Differential neural processing of value during decision-making in adults with attention-deficit/ hyperactivity disorder(ADHD) and healthy controls

Backgrounds:Attention-deficit/hyperactivity disorder (ADHD) has been associated with deficits in decision making and learning.These skills are guided by the dopaminergic system, which is impaired in ADHD.However, the precise learning and decision-making deficits and their neurobiological correlates in ADHD are not well known.The characteristics of ADHD include abnormalities in reward responsivity that may interfere with decision making.The development of functional neuroimaging has gradually allowed the exploration of the neurofunctional about of Decision-Making.Methods :Google Scholar, PubMed and Web of Science databases were comprehensively searched from ۲۰۱۵ to ۲۰۲۲۳. The keywords used included Attention-Deficit / Hyperactivity Disorder (ADHD), functional magnetic resonance imaging and decision-making. After removing irrelevant studies, finally ۱۱ studies that were compatible with the inclusion criteria were selected.Results :Importantly, functional connectivity between salience and frontoparietal networks predicted rate of evidence accumulation to a decision threshold, whereas functional connectivity between salience and default mode networks predicted inattention.The ventral and dorsolateral prefrontal cortex and the insula were activated during performance of the decision-making task in both the ADHD and healthy groups; however, activation in the ADHD group was less extended and did not involve other regions, such as anterior cingulate and hippocampus, that subserve emotion/memory processes.Direct comparison of data from the ADHD subjects and the healthy volunteers suggested that the healthy subjects engaged the hippocampal and insular regions more than did the ADHD subjects.Adults with ADHD had evidence of lower dorsolateral prefrontal cortex (DLPFC) activity and reduced sensitivity in the ventromedial prefrontal cortex (VMPFC) region of interest in response to linear changes in probability, compared with healthy controls.Compared with health controls, adults with ADHD showed higher responses to loss outcomes in the putamen and hippocampus.Conclusion :The findings suggest that the neural circuits engaged during decision making differ in subjects with ADHD and healthy comparison subjects. This difference may explain observed deficits in motivated behaviors in ADHD. Dysregulated neural computation of the values of behavioural actions and outcomes in the frontostriatal circuits may underlie decision processing distinct from reward learning differences among adults with ADHD. The combination of computational modeling of behavior and multimodal neuroimaging revealed that impaired decision making and learning mechanisms in adolescents with ADHD are driven by impaired RPE processing in the medial prefrontal cortex.A better understanding of the nature of these deficits could ultimately be applied to refine treatment strategies for ADHD.

Keywords:

ADHD , decision-making , fMRI