Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Rubia, K. Articles by Brammer, M. J. Search for Related Content PubMed Citation Articles by Rubia, K. Articles by Brammer, M. J. Attention Deficit Hyperactivity Disorder Conduct Disorders Related Articles

Disorder-Specific Dissociation of Orbitofrontal Dysfunction in Boys With Pure Conduct Disorder During Reward and Ventrolateral Prefrontal Dysfunction in Boys With Pure ADHD During Sustained Attention

OBJECTIVE: Among children, attention deficit hyperactivity disorder (ADHD) and conduct disorder are often comorbid and overlap clinically. Neuropsychological evidence suggests that children with conduct disorder demonstrate more prominent motivational problems and children with ADHD demonstrate more prominent attention deficits relative to healthy comparison subjects. The purpose of the present study was to investigate disorder-specific abnormalities in the neurobiological correlates of motivation and sustained attention in children and adolescents with pure conduct disorder and children and adolescents with pure ADHD. METHOD: Participants were male pediatric patients, ages 9–16 years, with noncomorbid conduct disorder (N=14) and noncomorbid ADHD, combined hyperactive-inattentive subtype (N=18), as well as age- and IQ-matched healthy comparison subjects (N=16). Both patient groups were medication naive. Event-related functional magnetic resonance imaging (fMRI) was used to compare brain activation during a rewarded continuous performance task that measured sustained attention as well as the effects of reward on performance. RESULTS: During the sustained attention condition, patients with noncomorbid ADHD showed significantly reduced activation in the bilateral ventrolateral prefrontal cortex and increased activation in the cerebellum relative to patients with noncomorbid conduct disorder and healthy comparison subjects. Patients with noncomorbid conduct disorder showed decreased activation in paralimbic regions of the insula, hippocampus, and anterior cingulate as well as the cerebellum relative to patients with noncomorbid ADHD and healthy comparison subjects. However, during the reward condition, patients with noncomorbid conduct disorder showed disorder-specific underactivation in the right orbitofrontal cortex, while patients with noncomorbid ADHD showed disorder-specific dysfunction in the posterior cingulate gyrus. CONCLUSIONS: The findings revealed a process-related dissociation of prefrontal dysfunction in ADHD and conduct disorder patients. Attention-related dysfunction in the ventrolateral prefrontal cortex was seen in ADHD patients, and reward-related dysfunction in the orbitofrontal cortex was seen in conduct disorder patients. These findings, together with the pattern of paralimbic dysfunction demonstrated among children with conduct disorder during sustained attention, support theories of abnormalities in orbitofrontal-paralimbic motivation networks in individuals with conduct disorder and, in contrast, ventrolateral fronto-cerebellar attention network dysfunction in individuals with ADHD.

Related Articles:

Child Psychiatry Growin’ Up

Daniel S. Pine and Robert Freedman
Am J Psychiatry 2009 166: 4-7. [Full Text] [PDF]

This article has been cited by other articles:

				A. Christakou, M. Brammer, V. Giampietro, and K. Rubia Right Ventromedial and Dorsolateral Prefrontal Cortices Mediate Adaptive Decisions under Ambiguity by Integrating Choice Utility and Outcome Evaluation J. Neurosci., September 2, 2009; 29(35): 11020 - 11028. [Abstract] [Full Text] [PDF]

				K. Rubia, R. Halari, A. Christakou, and E. Taylor Impulsiveness as a timing disturbance: neurocognitive abnormalities in attention-deficit hyperactivity disorder during temporal processes and normalization with methylphenidate Phil Trans R Soc B, July 12, 2009; 364(1525): 1919 - 1931. [Abstract] [Full Text] [PDF]

				D. S. Pine and R. Freedman Child Psychiatry Growin' Up Am J Psychiatry, January 1, 2009; 166(1): 4 - 7. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2009 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us