title: Atypical pulvinar-cortical pathways during sustained attention performance in children with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  The neurobiological basis of inattentiveness, a core feature of attention-deficit/hyperactivity disorder (ADHD), is not yet well understood. Structural abnormalities in thalamus, especially the pulvinar nuclei, have recently been reported in ADHD. Pulvinar nuclei maintain reciprocal connections with cortical/subcortical areas, and play a central coordinating role during visual attention processing. The objective of this study was to test the hypothesis that children and young adolescents with ADHD would show atypical pulvinar-cortical functional pathways during sustained attention performance, and that these functional abnormalities would be associated with the inattentive symptoms of the disorder.
  
  
  METHODS
  Visual attention task-based functional magnetic resonance imaging (fMRI) data from 22 children and young adolescents with ADHD and 22 demographically matched, normal control subjects were analyzed. Cortical activation maps and temporal correlations of activity patterns between pulvinar nuclei and the remainder of brain were constructed for each participant. Correlations between activation magnitude of pulvinar and diagnostic measures were calculated in subjects with ADHD.
  
  
  RESULTS
  Compared to controls, subjects with ADHD showed significantly reduced pulvinar activations bilaterally, significantly decreased functional connectivity between bilateral pulvinar and right prefrontal regions, and significantly increased connectivity between the right pulvinar and bilateral occipital regions. In addition, the activation magnitude in the left pulvinar was negatively correlated with the DSM-IV inattentive index in ADHD group.
  
  
  CONCLUSIONS
  Allied with previous evidence of structural abnormalities in pulvinar, the current data suggest that inappropriate development of pulvinar may lead to disrupted functional circuits for visual attention processing, and that these disruptions contribute significantly to the pathophysiological mechanisms of the inattentiveness symptoms in ADHD.
authors.affiliation: Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine of Yeshiva University. xiaobo.li@einstein.yu.edu
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Li
authors.forename: Ariane
authors.initials: A
authors.lastname: Sroubek
authors.forename: Mary S
authors.initials: MS
authors.lastname: Kelly
authors.forename: Iris
authors.initials: I
authors.lastname: Lesser
authors.forename: Elyse
authors.initials: E
authors.lastname: Sussman
authors.forename: Yong
authors.initials: Y
authors.lastname: He
authors.forename: Craig
authors.initials: C
authors.lastname: Branch
authors.forename: John J
authors.initials: JJ
authors.lastname: Foxe
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000473:pathology / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D063132:Connectome / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology*; D020649:Pulvinar / Q000473:pathology / Q000503:physiopathology*