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Cited by 254Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesNeurotransmitter Receptor Influence on Behavior

Neural substrates of decision making in adults with attention deficit hyperactivity disorder

Ernst, Monique, Kimes, Alane S., London, Edythe D., Matochik, John A., Eldreth, Dana, Tata, Satya, Contoreggi, Carlo, Leff, Michelle +1 more·2003·American Journal of Psychiatry
DOI 10.1176/appi.ajp.160.6.1061
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Abstract

OBJECTIVE: The characteristics of attention deficit hyperactivity disorder (ADHD) include abnormalities in reward responsivity that may interfere with decision making. The study examined reward responsivity in ADHD by comparing the neural correlates of decision making in adults with childhood-onset ADHD and in healthy adults. METHOD: The neural correlates of performance on a decision-making task and a control task were compared in 10 adults with ADHD and 12 age-matched healthy volunteers by using [(15)O]H(2)O positron emission tomography. The decision-making task tested the ability to weigh short-term rewards against long-term losses. The control task matched all components of the decision-making task except for the decision-making process and related contingency. RESULTS: The ventral and dorsolateral prefrontal cortex and the insula were activated during performance of the decision-making task in both the ADHD and healthy groups; however, activation in the ADHD group was less extended and did not involve other regions, such as anterior cingulate and hippocampus, that subserve emotion/memory processes. Direct comparison of data from the ADHD subjects and the healthy volunteers suggested that the healthy subjects engaged the hippocampal and insular regions more than did the ADHD subjects and that the ADHD subjects recruited the caudal part of the right anterior cingulate more than did the healthy subjects. CONCLUSIONS: The findings suggest that the neural circuits engaged during decision making differ in subjects with ADHD and healthy comparison subjects. This difference may explain observed deficits in motivated behaviors in ADHD. A better understanding of the nature of these deficits could ultimately be applied to refine treatment strategies for ADHD.

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Crossref · 10.1176/appi.ajp.160.6.1061

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  • Disturbed ACC functioning in ADHD is supported by a growing body of evidence.

    “Disturbed ACC functioning in ADHD is supported by a growing body of evidence.”

    From Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion (2010) · cites this paper as Ernst et al. 2003

  • Ernst et al. did not find any differences in the net score on the standard IGT between adults with ADHD and NCs (Cohen's d = 0.08).

    “Furthermore, a study by Ernst et al. [61] also did not find any differences in the net score on the standard IGT between adults with ADHD and NCs (Cohen’s d = 0.08).”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [61]

  • PET analyses of participants in the Ernst et al. study revealed involvement of different neural networks (anterior cingulate, hippocampus, and insula) subserving emotion and memory processing in adults with ADHD as compared to NCs during the IGT.

    “However, Positron Emission Tomography (PET) analyses of the participants in the Ernst et al. [61] study did reveal the involvement of different neural networks (in particular the anterior cingulate, hippocampus, and insula) subserving emotion and memory processing in adults with ADHD as compared to the NCs during the performance of the IGT.”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [61]

  • Two other studies reported no greater levels of risky performance in adults with ADHD on the standard IGT compared to NCs, and one other study only revealed aberrant performance on the standard IGT in a subgroup of adults with ADHD with both hard drug dependence and working memory problems.

    “Much like Agay et al. [59], two other studies have also reported no greater levels of risky performance in adults with ADHD on the standard IGT when compared to NCs [61], [64], and one other study only revealed aberrant performance on the standard IGT in a subgroup of adults with ADHD with both hard drug dependence and working memory problems [60].”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [61]

  • The reviewed studies with mixed ADHD subtype samples included studies examining participants with ADHD-C and ADHD-I (3/15 = 20% of studies with null findings).

    “participants with ADHD-C and ADHD-I [51], [61], [68] (3/15 = 20% of studies with null findings)”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [61]

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Authors
Ernst, M., Kimes, A. S., London, E. D., Matochik, J. A., Eldreth, D., Tata, S., Contoreggi, C., Leff, M., & Bolla, K.
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2003-06-01
Volume
160
Issue
6
Pages
1061-1070
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.160.6.1061
OpenAlex
W2151854266
Cited by
254
References
46
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 8 · 2017: 5 · 2016: 11 · 2015: 12 · 2014: 21 · 2013: 12 · 2012: 21
FWCI
10.42
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Drug Abuse (DA11426, R01DA011426)
  • National Center for Research Resources (RR0 2719, M01RR002719)
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 › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
attention deficit hyperactivity disorder, decision-making, reward sensitivity, neural correlates, ventral prefrontal cortex, dorsolateral prefrontal cortex, insula, anterior cingulate cortex, hippocampus, motivated behavior, adult ADHD
MeSH terms
Adult, Attention Deficit Disorder with Hyperactivity, Brain, Brain Mapping, Cerebral Cortex, Decision Making, Female, Frontal Lobe, Humans, Male, Middle Aged, Motivation, Regional Blood Flow, Reward, Task Performance and Analysis, Tomography, Emission-Computed, Prefrontal Cortex

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