Sex differences in medication-naïve adults with attention-deficit/hyperactivity disorder: A counting Stroop functional MRI study

Shu-Hui Lee; Seng Chia; Tai-Li Chou; Susan Shur-Fen Gau

doi:10.1016/j.biopsycho.2023.108552

Sex differences in medication-naïve adults with attention-deficit/hyperactivity disorder: A counting Stroop functional MRI study

Biol Psychol. 2023 Apr:179:108552. doi: 10.1016/j.biopsycho.2023.108552. Epub 2023 Apr 6.

Authors

Shu-Hui Lee¹, Seng Chia², Tai-Li Chou³, Susan Shur-Fen Gau⁴

Affiliations

¹ Department of Educational Psychology and Counseling, National Tsing Hua University, Taiwan; Center for General Education, National Tsing Hua University, Taiwan.
² Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taiwan.
³ Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taiwan; Department of Psychology, National Taiwan University, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taiwan. Electronic address: tlchou25@ntu.edu.tw.
⁴ Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taiwan; Department of Psychology, National Taiwan University, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taiwan. Electronic address: gaushufe@ntu.edu.tw.

PMID: 37028795
DOI: 10.1016/j.biopsycho.2023.108552

Abstract

Emerging evidence supports deficits in executive functions in the fronto-striato-parietal network in individuals with attention-deficit/hyperactivity disorder (ADHD). However, most functional studies recruited men with ADHD only, leaving it unclear whether executive deficits are also demonstrated in women with ADHD. Thus, we used functional magnetic resonance imaging to examine the sex differences in a counting Stroop task that explored interference control. The sample consisted of 55 medication-naïve adults with ADHD (28 men, 27 women) and 52 healthy controls (HC, 26 men, 26 women). The Conners' Continuous Performance Test further evaluated the performance of focused attention (standard deviation of the reaction time, RTSD) and vigilance (the reaction time change across different inter-stimulus intervals, RTISI). First, for the main effect of diagnosis, compared to the HC group, the ADHD group showed less activation in the caudate nucleus and inferior frontal gyrus (IFG). Second, for the main effect of sex, no significant effects were found. Third, a diagnosis-by-sex interaction indicated that the magnitude of ADHD-HC difference was greater for women than men in the right IFG and precuneus, reflecting greater difficulties for ADHD women to resolve interference. Conversely, no significant brain activation showed greater ADHD-HC difference in men than women. Also, reduced right IFG and precuneus activation was negatively associated with the scores assessing focused attention and vigilance in ADHD women, indicating that the attentional abilities are disrupted in ADHD women. Abnormalities in the frontoparietal areas may represent the main difference between ADHD women and ADHD men.

Keywords: Focused attention; Gender; Interference control; Vigilance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity* / diagnostic imaging
Brain / diagnostic imaging
Female
Humans
Magnetic Resonance Imaging / methods
Male
Neuropsychological Tests
Sex Characteristics