Orbitofrontal dysfunction during the reward process in adults with ADHD: An fMRI study

Dong-Yu Yang; Mei Hung Chi; Ching-Lin Chu; Chun-Yu Lin; Shuo-En Hsu; Kao Chin Chen; I Hui Lee; Po See Chen; Yen Kuang Yang

doi:10.1016/j.clinph.2019.01.022

Orbitofrontal dysfunction during the reward process in adults with ADHD: An fMRI study

Clin Neurophysiol. 2019 May;130(5):627-633. doi: 10.1016/j.clinph.2019.01.022. Epub 2019 Feb 19.

Authors

Dong-Yu Yang¹, Mei Hung Chi¹, Ching-Lin Chu¹, Chun-Yu Lin², Shuo-En Hsu¹, Kao Chin Chen¹, I Hui Lee¹, Po See Chen³, Yen Kuang Yang⁴

Affiliations

¹ Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Psychology, National Cheng Kung University, Tainan, Taiwan.
³ Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan. Electronic address: ykyang@mail.ncku.edu.tw.

PMID: 30870798
DOI: 10.1016/j.clinph.2019.01.022

Abstract

Objective: The present study aimed to detect differences in the reward response between adults with attention deficit hyperactivity disorder (ADHD) and healthy controls (HCs) using functional magnetic resonance imaging (fMRI).

Methods: The Iowa gambling task (IGT) was designed to explore participants' reward-related decision-making in relation to selections during risky behaviors. Twenty adults with ADHD and 20 HCs were enrolled. fMRI with a modified IGT was performed.

Results: The adults with ADHD showed a poorer performance in terms of avoidance during risky behaviors. The fMRI results indicated that the adults with ADHD had significantly lower orbitofrontal cortex (OFC) activation. A positive correlation between performance in the IGT and brain activation in the OFC was detected.

Conclusions: The results suggested that the adults with ADHD exhibited abnormal OFC responses during decision-making.

Significance: To the best of our knowledge, this is the first study to use fMRI to collect brain activation data while performing the IGT in adults with ADHD. Our findings suggest that deficits in reward processing in ADHD are still present during adulthood.

Keywords: ADHD; Iowa gambling task; Orbitofrontal cortex; fMRI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity / diagnostic imaging*
Attention Deficit Disorder with Hyperactivity / psychology
Decision Making / physiology*
Female
Functional Neuroimaging
Humans
Magnetic Resonance Imaging
Male
Neuropsychological Tests
Prefrontal Cortex / diagnostic imaging*
Reward*
Young Adult