Striatal sensitivity during reward processing in attention-deficit/hyperactivity disorder

J Am Acad Child Adolesc Psychiatry. 2012 Jul;51(7):722-732.e9. doi: 10.1016/j.jaac.2012.05.006. Epub 2012 Jun 5.


Objective: Attention-deficit/hyperactivity disorder (ADHD) has been linked to deficits in the dopaminergic reward-processing circuitry; yet, existing evidence is limited, and the influence of genetic variation affecting dopamine signaling remains unknown. We investigated striatal responsivity to rewards in ADHD combined type (ADHD-CT) using functional magnetic resonance imaging (fMRI), and whether it is modulated by variation in the dopamine transporter gene (DAT1).

Method: We tested 29 male adolescents with ADHD-CT and 30 age-, handedness-, and gender-matched healthy controls who were selected for DAT1(10/6) haplotype dosage. Based on previous research, we focused our analysis on the ventral striatum and the caudate nucleus.

Results: Three main findings emerged. First, male adolescents with ADHD-CT did not differ from controls in terms of blood oxygen-level dependent (BOLD) fMRI response to reward-predicting cues (gain or loss-avoidance) in the ventral striatum. Second, male adolescents with ADHD-CT showed a relative increase, compared with controls, in the striatal BOLD response to successful outcomes. Third, DAT1(10/6) dosage differentially modulated neural activation to reward-predicting cues in the caudate nucleus in the ADHD-CT and control groups.

Conclusions: The findings challenge the idea of a deficit in anticipation-related activation in the ventral striatum in male adolescents with ADHD-CT, while suggesting that the processing of reward outcomes is dysfunctional, consistent with a recent neurobiological model of the disorder. Preliminary evidence suggests that polymorphic variations in genes affecting dopamine signaling need to be taken into consideration when investigating reward-related deficits in ADHD-CT.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anticipation, Psychological / physiology
  • Arousal / physiology
  • Attention Deficit Disorder with Hyperactivity / genetics
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Basal Ganglia / physiopathology*
  • Brain Mapping
  • Caudate Nucleus / physiopathology
  • Cues
  • Decision Making / physiology
  • Dominance, Cerebral / physiology
  • Dopamine Plasma Membrane Transport Proteins / genetics
  • Executive Function / physiology
  • Feedback, Psychological / physiology
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Magnetic Resonance Imaging*
  • Male
  • Motivation / physiology*
  • Nerve Net / physiopathology
  • Oxygen / blood
  • Reference Values
  • Reward*


  • Dopamine Plasma Membrane Transport Proteins
  • SLC6A3 protein, human
  • Oxygen