Reduced lateral prefrontal activation in adult patients with attention-deficit/hyperactivity disorder (ADHD) during a working memory task: A functional near-infrared spectroscopy (fNIRS) study

https://doi.org/10.1016/j.jpsychires.2007.11.011Get rights and content

Abstract

Near-infrared spectroscopy (NIRS) is an optical imaging method, which allows non-invasive in vivo measurements of changes in the concentration of oxygenated (O2Hb) and deoxygenated (HHb) haemoglobin in cortical tissue. For the present study, we examined 13 adult ADHD patients and 13 age- and gender-matched healthy controls by means of multi-channel NIRS (Optical Topography; ETG-100, Hitachi Medical Co., Japan) during performance of a working memory (n-back) paradigm. Compared to the healthy control group, ADHD patients showed reduced task-related increases in the concentration of O2Hb in NIRS channels located over the ventro-lateral prefrontal cortex, indicating reduced activation during performance of the n-back task in this part of the brain. This finding was particularly apparent for the task condition with high working memory load (2-back), and was accompanied by a statistical trend towards an increased number of omission errors in the patient group. The data confirm previous findings of working memory deficits and prefrontal cortex dysfunction in patients suffering from ADHD, and are discussed in the light of imaging findings and theoretical models of working memory function.

Section snippets

Objectives of the study

During the last decades, the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) has gathered increasing interest both in clinical practice and research. Over the years, it has become apparent that ADHD is not only a childhood disorder, but that the symptomatology frequently persists in adulthood as a full or incomplete syndrome (Wender, 1998). The clinical symptomatology of ADHD is characterized by attentional deficits, motor hyperactivity, and increased impulsivity. On

Participants

Thirteen out-patients of the Department of Psychiatry and Psychotherapy at the University of Wuerzburg fulfilling the diagnostic criteria for ADHD (ICD-10: F90.0) and 13 healthy volunteers participated in this study. Both groups did not differ significantly regarding their mean age (patients: 29.8 ± 8.0 years, control group: 26.8 ± 3.6 years; t17 = 1.23, p > 0.2), years of school education (10.2 ± 1.3 versus 10.5 ± 1.5; t25 = .065, p > 0.5), or gender distribution (ADHD patients: nine male, four female;

N-back performance

Mann-Whitney-U tests revealed that ADHD patients tended to make more omission errors than healthy controls in the 2-back condition of the n-back task (see Table 1). None of the other performance measures (omission errors during 1-back trials; commission errors; button presses (i.e. responses) irrespective of correctness) showed any statistically significant differences between the two groups.

NIRS data – O2Hb

For t-maps depicting the statistical differences between the two groups (healthy controls versus ADHD

Discussion

The present study investigated prefrontal changes in the concentration of oxygenated and deoxygenated haemoglobin during performance of two versions of a classical working memory task, in a group of patients suffering from ADHD and an age- and gender-matched healthy control group. The analyses revealed that healthy controls exhibited stronger increases in the concentration of O2Hb than ADHD patients, particularly for the 2-back condition (the actual working memory task) and particularly for

Conflict of interest

All the authors declare that they have no conflicts of interest with respect to this study or its publication.

Role of funding source

The study was supported by grants of the Deutsche Forschungsgemeinschaft (DFG) to A.J.F. (KFO-125/1-2; Fa 361/8-3); the DFG had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Contributors

A.-C. Ehlis designed the study, wrote the protocol, statistically analyzed the data, and wrote the first draft of the manuscript. C.G. Bähne was involved in data collection and analysis; she also contributed to writing the final version of the manuscript. C.P. Jacob was involved in patient recruitment and data collection; he also contributed to writing the final version of the manuscript. M.J. Herrmann was involved in working out the study design and writing the protocol. He also participated

Acknowledgement

The authors would like to thank Hitachi Medical Corporation for the ETG-100 equipment and skilled technical support, and Melanie Harder and Inge Gröbner for their proficient technical assistance.

References (51)

  • Y. Hoshi et al.

    Spatiotemporal characteristics of hemodynamic changes in the human lateral prefrontal cortex during working memory tasks

    Neuroimage

    (2003)
  • R. Martinussen et al.

    A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder

    Journal of the American Academy of Child & Adolescent Psychiatry

    (2005)
  • K. Matsuo et al.

    Hypoactivation of the prefrontal cortex during verbal fluency test in PTSD: a near-infrared spectroscopy study

    Psychiatry Research

    (2003)
  • H. Obrig et al.

    Near-infrared spectroscopy: does it function in functional activation studies of the adult brain

    International Journal of Psychophysiology

    (2000)
  • M. Okamoto et al.

    Three-dimensional probabilistic anatomical cranio-cerebral correlation via the international 10–20 system oriented for transcranial functional brain mapping

    Neuroimage

    (2004)
  • J.H. Song et al.

    Visual working memory for simple and complex features: an fMRI study

    Neuroimage

    (2006)
  • G. Taga et al.

    Spontaneous oscillation of oxy- and deoxy-hemoglobin changes with a phase difference throughout the occipital cortex of newborn infants observed using non-invasive optical topography

    Neuroscience Letters

    (2000)
  • E.M. Valera et al.

    Functional neuroanatomy of working memory in adults with attention-deficit/hyperactivity disorder

    Biological Psychiatry

    (2005)
  • A. Villringer et al.

    Near infrared spectroscopy (NIRS): a new tool to study hemodynamic changes during activation of brain function in human adults

    Neuroscience Letters

    (1993)
  • E. Watanabe et al.

    Non-invasive assessment of language dominance with near-infrared spectroscopic mapping

    Neuroscience Letters

    (1998)
  • E. Watanabe et al.

    Non-invasive functional mapping with multi-channel near infra-red spectroscopic topography in humans

    Neuroscience Letters

    (1996)
  • P.H. Wender

    Attention-deficit hyperactivity disorder in adults

    The Psychiatric clinics of North America

    (1998)
  • E.G. Willcutt et al.

    Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review

    Biological Psychiatry

    (2005)
  • E. Awh et al.

    Dissociation of storage and rehearsal in verbal working memory

    Psychological Science

    (1996)
  • A.D. Baddeley

    Working memory

    (1986)
  • Cited by (168)

    • Cognitive deficit in adults with ADHD lies in the cognitive state disorder rather than the working memory deficit: A functional near-infrared spectroscopy study

      2022, Journal of Psychiatric Research
      Citation Excerpt :

      This is not a comprehensive examination of the cognitive characteristics of adult ADHD in terms of behavioural performance and the temporal and spatial performance characteristics of brain area activation. Second, in terms of the research content, most previous research has only analysed the appearance of ADHD in the WM task (Ehlis et al., 2008; Wolf et al., 2009; Stroux et al., 2016), but did not explore whether ADHD's performance would be abnormal as memory load, stimulus novelty, and time duration changed. Specifically, Ehlis et al. (2008) used fNIRS to combine with N-back tasks while having a classification of high and low memory load, which also showed that the ventrolateral prefrontal cortex (PFC) of adult ADHD was activated abnormally in N-back tasks.

    • Human creativity escapes in the struggle against threat: Evidence from neural mechanisms

      2022, Biological Psychology
      Citation Excerpt :

      The supramarginal gyrus (SMG) plays a role in automatically activating relevant knowledge and maintaining attention, and is important in mental manipulation (Cogdell-Brooke et al., 2020; Fink et al., 2010). Therefore, a decrease in cortical activation may reflect a decrease in information manipulation ability and attentional resources (Ehlis et al., 2008), which prevents an individual from maintaining knowledge related to effective attention activation and analytical creativity, resulting in decreased creativity. Thus, in this study, decreased activation of the PFC and SMG can be understood in terms of attentional resources, i.e., threat leads to depletion of critical resources, triggering poor performance on cognitive tasks (Plessow et al., 2011).

    View all citing articles on Scopus
    View full text