University of California, Davis, CA, USA.
Georgetown University, Washington, DC, USA.
J Atten Disord. 2022 May;26(7):1040-1050. doi: 10.1177/10870547211057074. Epub 2021 Nov 2.
Irritability is a common characteristic in ADHD. We examined whether dysfunction in neural connections supporting threat and reward processing was related to irritability in adolescents and young adults with ADHD.
We used resting-state fMRI to assess connectivity of amygdala and nucleus accumbens seeds in those with ADHD ( = 34) and an age- and gender-matched typically-developing comparison group ( = 34).
In those with ADHD, irritability was associated with atypical functional connectivity of both seed regions. Amygdala seeds showed greater connectivity with right inferior frontal gyrus and caudate/putamen, and less connectivity with precuneus. Nucleus accumbens seeds showed altered connectivity with middle temporal gyrus and precuneus.
The irritability-ADHD presentation is associated with atypical functional connectivity of reward and threat processing regions with cognitive control and emotion processing regions. These patterns provide novel evidence for irritability-associated neural underpinnings in adolescents and young adults with ADHD. The findings suggest cognitive and behavioral treatments that address response to reward, including omission of an expected reward and irritability, may be beneficial for ADHD.
易激惹是 ADHD 的一个常见特征。我们研究了青少年和年轻的 ADHD 患者中，支持威胁和奖励处理的神经连接功能障碍是否与易激惹有关。
我们使用静息态 fMRI 评估 ADHD 患者（ = 34）和年龄及性别匹配的正常对照组（ = 34）的杏仁核和伏隔核种子的连接。
在 ADHD 患者中，易激惹与两个种子区域的非典型功能连接有关。杏仁核种子与右侧额下回和尾状核/壳核的连接增强，与楔前叶的连接减弱。伏隔核种子与颞中回和楔前叶的连接改变。
易激惹与 ADHD 的表现与奖励和威胁处理区域与认知控制和情绪处理区域的异常功能连接有关。这些模式为 ADHD 青少年和年轻成人的易激惹相关神经基础提供了新的证据。研究结果表明，针对奖励反应的认知和行为治疗，包括预期奖励的缺失和易激惹，可能对 ADHD 有益。
