title: Thalamo-cortical activation and connectivity during response preparation in adults with persistent and remitted ADHD.
abstract: OBJECTIVE
  The neural correlates of stimulus-driven processes, such as response preparation, have been posited to be associated with the onset of attention deficit hyperactivity disorder (ADHD) while being distinct from the neural mechanisms associated with recovery. The authors tested this hypothesis in adults with remitted and persistent ADHD.
  
  
  METHODS
  Thirty-eight young adults who were diagnosed with combined-type ADHD in childhood (probands) and 32 carefully matched comparison subjects were followed longitudinally and scanned with functional MRI while performing an event-related cued reaction time task. Probands were characterized as individuals with persistent or remitted ADHD. Differences in thalamo-cortical activation and functional connectivity during response preparation between comparison subjects and probands and between individuals with persistent ADHD and those with remitted ADHD were assessed by contrasting neural activation and functional connectivity during cue or noncue events.
  
  
  RESULTS
  Probands exhibited less cue-related activation than comparison subjects in the thalamus, anterior cingulate cortex, supplementary motor area, inferior parietal lobe, and dorsolateral prefrontal cortex despite similar overall patterns of activation. There were no differences in activation between individuals in the remitted ADHD group and those in the persistent ADHD group in any hypothesized regions. However, cue-related functional connectivity between the right thalamus and brainstem was greater in comparison subjects relative to probands, and cue-related connectivity was greater between the right thalamus and prefrontal regions in individuals with remitted ADHD relative to those with persistent ADHD.
  
  
  CONCLUSIONS
  Decreased thalamo-cortical activation during response preparation was present in adults diagnosed with ADHD in childhood regardless of symptom remission in adulthood, and may be partly driven by less functional coordination between the brainstem and thalamus. Greater functional integration of the thalamo-cortical network might parallel symptom recovery.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Clerkin
authors.forename: Kurt P
authors.initials: KP
authors.lastname: Schulz
authors.forename: Olga G
authors.initials: OG
authors.lastname: Berwid
authors.forename: Jin
authors.initials: J
authors.lastname: Fan
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Newcorn
authors.forename: Cheuk Y
authors.initials: CY
authors.lastname: Tang
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Halperin
mesh_terms: D000328:Adult; D017668:Age of Onset; D058070:Asymptomatic Diseases; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time; D013647:Task Performance and Analysis; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology