title: Cingulate-precuneus interactions: a new locus of dysfunction in adult attention-deficit/hyperactivity disorder.
abstract: 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 x 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.
authors: Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience, New York University Child Study Center, New York, NY 10016, USA. castef01@nyumc.org
authors: F Xavier
authors: FX
authors: Castellanos
authors: Daniel S
authors: DS
authors: Margulies
authors: Clare
authors: C
authors: Kelly
authors: Lucina Q
authors: LQ
authors: Uddin
authors: Manely
authors: M
authors: Ghaffari
authors: Andrew
authors: A
authors: Kirsch
authors: David
authors: D
authors: Shaw
authors: Zarrar
authors: Z
authors: Shehzad
authors: Adriana
authors: A
authors: Di Martino
authors: Bharat
authors: B
authors: Biswal
authors: Edmund J S
authors: EJ
authors: Sonuga-Barke
authors: John
authors: J
authors: Rotrosen
authors: Lenard A
authors: LA
authors: Adler
authors: Michael P
authors: MP
authors: Milham
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006179:Gyrus Cinguli / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017397:Prefrontal Cortex / Q000098:blood supply / Q000473:pathology*
chemical_list: D010100:Oxygen