Hulvershorn, Leslie A.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 53
- Issue
- 3
- Pages
- 351-361.e1
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3961844
- OpenAlex
- W2127237900
- Cited by
- 138
- References
- 57
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 24 · 2020: 9 · 2019: 3 · 2018: 13 · 2017: 13 · 2016: 10 · 2015: 13 · 2014: 10
- FWCI
- 7.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Institute of Mental Health (K23MH087770, K23MH074821, R01MH081218)
- National Institute on Drug Abuse (K12DA000357)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065282)
- 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, emotional lability, amygdala, intrinsic functional connectivity, emotion regulation, rostral anterior cingulate cortex, posterior insula, superior temporal gyrus, children, irritability, temper outbursts
- MeSH terms
- Adolescent, Affective Symptoms, Amygdala, Attention Deficit Disorder with Hyperactivity, Cerebral Cortex, Child, Female, Humans, Magnetic Resonance Imaging, Male, Nerve Net
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