Executive attention control and emotional responding in attention-deficit/hyperactivity disorder–A functional MRI study
Open accessAbstract
BACKGROUND: There are suggestions that patients with attention-deficit/hyperactivity disorder (ADHD) show impairment in executive attention control and emotion regulation. This study investigated emotion regulation as a function of the recruitment of executive attention in patients with ADHD. METHODS: Thirty-five healthy children/adolescents (mean age = 13.91) and twenty-six children/adolescents with ADHD (mean age = 14.53) participated in this fMRI study. They completed the affective Stroop paradigm viewing positive, neutral and negative images under varying cognitive loads. A 3-way ANOVA (diagnosis-by-condition-by-emotion) was conducted on the BOLD response data. Following this, 2 3-way ANOVAs (diagnosis-by-condition-by-emotion) were applied to context-dependent psychophysiological interaction (gPPI) analyses generated from a dorsomedial frontal cortex and an amygdala seed (identified from the BOLD response ANOVA main effects of condition and emotion respectively). RESULTS: A diagnosis-by-condition interaction within dorsomedial frontal cortex revealed reduced recruitment of dorsomedial frontal cortex as a function of increased task demands in the children/adolescents with ADHD relative to healthy children/adolescents. The level of reduction in recruitment of dorsomedial frontal cortex was significantly correlated with symptom severity (total and hyperactivity) measured by Conner's Parent Report Scale in the children/adolescents with ADHD. In addition, analysis of gPPI data from a dorsomedial frontal cortex seed revealed significant diagnosis-by-condition interactions within lateral frontal cortex; connectivity between dorsomedial frontal cortex and lateral frontal cortex was reduced in the patients with ADHD relative to comparison youth during congruent and incongruent task trials relative to view trials. There were no interactions of group, or main effect of group, within the amygdala in the BOLD response ANOVA (though children/adolescents with ADHD showed increased responses to positive images within temporal cortical regions during task trials; identified by the diagnosis-by-condition-by-emotion interaction). However, analysis of gPPI data from an amygdala seed revealed decreased connectivity between amygdala and lentiform nucleus in the presence of emotional stimuli in children/adolescents with ADHD (diagnosis-by-emotion interaction). CONCLUSION: The current study demonstrated disrupted recruitment of regions implicated in executive function and impaired connectivity within those regions in children/adolescents with ADHD. There were also indications of heightened representation of emotional stimuli in patients with ADHD. However, as the findings were specific for positive stimuli, the suggestion of a general failure in emotion regulation in ADHD was not supported.
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Happy distractors in the emotional Stroop task elicited enhanced connectivity in ADHD patients between the amygdala and striatal and occipital regions.
“Similarly, happy distractors in the emotional Stroop task elicited enhanced connectivity in ADHD patients between the amygdala and striatal and occipital regions (Hwang et al., 2015).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Hwang et al., 2015
The Results (MRI results: gPPI results; page unavailable) report significantly decreased—not enhanced—amygdala connectivity with both the left lentiform nucleus (a striatal region) and right middle occipital gyrus in children and adolescents with ADHD, compared with controls, for positive relative to neutral stimuli. The Introduction and Discussion distinguish the affective Stroop task used in this study from the emotional Stroop task named in the claim. (LLM, conf=0.95)
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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 Hwang et al., 2015
During the Stroop task, left dorsomedial prefrontal cortex showed reduced functional connectivity with right lateral prefrontal cortex, but increased connectivity with left insula in ADHD.
“During the Stroop task, left dorsomedial prefrontal cortex showed reduced functional connectivity with right lateral prefrontal cortex, but increased connectivity with left insula (Hwang et al., 2015).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Hwang et al., 2015
During emotion processing, abnormally enhanced functional connectivity has been observed between limbic and orbitofrontal regions in ADHD.
“During emotion processing, abnormally enhanced functional connectivity has been observed between limbic and orbitofrontal regions.”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Hwang et al., 2015
The Results and Discussion report decreased connectivity between the amygdala and lentiform nucleus during emotional stimuli in children and adolescents with ADHD. A search for orbitofrontal connectivity found no passage addressing connectivity between limbic and orbitofrontal regions; the finding in a different circuit does not establish or contradict the claim. (LLM, conf=0.74)
Experimental — accuracy not yet measured
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- Authors
- Hwang, S., White, S. F., Nolan, Z. T., Craig Williams, W., Sinclair, S., & Blair, R. J. R.
- Affiliations
- National Institutes of Health (US)
- Pennsylvania State University (US)
- Corresponding author
- Hwang, Soonjo
- Venue
- NeuroImage Clinical
- Publisher
- Elsevier BV
- Published
- 2015
- Volume
- 9
- Pages
- 545-554
- ISSN
- 2213-1582 (ISSN-L)
- PMC
- PMC4632075
- OpenAlex
- W2196470354
- Cited by
- 43
- References
- 67
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 10 · 2019: 2 · 2018: 7 · 2017: 3
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- NeuroImage Clinical (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Mental Health
- National Institutes of Health (1-ZIA-MH002860-08)
- 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, emotion regulation, dorsomedial frontal cortex, amygdala, functional connectivity, cognitive load, symptom severity, children and adolescents, positive emotional stimuli, lentiform nucleus, lateral frontal cortex, psychophysiological interaction, hyperactivity symptoms, BOLD signal
- MeSH terms
- Adolescent, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Brain, Child, Cognition Disorders, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Oxygen, Psychiatric Status Rating Scales, Reaction Time, Mood Disorders, Executive Function
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