Shared and disorder-specific task-positive and default mode network dysfunctions during sustained attention in
Luke J Norman1, Christina O Carlisi1, Anastasia Christakou2
1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Insights
Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) patients exhibit distinct brain activation patterns during sustained attention tasks. These differences, particularly in frontal and default mode networks, suggest disorder-specific neural underpinnings for attention deficits.
Area of Science:
- Neuroscience
- Cognitive Neuroscience
- Developmental Neuroscience
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) are associated with attention deficits.
- Shared deficits in network switching between default mode and task-positive networks are hypothesized for both ADHD and OCD.
- Understanding distinct neural correlates is crucial for targeted interventions.
Purpose of the Study:
- To investigate shared and disorder-specific brain activation abnormalities during sustained attention in ADHD and OCD.
- To compare functional magnetic resonance imaging (fMRI) activation patterns between boys with ADHD, boys with OCD, and healthy controls.
- To correlate brain activation with task performance under varying attentional loads.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was employed in a sustained attention task with parametric modulation of attentional load.
- Twenty boys with ADHD, 20 boys with OCD, and 20 age-matched healthy controls (12-18 years) participated.
- Performance and brain activation were analyzed comparing the three groups.
Main Results:
- ADHD patients showed performance impairments, unlike OCD patients and controls.
- OCD patients exhibited unique middle anterior cingulate underactivation.
- ADHD patients displayed disorder-specific underactivation in the left dorsolateral prefrontal cortex/dorsal inferior frontal gyrus (IFG).
- Shared underactivation in the left insula/ventral IFG and posterior default mode network (DMN) activation were observed in both ADHD and OCD groups.
- Disorder-specific overactivation in anterior DMN regions (dorsal anterior cingulate for ADHD, anterior ventromedial prefrontal cortex for OCD) was noted.
Conclusions:
- ADHD and OCD present largely distinct patterns of brain abnormalities in task-positive networks (salience/ventral attention) and DMN deactivation.
- Lateral frontal deficits characterize ADHD, while middle ACC deficits are specific to OCD.
- Disorder-specific activation patterns in neural networks underpin attention performance in ADHD and OCD.
Abstract:
Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) and obsessive/compulsive disorder (OCD) share problems with sustained attention, and are proposed to share deficits in switching between default mode and task positive networks. The aim of this study was to investigate shared and disorder-specific brain activation abnormalities during sustained attention in the two disorders. Twenty boys with ADHD, 20 boys with OCD and 20 age-matched healthy controls aged between 12 and 18 years completed a functional magnetic resonance imaging (fMRI) version of a parametrically modulated sustained attention task with a progressively increasing sustained attention load. Performance and brain activation were compared between groups. Only ADHD patients were impaired in performance. Group by sustained attention load interaction effects showed that OCD patients had disorder-specific middle anterior cingulate underactivation relative to controls and ADHD patients, while ADHD patients showed disorder-specific underactivation in left dorsolateral prefrontal cortex/dorsal inferior frontal gyrus (IFG). ADHD and OCD patients shared left insula/ventral IFG underactivation and increased activation in posterior default mode network relative to controls, but had disorder-specific overactivation in anterior default mode regions, in dorsal anterior cingulate for ADHD and in anterior ventromedial prefrontal cortex for OCD. In sum, ADHD and OCD patients showed mostly disorder-specific patterns of brain abnormalities in both task positive salience/ventral attention networks with lateral frontal deficits in ADHD and middle ACC deficits in OCD, as well as in their deactivation patterns in medial frontal DMN regions. The findings suggest that attention performance in the two disorders is underpinned by disorder-specific activation patterns.
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