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Sex Differences in the Functional Neuroanatomy of Working Memory in Adults With ADHD
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OBJECTIVE: Although attention deficit hyperactivity disorder (ADHD) in adults is associated with significant morbidity and dysfunction and afflicts both sexes, relatively few imaging studies have examined female subjects and none have had sufficient power to adequately examine sex differences. The authors examined sex differences in the neural functioning of adults with ADHD during performance of a verbal working memory task. METHOD: The participants were 44 adults with ADHD matched on age, sex, and estimated IQ to 49 comparison subjects. Accuracy and reaction time on an N-back task were measured to assess working memory. The blood-oxygen-level-dependent functional MRI response was used as a measure of neural activity. RESULTS: A group-by-sex analysis of variance showed no between-group differences in either reaction time or percent correct for the working memory task. For both sexes combined, the adults with ADHD showed less activity than comparison subjects in prefrontal regions. However, sex-by-group analyses revealed an interaction, such that male ADHD subjects showed significantly less activity in right frontal, temporal, and subcortical regions and left occipital and cerebellar regions relative to male comparison subjects, whereas female ADHD subjects showed no differences from female comparison subjects. Exploratory correlation analyses revealed negative associations between working-memory-related activation and number of hyperactive symptoms for men and number of inattentive symptoms for women. CONCLUSIONS: Male but not female adults with ADHD showed significantly altered patterns of neural activity during a verbal working memory task. Men and women showed different associations between neural activity and ADHD symptoms.
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“A study in adults with ADHD found that 23 males had significant underactivation in widespread networks of frontal, temporal, cerebellar, occipital and subcortical regions during WM, whereas 21 females with ADHD showed no impairment relative to control females (Valera et al., 2010).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Valera et al., 2010
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Metadata
- Authors
- Valera, E. M., Brown, A., Biederman, J., Faraone, S. V., Makris, N., Monuteaux, M. C., Whitfield-Gabrieli, S., Vitulano, M., Schiller, M., & Seidman, L. J.
- Affiliations
- Harvard University (US)
- Boston University (US)
- SUNY Upstate Medical University (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Valera, Eve M
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2010-01-01
- Volume
- 167
- Issue
- 1
- Pages
- 86-94
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3777217
- OpenAlex
- W2151036885
- Cited by
- 138
- References
- 40
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 6 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 9 · 2018: 4 · 2017: 8 · 2016: 7 · 2015: 19 · 2014: 9 · 2013: 13 · 2012: 9
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- March of Dimes Foundation
- Eli Lilly and Company
- Pfizer
- Massachusetts General Hospital (P41RR14075, 071535)
- National Alliance for Research on Schizophrenia and Depression
- Shire
- National Institutes of Health (071535, 1f32mh065040-01a1)
- National Institute of Mental Health (MH-084041, MH 16259, F32 MH065040, MH-62152, K23MH071535, MH-071535, R01MH057934, MH-57934, R01MH062152, R21MH084041, T32MH016259)
- National Center for Research Resources (071535, P41-RR-14075, P41RR014075)
- National Center for Complementary and Integrative Health (1P01 AT-002048-06, P01AT002048)
- Janssen Pharmaceuticals
- 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
- adult ADHD, sex differences, working memory, functional neuroanatomy, n-back task, prefrontal cortex, inattentive symptoms, neuronal activation, cerebellum, temporal lobe
- MeSH terms
- Adolescent, Adult, Attention, Attention Deficit Disorder with Hyperactivity, Brain, Brain Mapping, Female, Humans, Intelligence Tests, Functional Laterality, Magnetic Resonance Imaging, Male, Memory, Short-Term, Neuropsychological Tests, Oxygen, Psychiatric Status Rating Scales, Reaction Time, Sex Factors, Prefrontal Cortex, Sex Distribution
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