Dept. of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany.
J Psychiatr Res. 2013 Mar;47(3):350-6. doi: 10.1016/j.jpsychires.2012.09.026. Epub 2012 Nov 30.
Abnormalities in reward processing have been found in adolescents and adults with ADHD using the 'Monetary Incentive Delay' (MID) task. However, ADHD groups in previous studies were heterogeneous regarding ADHD subtype, gender and, in part, drug treatment status. This study sought to compare neural activations in the ventral striatum (VS) and prefrontal regions during reward processing in homogenous ADHD subtype groups and healthy adults, using the MID task.
In total, 24 drug-naïve, right-handed male adults with ADHD (12 subjects with combined type (ADHD-ct) and 12 subjects with predominantly inattentive (ADHD-it) type ADHD), and twelve healthy right-handed male control subjects were included.
Compared to ADHD-ct and healthy subjects, ADHD-it subjects showed a bilateral ventral striatal deficit during reward anticipation. In contrast, ADHD-ct subjects showed orbitofrontal hyporesponsiveness to reward feedback when compared with ADHD-it and healthy subjects.
This is the first fMRI study that delineates dysfunctional and subtype-divergent neural and behavioural reward processing in adults with ADHD.
使用“金钱激励延迟”（MID）任务，已在 ADHD 青少年和成年人中发现奖励处理异常。然而，以前的研究中的 ADHD 组在 ADHD 亚型、性别以及部分药物治疗状况方面存在异质性。本研究旨在使用 MID 任务，比较同质性 ADHD 亚型组和健康成年人在奖励处理过程中腹侧纹状体（VS）和前额叶区域的神经激活。
共纳入 24 名未服用药物的右利手男性 ADHD 成年患者（12 名共病型（ADHD-ct）和 12 名注意力不集中为主型（ADHD-it））和 12 名健康右利手男性对照者。
与 ADHD-ct 和健康受试者相比，ADHD-it 受试者在奖励预期期间表现出双侧腹侧纹状体缺陷。相比之下，ADHD-ct 受试者与 ADHD-it 和健康受试者相比，对奖励反馈的眶额皮质反应不足。
这是第一项阐明 ADHD 成年患者神经和行为奖励处理功能障碍和亚型差异的 fMRI 研究。
