Cingulate-Precuneus Interactions: A New Locus of Dysfunction in Adult Attention-Deficit/Hyperactivity Disorder
Received 4 April 2007; received in revised form 31 May 2007; accepted 29 June 2007. published online 24 September 2007.
Background
Pathophysiologic models of attention-deficit/hyperactivity disorder (ADHD) have focused on frontal-striatal circuitry with alternative hypotheses relatively unexplored. On the basis of evidence that negative interactions between frontal foci involved in cognitive control and the non-goal-directed “default-mode” network prevent attentional lapses, we hypothesized abnormalities in functional connectivity of these circuits in ADHD.
Methods
Resting-state blood oxygen level–dependent functional magnetic resonance imaging (fMRI) scans were obtained at 3.0-Tesla in 20 adults with ADHD and 20 age- and sex-matched healthy volunteers.
Results
Examination of healthy control subjects verified presence of an antiphasic or negative relationship between activity in dorsal anterior cingulate cortex (centered at x = 8, y = 7, z = 38) and in default-mode network components. Group analyses revealed ADHD-related compromises in this relationship, with decreases in the functional connectivity between the anterior cingulate and precuneus/posterior cingulate cortex regions (p < .0004, corrected). Secondary analyses revealed an extensive pattern of ADHD-related decreases in connectivity between precuneus and other default-mode network components, including ventromedial prefrontal cortex (p < 3 × 10−11, corrected) and portions of posterior cingulate (p < .02, corrected).
Conclusions
Together with prior unbiased anatomic evidence of posterior volumetric abnormalities, our findings suggest that the long-range connections linking dorsal anterior cingulate to posterior cingulate and precuneus should be considered as a candidate locus of dysfunction in ADHD.
aPhyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience, New York University Child Study Center, New York
bNathan Kline Institute for Psychiatric Research, Orangeburg, New York
cDepartment of Psychiatry, New York University School of Medicine, New York
dDepartment of Radiology, University of Medicine and Dentistry of New Jersey, Newark
eInstitute for Disorders of Impulse and Attention, School of Psychology, University of Southampton, Southampton, United Kingdom
fSocial, Genetic, Developmental Psychiatry Research Centre, Institute of Psychiatry, Kings College London, London, United Kingdom.
Address reprint requests to F. Xavier Castellanos, M.D., Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience, NYU Child Study Center, 215 Lexington Avenue, 14th Floor, New York, NY 10016
ABSTRACT