title: Abnormal amygdalar activation and connectivity in adolescents with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  Emotional reactivity is one of the most disabling symptoms associated with attention-deficit/hyperactivity disorder (ADHD). We aimed to identify neural substrates associated with emotional reactivity and to assess the effects of stimulants on those substrates.
  
  
  METHODS
  We used functional magnetic resonance imaging (fMRI) to assess neural activity in adolescents with (n = 15) and without (n = 15) ADHD while they performed a task involving the subliminal presentation of fearful faces. Using dynamic causal modeling, we also examined the effective connectivity of two regions associated with emotional reactivity, i.e., the amygdala and the lateral prefrontal cortex (LPFC). The participants with ADHD underwent scanning both on and off stimulant medication in a counterbalanced fashion.
  
  
  RESULTS
  During the task, we found that activity in the right amygdala was greater in adolescents with ADHD than in control subjects. In addition, in adolescents with ADHD, greater connectivity was detected between the amygdala and LPFC. Stimulants had a normalizing effect on both the activity in the right amygdala and the connectivity between the amygdala and LPFC.
  
  
  CONCLUSIONS
  Our findings demonstrate that in adolescents with ADHD, a neural substrate of fear processing is atypical, as is the connectivity between the amygdala and LPFC. These findings suggest possible neural substrates for the emotional reactivity that is often present in youths with ADHD, and provide putative neural targets for the development of novel therapeutic interventions for this condition.
authors.affiliation: Columbia College of Physicians and Surgeons, New York, NY 10032, USA. posnerj@childpsych.columbia.edu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Posner
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Nagel
authors.forename: Tiago V
authors.initials: TV
authors.lastname: Maia
authors.forename: Anna
authors.initials: A
authors.lastname: Mechling
authors.forename: Milim
authors.initials: M
authors.lastname: Oh
authors.forename: Zhishun
authors.initials: Z
authors.lastname: Wang
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000503:physiopathology*; D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000503:physiopathology*; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D005239:Fear; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008959:Models, Neurological; D009431:Neural Conduction / Q000187:drug effects; D017397:Prefrontal Cortex / Q000503:physiopathology*; D013360:Subliminal Stimulation
chemical_list: D000697:Central Nervous System Stimulants