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Anterior cingulate cortex alterations in children and adolescents with Attention Deficit and Hyperactivity Disorder:
Tonia Salem1, Hayat Harati1, Marwa Summaka1
1Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon.
Insights
Children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) show consistent brain differences. The anterior cingulate cortex (ACC) exhibits structural changes and functional disruptions impacting inhibitory control and connectivity.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder.
- ADHD is characterized by persistent inattention and hyperactivity-impulsivity.
- The anterior cingulate cortex (ACC) plays a crucial role in executive functions and emotional regulation.
Purpose of the Study:
- To systematically review structural and functional alterations of the ACC in pediatric ADHD.
- To synthesize neuroimaging findings in children and adolescents with ADHD.
- To identify a coherent neurobiological pattern associated with ADHD in youth.
Main Methods:
- Systematic review adhering to the PICO framework.
- Inclusion of studies on individuals under 18 years with ADHD.
- Neuroimaging modalities (MRI, fMRI, EEG) assessing the ACC compared to typically developing controls.
Main Results:
- Structural MRI revealed reduced gray matter volume, cortical thinning, and atypical sulcal morphology in the ACC.
- Functional MRI indicated diminished ACC activation during inhibitory control tasks and altered resting-state connectivity.
- EEG studies showed attenuated N2/P3 amplitudes and disrupted theta oscillations.
Conclusions:
- Pediatric ADHD is associated with a distinct neurobiological profile involving the ACC.
- Structural changes include reduced volume, thinning, and atypical folding of the ACC.
- Functional dysregulation encompasses abnormal activation, disrupted connectivity, and altered electrophysiological responses in the ACC.
Purpose:
This systematic review investigates existing evidence regarding the structural and functional alterations of the anterior cingulate cortex (ACC) in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental disorder characterized by persistent inattention and hyperactivity-impulsivity.
Materials And Methods:
Following the PICO framework, inclusion criteria specified populations of children and adolescents aged under 18 years. The intervention comprised neuroimaging modalities assessing the ACC, compared against typically developing controls, with neuroimaging findings as the primary outcomes.
Results:
Structural MRI findings reported reduced gray matter volume, cortical thinning, and atypical sulcal morphology within the ACC. Functional MRI studies indicated diminished ACC activation during inhibitory control tasks, alongside selective hyperactivation potentially reflecting compensatory mechanisms. Resting-state analyses revealed hypo-connectivity between the ACC and regulatory regions-including the dorsolateral prefrontal cortex, cerebellum, and default mode network-with mixed connectivity patterns suggesting neurofunctional subtypes. Additionally, EEG studies demonstrated attenuated N2/P3 amplitudes and disrupted theta oscillations.
Conclusions:
This review demonstrates a coherent neurobiological pattern in pediatric ADHD, characterized by both structural alterations (reduced ACC volume, thickness, and atypical folding) and functional dysregulation (abnormal activation, disrupted connectivity, and altered electrophysiological responses) across tasks probing inhibitory control, reward processing, and resting-state dynamics.
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