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Delay aversion in attention deficit/hyperactivity disorder is mediated by amygdala and prefrontal cortex hyper-activation

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Abstract
Background: Experimental research supports delay aversion as a motivational feature of attention deficit/hyperactivity disorder (ADHD). To investigate the neurobiology of delay aversion in ADHD, this study examined whether adolescents with ADHD display an unusually strong activation in affective brain regions in response to cues predicting forthcoming delay and whether these effects are (a) delay-dose dependent and (b) statistically mediate the association between ADHD and self-reported delay aversion. Methods: Twenty-nine right-handed male adolescents with combined type ADHD and 32 typically developing controls (ages 10-18 years) performed a reaction time task in an MRI scanner. Pretarget cues indicated delay-related response consequences. One indicated that delay would follow the response irrespective of response speed (CERTAIN DELAY), a second that delay would only follow if the response was too slow (CONDITIONAL DELAY), and a third that no delay would follow the response whatever its speed (NO DELAY). Delay levels were 2, 6, or 14s. Participants also rated their own delay aversion in everyday life. Results: Individuals with ADHD rated themselves as more delay averse than controls. Significantly greater activation to CERTAIN DELAY cues relative to NO DELAY cues was found in participants with ADHD compared to controls (bilaterally) in amygdala, anterior insula, temporal pole, dorsolateral prefrontal cortex (DLPFC), and ventromedial prefrontal cortex. Amygdala and DLPFC activation strength were strongly and delay-dose dependently correlated with delay aversion ratings, and statistically mediated the relationship between ADHD status and delay aversion. Conclusions: When presented with cues predicting impending delay, adolescents with ADHD, relative to controls, displayed a delay-related increase in activation in amygdala and DLPFC, regions known to be implicated in the processing of aversive events. Future studies should examine the specificity of these effects to delay aversion compared to aversive events in general.
Keywords
DEFICIT HYPERACTIVITY DISORDER, FUNCTIONAL CONNECTIVITY, CONDITIONING, PARADIGM, EMOTION REGULATION, ABNORMAL AMYGDALA, CHILDREN, BRAIN, ADHD, ANTICIPATION, CHOICE, Attention deficit/hyperactivity disorder, fMRI, delay aversion, amygdala, dorsolateral prefrontal cortex, affective network

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Chicago
Van Dessel, Jeroen, Edmund Barke, Gabry Mies, Jurgen Lemiere, Saskia Van der Oord, Sarah Morsink, and Marina Danckaerts. 2018. “Delay Aversion in Attention Deficit/hyperactivity Disorder Is Mediated by Amygdala and Prefrontal Cortex Hyper-activation.” Journal of Child Psychology and Psychiatry 59 (8): 888–899.
APA
Van Dessel, J., Barke, E., Mies, G., Lemiere, J., Van der Oord, S., Morsink, S., & Danckaerts, M. (2018). Delay aversion in attention deficit/hyperactivity disorder is mediated by amygdala and prefrontal cortex hyper-activation. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY, 59(8), 888–899.
Vancouver
1.
Van Dessel J, Barke E, Mies G, Lemiere J, Van der Oord S, Morsink S, et al. Delay aversion in attention deficit/hyperactivity disorder is mediated by amygdala and prefrontal cortex hyper-activation. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY. Hoboken: Wiley; 2018;59(8):888–99.
MLA
Van Dessel, Jeroen et al. “Delay Aversion in Attention Deficit/hyperactivity Disorder Is Mediated by Amygdala and Prefrontal Cortex Hyper-activation.” JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY 59.8 (2018): 888–899. Print.
@article{8610867,
  abstract     = {Background: Experimental research supports delay aversion as a motivational feature of attention deficit/hyperactivity disorder (ADHD). To investigate the neurobiology of delay aversion in ADHD, this study examined whether adolescents with ADHD display an unusually strong activation in affective brain regions in response to cues predicting forthcoming delay and whether these effects are (a) delay-dose dependent and (b) statistically mediate the association between ADHD and self-reported delay aversion. Methods: Twenty-nine right-handed male adolescents with combined type ADHD and 32 typically developing controls (ages 10-18 years) performed a reaction time task in an MRI scanner. Pretarget cues indicated delay-related response consequences. One indicated that delay would follow the response irrespective of response speed (CERTAIN DELAY), a second that delay would only follow if the response was too slow (CONDITIONAL DELAY), and a third that no delay would follow the response whatever its speed (NO DELAY). Delay levels were 2, 6, or 14s. Participants also rated their own delay aversion in everyday life. Results: Individuals with ADHD rated themselves as more delay averse than controls. Significantly greater activation to CERTAIN DELAY cues relative to NO DELAY cues was found in participants with ADHD compared to controls (bilaterally) in amygdala, anterior insula, temporal pole, dorsolateral prefrontal cortex (DLPFC), and ventromedial prefrontal cortex. Amygdala and DLPFC activation strength were strongly and delay-dose dependently correlated with delay aversion ratings, and statistically mediated the relationship between ADHD status and delay aversion. Conclusions: When presented with cues predicting impending delay, adolescents with ADHD, relative to controls, displayed a delay-related increase in activation in amygdala and DLPFC, regions known to be implicated in the processing of aversive events. Future studies should examine the specificity of these effects to delay aversion compared to aversive events in general.},
  author       = {Van Dessel, Jeroen and Barke, Edmund and Mies, Gabry and Lemiere, Jurgen and Van der Oord, Saskia and Morsink, Sarah and Danckaerts, Marina},
  issn         = {0021-9630},
  journal      = {JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY},
  keywords     = {DEFICIT HYPERACTIVITY DISORDER,FUNCTIONAL CONNECTIVITY,CONDITIONING,PARADIGM,EMOTION REGULATION,ABNORMAL AMYGDALA,CHILDREN,BRAIN,ADHD,ANTICIPATION,CHOICE,Attention deficit/hyperactivity disorder,fMRI,delay aversion,amygdala,dorsolateral prefrontal cortex,affective network},
  language     = {eng},
  number       = {8},
  pages        = {888--899},
  publisher    = {Wiley},
  title        = {Delay aversion in attention deficit/hyperactivity disorder is mediated by amygdala and prefrontal cortex hyper-activation},
  url          = {http://dx.doi.org/10.1111/jcpp.12868},
  volume       = {59},
  year         = {2018},
}

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