Altered Lateral Prefrontal Cortex Functioning During Emotional Interference Resistance Is Associated With Affect Lability in Adults With Persisting Symptoms of Attention-Deficit/Hyperactivity Disorder From Childhood

Amar Ojha; Neil P Jones; Teague Henry; Amelia Versace; Elizabeth M Gnagy; Heather M Joseph; Brooke S G Molina; Cecile D Ladouceur

doi:10.1016/j.bpsc.2024.02.003

Altered Lateral Prefrontal Cortex Functioning During Emotional Interference Resistance Is Associated With Affect Lability in Adults With Persisting Symptoms of Attention-Deficit/Hyperactivity Disorder From Childhood

Biol Psychiatry Cogn Neurosci Neuroimaging. 2024 Feb 18:S2451-9022(24)00054-5. doi: 10.1016/j.bpsc.2024.02.003. Online ahead of print.

Authors

Amar Ojha¹, Neil P Jones², Teague Henry³, Amelia Versace², Elizabeth M Gnagy⁴, Heather M Joseph², Brooke S G Molina², Cecile D Ladouceur⁵

Affiliations

¹ Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
² Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
³ Department of Psychology, University of Virginia, Charlottesville, Virginia; School of Data Science, University of Virginia, Charlottesville, Virginia.
⁴ Department of Psychology, Florida International University, Miami, Florida.
⁵ Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: ladouceurcd@upmc.edu.

PMID: 38378127
DOI: 10.1016/j.bpsc.2024.02.003

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention and/or impulsivity/hyperactivity. ADHD, especially when persisting into adulthood, often includes emotional dysregulation, such as affect lability; however, the neural correlates of emotionality in adults with heterogeneous ADHD symptom persistence remain unclear.

Methods: The present study sought to determine shared and distinct functional neuroanatomical profiles of neural circuitry during emotional interference resistance using the emotional face n-back task in adult participants with persisting (n = 47), desisting (n = 93), or no (n = 42) childhood ADHD symptoms while undergoing functional magnetic resonance imaging.

Results: Participants without any lifetime ADHD diagnosis performed significantly better (faster and more accurately) than participants with ADHD diagnoses on trials with high cognitive loads (2-back) that included task-irrelevant emotional distractors, tapping into executive functioning and emotion regulatory processes. In participants with persisting ADHD symptoms, more severe emotional symptoms were related to worse task performance. Heightened dorsolateral and ventrolateral prefrontal cortex activation was associated with more accurate and faster performance on 2-back emotional faces trials, respectively. Reduced activation was associated with greater affect lability in adults with persisting ADHD, and dorsolateral prefrontal cortex activation mediated the relationship between affect lability and task accuracy.

Conclusions: These findings suggest that alterations in dorsolateral prefrontal cortex function associated with greater interference in cognitive processes from emotion could represent a marker of risk for problems with emotional dysregulation in individuals with persisting ADHD and thus represent a potential therapeutic target for those with greater emotional symptoms of ADHD.

Keywords: Affect lability; Attention-deficit/hyperactivity disorder; Emotional faces; Neuroimaging; Task functional magnetic resonance imaging; Working memory.