title: Behavioural treatment increases activity in the cognitive neuronal networks in children with attention deficit/hyperactivity disorder.
abstract: Response cost and token approach (RCT) within the scope of a summer camp training is an effective treatment program for attention deficit hyperactivity disorder (ADHD). It is likely that intensive RCT training influences networks responsible for ADHD symptoms. Functional magnetic resonance imaging (fMRI) was carried out in 12 children with ADHD before and after the RCT program and in 12 healthy control children twice. For fMRI, a Go/No-go paradigm was used to investigate the influence of RCT training on attention and impulsivity. The No-go condition revealed only weak activation in the dorsal part of the anterior cingulate cortex (ACC), parietal and dorsolateral prefrontal cortex (DLPFC) before the training in children with ADHD compared to healthy children. However, this activation in these brain regions was significantly more pronounced after the training. This increase in hemodynamic response cannot be attributed merely to repetition of the measurement since the effect was not observed in healthy children. The increase in hemodynamic response in the ACC and right DLPFC was significantly associated with a reduction in response time variability and clinical symptoms in ADHD patients. After the RCT training, the children with ADHD demonstrated more pronounced activation of cortical structures which are typically related to response monitoring and self-control. It seems likely that children with ADHD learned more cognitive control in a continuous performance task as was revealed by both neuropsychological outcome and fMRI.
authors.affiliation: Clinic for Child and Adolescents Psychiatry, Goethe-University, Frankfurt, Germany. m.siniatchkin@pedneuro.uni-kiel.de
authors.forename: Michael
authors.initials: M
authors.lastname: Siniatchkin
authors.forename: Nora
authors.initials: N
authors.lastname: Glatthaar
authors.forename: Gabriele Gerber
authors.initials: GG
authors.lastname: von Müller
authors.forename: Alexander
authors.initials: A
authors.lastname: Prehn-Kristensen
authors.forename: Stephan
authors.initials: S
authors.lastname: Wolff
authors.forename: Silja
authors.initials: S
authors.lastname: Knöchel
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Steinmann
authors.forename: Anna
authors.initials: A
authors.lastname: Sotnikova
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stephani
authors.forename: Franz
authors.initials: F
authors.lastname: Petermann
authors.forename: Wolf-Dieter
authors.initials: WD
authors.lastname: Gerber
mesh_terms: D000293:Adolescent; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007175:Impulsive Behavior; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011930:Reaction Time; D016896:Treatment Outcome