fMRI of Intrasubject Variability in ADHD: Anomalous Premotor Activity With Prefrontal Compensation
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Objective Children with attention-deficit/hyperactivity disorder (ADHD) consistently display increased intrasubject variability (ISV) in response time across varying tasks, signifying inefficiency of response preparation compared to typically developing (TD) children. Children with ADHD also demonstrate impaired response inhibition; inhibitory deficits correlate with ISV, suggesting that similar brain circuits may underlie both processes. To better understand the neural mechanisms underlying increased ISV and inhibitory deficits in children with ADHD, functional magnetic resonance imaging was used to examine the neural correlates of ISV during Go/No-go task performance.Method Event-related functional magnetic resonance imaging was used to study 25 children with ADHD and 25 TD children ages 8 to 13 years performing a simplified Go/No-go task. Brain-behavior correlations were examined between functional magnetic resonance imaging activation and ISV within and between groups.Results For TD children, increased rostral supplementary motor area (pre-supplementary motor area) activation during No-go events was associated with less ISV, whereas the reverse was true for children with ADHD for whom increased pre-supplementary motor area activation was associated with more ISV. In contrast, children with ADHD with less ISV showed greater prefrontal activation, whereas TD children with more prefrontal activation demonstrated more ISV.Conclusions These findings add to evidence that dysfunction of premotor systems may contribute to increased variability and impaired response inhibition in children with ADHD and that compensatory strategies eliciting increased cognitive control may improve function. However, recruitment of prefrontal resources as a compensatory mechanism for motor task performance may preclude the use of those prefrontal resources for higher order, more novel executive functions with which children with ADHD often struggle.
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One correlational fMRI study found that higher reaction time variability was associated with decreased activation of the prefrontal cortex in individuals with ADHD.
“Also, 1 correlational fMRI study found that higher RTV was associated with decreased activation of the prefrontal cortex in those with ADHD [82].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [82]
This hypothesis is consistent with data suggesting that trajectories of cortical development throughout middle childhood might be closely linked to ADHD outcomes, and that lower reaction time variability is associated with increased activation of the prefrontal circuit in children with ADHD.
“This hypothesis is consistent with data suggesting that trajectories of cortical development throughout middle childhood might be closely linked to ADHD outcomes (Shaw et al., 2006; Shaw et al., 2007b), and that lower reaction time variability is associated with increased activation of the prefrontal circuit (prefrontal cortex and caudate) in children with ADHD (Suskauer et al., 2008).”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Suskauer et al., 2008
This latter finding was interpreted as prefrontal compensation for a more primary motor deficiency.
“This latter finding was interpreted as prefrontal compensation for a more primary motor deficiency.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Suskauer et al., 2008
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- Authors
- Suskauer, S. J., Simmonds, D. J., Caffo, B. S., Denckla, M. B., Pekar, J. J., & Mostofsky, S. H.
- Affiliations
- Kennedy Krieger Institute (US)
- Johns Hopkins University (US)
- Corresponding author
- Mostofsky, Stewart H.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 47
- Issue
- 10
- Pages
- 1141-1150
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3932630
- OpenAlex
- W2049669566
- Cited by
- 143
- References
- 46
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 5 · 2017: 9 · 2016: 10 · 2015: 14 · 2014: 12 · 2013: 10 · 2012: 9
- FWCI
- 7.50
- 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)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH085328, R01MH078160)
- National Institute of Neurological Disorders and Stroke (K02NS044850, K02 NS04485, R01NS047781)
- National Institute of Biomedical Imaging and Bioengineering (K25EB003491)
- National Center for Research Resources (M01 RR-00052, M01RR000052)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD24061, K12HD001097, P30HD024061)
- 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, within-person variability, response inhibition, premotor cortex, supplementary motor area, prefrontal cortex activation, compensatory neural mechanisms, cognitive control, go/no-go task, children, executive function
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Color Perception, Female, Frontal Lobe, Humans, Image Processing, Computer-Assisted, Inhibition, Psychological, Magnetic Resonance Imaging, Male, Motor Cortex, Nerve Net, Pattern Recognition, Visual, Psychomotor Performance, Reaction Time, Prefrontal Cortex
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