title: Impaired neural reward processing in children and adolescents with reactive attachment disorder: A pilot study.
abstract: Reactive attachment disorder (RAD) is characterized by markedly disturbed and developmentally inappropriate social relatedness due to parental maltreatment. RAD patients often display a high number of comorbid attention deficit/hyperactivity disorder (ADHD) symptoms, and certain RAD symptoms are difficult to discriminate from ADHD. One of the core characteristics of ADHD is a decrease in neural reward processing due to dopamine dysfunction. The aim of the present study was to determine whether the brain activity involved in reward processing in RAD patients is impaired in comparison with ADHD patients and typically developed controls. Five RAD patients, 17 typically developed (TD) controls and 17 ADHD patients aged 10-16 years performed tasks with high and low monetary reward while undergoing functional magnetic resonance imaging. ADHD patients were tested before and after 3 months treatment with osmotic release oral system-methylphenidate. Before treatment, ADHD patients showed that striatal and thalamus activities only in the tasks with low monetary reward were lower than TD controls. RAD patients showed decrease in activity of the caudate, putamen and thalamus during both the high and low monetary reward conditions in comparison with all the other groups. In RAD patients, the activity of the putamen was associated with the severity of posttraumatic stress and overt dissociation. Reward sensitivity was markedly decreased in children and adolescents with RAD, as evidenced by a diminished neural response during reward perception. This suggests that dopaminergic dysfunction exists in these patients, and may inform future dopaminergic treatment strategies for RAD.
authors: Pathophysiological and Health Science Team, RIKEN Center for Life Science Technologies, 6-7-3 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Hyogo, Japan; Department of Medical Science on Fatigue, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City 545-8585, Osaka, Japan. Electronic address: keimizuno@riken.jp.
authors: Kei
authors: K
authors: Mizuno
authors: Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho 910-1193, Fukui, Japan. Electronic address: stakky@u-fukui.ac.jp.
authors: Shinichiro
authors: S
authors: Takiguchi
authors: Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho 910-1193, Fukui, Japan. Electronic address: yamazakimm@gmail.com.
authors: Mika
authors: M
authors: Yamazaki
authors: Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho 910-1193, Fukui, Japan. Electronic address: plusloin.morio@gmail.com.
authors: Mizuki
authors: M
authors: Asano
authors: Department of Child Psychiatry, Aichi Children's Health and Medical Center, 1-2 Osakada, Moriokacho, Obu 474-8710, Aichi, Japan. Electronic address: sihho-_-kartoon@nifty.com.
authors: Shiho
authors: S
authors: Kato
authors: Department of Child Psychiatry, Aichi Children's Health and Medical Center, 1-2 Osakada, Moriokacho, Obu 474-8710, Aichi, Japan. Electronic address: caf17640@pop12.odn.ne.jp.
authors: Kikuko
authors: K
authors: Kuriyama
authors: Pathophysiological and Health Science Team, RIKEN Center for Life Science Technologies, 6-7-3 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Hyogo, Japan; Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City 545-8585, Osaka, Japan. Electronic address: yywata@riken.jp.
authors: Yasuyoshi
authors: Y
authors: Watanabe
authors: Division of Cerebral Integration, Department of Cerebral Research, National Institute for Physiological Sciences, 38 Nishigonaka, Myodaiji, Okazaki 444-8585, Aichi, Japan. Electronic address: sadato@nips.ac.jp.
authors: Norihiro
authors: N
authors: Sadato
authors: Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho 910-1193, Fukui, Japan. Electronic address: atomoda@u-fukui.ac.jp.
authors: Akemi
authors: A
authors: Tomoda
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D002648:Child; D002649:Child Abuse / Q000523:psychology; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics; D059290:Dopaminergic Neurons / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000493:pharmacokinetics; D010865:Pilot Projects; D019962:Reactive Attachment Disorder / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D012201:Reward; D012919:Social Behavior; D013647:Task Performance and Analysis
chemical_list: D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate
keywords: Caudate nucleus; Dopamine; Functional magnetic resonance imaging; Putamen; Reward; Thalamus