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Carlisi CO, Norman L, Murphy CM, Christakou A, Chantiluke K, Giampietro V, Simmons A, Brammer M, Murphy DG, Mataix-Cols D, Rubia K. Comparison of neural substrates of temporal discounting between youth with autism spectrum disorder and with obsessive-compulsive disorder. Psychol Med 2017; 47:2513-2527. [PMID: 28436342 PMCID: PMC5964452 DOI: 10.1017/s0033291717001088] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 03/10/2017] [Accepted: 03/29/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) share abnormalities in hot executive functions such as reward-based decision-making, as measured in the temporal discounting task (TD). No studies, however, have directly compared these disorders to investigate common/distinct neural profiles underlying such abnormalities. We wanted to test whether reward-based decision-making is a shared transdiagnostic feature of both disorders with similar neurofunctional substrates or whether it is a shared phenotype with disorder-differential neurofunctional underpinnings. METHODS Age and IQ-matched boys with ASD (N = 20), with OCD (N = 20) and 20 healthy controls, performed an individually-adjusted functional magnetic resonance imaging (fMRI) TD task. Brain activation and performance were compared between groups. RESULTS Boys with ASD showed greater choice-impulsivity than OCD and control boys. Whole-brain between-group comparison revealed shared reductions in ASD and OCD relative to control boys for delayed-immediate choices in right ventromedial/lateral orbitofrontal cortex extending into medial/inferior prefrontal cortex, and in cerebellum, posterior cingulate and precuneus. For immediate-delayed choices, patients relative to controls showed reduced activation in anterior cingulate/ventromedial prefrontal cortex reaching into left caudate, which, at a trend level, was more decreased in ASD than OCD patients, and in bilateral temporal and inferior parietal regions. CONCLUSIONS This first fMRI comparison between youth with ASD and with OCD, using a reward-based decision-making task, shows predominantly shared neurofunctional abnormalities during TD in key ventromedial, orbital- and inferior fronto-striatal, temporo-parietal and cerebellar regions of temporal foresight and reward processing, suggesting trans-diagnostic neurofunctional deficits.
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Affiliation(s)
- C. O. Carlisi
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry, Psychology and Neuroscience,
King's College, London, UK
| | - L. Norman
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry, Psychology and Neuroscience,
King's College, London, UK
| | - C. M. Murphy
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry, Psychology and Neuroscience,
King's College, London, UK
- Department of Forensic and Neurodevelopmental
Sciences, Sackler Institute for Translational Neurodevelopmental
Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's
College, London, UK
- Behavioural Genetics Clinic, Adult Autism
Service, Behavioural and Developmental Psychiatry Clinical Academic
Group, South London and Maudsley Foundation NHS Trust,
London, UK
| | - A. Christakou
- Centre for Integrative Neuroscience and
Neurodynamics, School of Psychology and Clinical Language Sciences, University of
Reading, Reading, UK
| | - K. Chantiluke
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry, Psychology and Neuroscience,
King's College, London, UK
| | - V. Giampietro
- Department of Neuroimaging,
Institute of Psychiatry, Psychology and Neuroscience, King's
College, London, UK
| | - A. Simmons
- Department of Neuroimaging,
Institute of Psychiatry, Psychology and Neuroscience, King's
College, London, UK
- National Institute for Health Research (NIHR)
Biomedical Research Centre (BRC) for Mental Health at South London and Maudsley NHS
Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's
College London, London, UK
- Department of Neurobiology, Care Sciences and
Society, Center for Alzheimer Research, Division of Clinical
Geriatrics, Karolinska Institutet, Stockholm,
Sweden
| | - M. Brammer
- Department of Neuroimaging,
Institute of Psychiatry, Psychology and Neuroscience, King's
College, London, UK
| | - D. G. Murphy
- Department of Forensic and Neurodevelopmental
Sciences, Sackler Institute for Translational Neurodevelopmental
Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's
College, London, UK
- Behavioural Genetics Clinic, Adult Autism
Service, Behavioural and Developmental Psychiatry Clinical Academic
Group, South London and Maudsley Foundation NHS Trust,
London, UK
| | | | - D. Mataix-Cols
- Department of Clinical Neuroscience,
Centre for Psychiatry Research, Karolinska Institutet,
Stockholm, Sweden
| | - K. Rubia
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry, Psychology and Neuroscience,
King's College, London, UK
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Carlisi CO, Chantiluke K, Norman L, Christakou A, Barrett N, Giampietro V, Brammer M, Simmons A, Rubia K. The effects of acute fluoxetine administration on temporal discounting in youth with ADHD. Psychol Med 2016; 46:1197-1209. [PMID: 26708124 DOI: 10.1017/s0033291715002731] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Serotonin is under-researched in attention deficit hyperactivity disorder (ADHD), despite accumulating evidence for its involvement in impulsiveness and the disorder. Serotonin further modulates temporal discounting (TD), which is typically abnormal in ADHD relative to healthy subjects, underpinned by reduced fronto-striato-limbic activation. This study tested whether a single acute dose of the selective serotonin reuptake inhibitor (SSRI) fluoxetine up-regulates and normalizes reduced fronto-striato-limbic neurofunctional activation in ADHD during TD. METHOD Twelve boys with ADHD were scanned twice in a placebo-controlled randomized design under either fluoxetine (between 8 and 15 mg, titrated to weight) or placebo while performing an individually adjusted functional magnetic resonance imaging TD task. Twenty healthy controls were scanned once. Brain activation was compared in patients under either drug condition and compared to controls to test for normalization effects. RESULTS Repeated-measures whole-brain analysis in patients revealed significant up-regulation with fluoxetine in a large cluster comprising right inferior frontal cortex, insula, premotor cortex and basal ganglia, which further correlated trend-wise with TD performance, which was impaired relative to controls under placebo, but normalized under fluoxetine. Fluoxetine further down-regulated default mode areas of posterior cingulate and precuneus. Comparisons between controls and patients under either drug condition revealed normalization with fluoxetine in right premotor-insular-parietal activation, which was reduced in patients under placebo. CONCLUSIONS The findings show that a serotonin agonist up-regulates activation in typical ADHD dysfunctional areas in right inferior frontal cortex, insula and striatum as well as down-regulating default mode network regions in the context of impulsivity and TD.
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Affiliation(s)
- C O Carlisi
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - K Chantiluke
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - L Norman
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - A Christakou
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - N Barrett
- South London and Maudsley NHS Trust,London,UK
| | - V Giampietro
- Department of Neuroimaging,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - M Brammer
- Department of Neuroimaging,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - A Simmons
- Department of Neuroimaging,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
| | - K Rubia
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience,King's College,London,UK
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Lim L, Chantiluke K, Cubillo AI, Smith AB, Simmons A, Mehta MA, Rubia K. Disorder-specific grey matter deficits in attention deficit hyperactivity disorder relative to autism spectrum disorder. Psychol Med 2015; 45:965-76. [PMID: 25229248 PMCID: PMC4413819 DOI: 10.1017/s0033291714001974] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 07/20/2014] [Accepted: 07/21/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are two common childhood disorders that exhibit genetic and behavioural overlap and have abnormalities in similar brain systems, in particular in frontal and cerebellar regions. This study compared the two neurodevelopmental disorders to investigate shared and disorder-specific structural brain abnormalities. METHOD Forty-four predominantly medication-naïve male adolescents with ADHD, 19 medication-naïve male adolescents with ASD and 33 age-matched healthy male controls were scanned using high-resolution T1-weighted volumetric imaging in a 3-T magnetic resonance imaging (MRI) scanner. Voxel-based morphometry (VBM) was used to test for group-level differences in structural grey matter (GM) and white matter (WM) volumes. RESULTS There was a significant group difference in the GM of the right posterior cerebellum and left middle/superior temporal gyrus (MTG/STG). Post-hoc analyses revealed that this was due to ADHD boys having a significantly smaller right posterior cerebellar GM volume compared to healthy controls and ASD boys, who did not differ from each other. ASD boys had a larger left MTG/STG GM volume relative to healthy controls and at a more lenient threshold relative to ADHD boys. CONCLUSIONS The study shows for the first time that the GM reduction in the cerebellum in ADHD is disorder specific relative to ASD whereas GM enlargement in the MTG/STG in ASD may be disorder specific relative to ADHD. This study is a first step towards elucidating disorder-specific structural biomarkers for these two related childhood disorders.
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Affiliation(s)
- L. Lim
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
- Department of Psychological Medicine,
Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
| | - K. Chantiluke
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. I. Cubillo
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. B. Smith
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. Simmons
- Department of Neuroimaging,
Institute of Psychiatry, King's College London,
UK
- NIHR Biomedical Research Centre at South London
and Maudsley NHS Foundation Trust (SLaM), London,
UK
| | - M. A. Mehta
- Department of Neuroimaging,
Institute of Psychiatry, King's College London,
UK
| | - K. Rubia
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
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Chantiluke K, Barrett N, Giampietro V, Brammer M, Simmons A, Rubia K. Disorder-dissociated effects of fluoxetine on brain function of working memory in attention deficit hyperactivity disorder and autism spectrum disorder. Psychol Med 2015; 45:1195-1205. [PMID: 25292351 DOI: 10.1017/s0033291714002232] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are often co-morbid and share performance and brain dysfunctions during working memory (WM). Serotonin agonists modulate WM and there is evidence of positive behavioural effects in both disorders. We therefore used functional magnetic resonance imaging (fMRI) to investigate shared and disorder-specific brain dysfunctions of WM in these disorders, and the effects of a single dose of the selective serotonin reuptake inhibitor (SSRI) fluoxetine. METHOD Age-matched boys with ADHD (n = 17), ASD (n = 17) and controls (n = 22) were compared using fMRI during an N-back WM task. Patients were scanned twice, under either an acute dose of fluoxetine or placebo in a double-blind, placebo-controlled randomized design. Repeated-measures analyses within patients assessed drug effects on performance and brain function. To test for normalization effects of brain dysfunctions, patients under each drug condition were compared to controls. RESULTS Under placebo, relative to controls, both ADHD and ASD boys shared underactivation in the right dorsolateral prefrontal cortex (DLPFC). Fluoxetine significantly normalized the DLPFC underactivation in ASD relative to controls whereas it increased posterior cingulate cortex (PCC) deactivation in ADHD relative to control boys. Within-patient analyses showed inverse effects of fluoxetine on PCC deactivation, which it enhanced in ADHD and decreased in ASD. CONCLUSIONS The findings show that fluoxetine modulates brain activation during WM in a disorder-specific manner by normalizing task-positive DLPFC dysfunction in ASD boys and enhancing task-negative default mode network (DMN) deactivation in ADHD.
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Affiliation(s)
- K Chantiluke
- Department of Child and Adolescent Psychiatry,Institute of Psychiatry, King's College London,UK
| | - N Barrett
- South London and Maudsley NHS Trust,London,UK
| | - V Giampietro
- Department of Neuroimaging,Institute of Psychiatry, King's College London,UK
| | - M Brammer
- Department of Neuroimaging,Institute of Psychiatry, King's College London,UK
| | - A Simmons
- Department of Neuroimaging,Institute of Psychiatry, King's College London,UK
| | - K Rubia
- Department of Child and Adolescent Psychiatry,Institute of Psychiatry, King's College London,UK
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Christakou A, Murphy CM, Chantiluke K, Cubillo AI, Smith AB, Giampietro V, Daly E, Ecker C, Robertson D, Murphy DG, Rubia K. Disorder-specific functional abnormalities during sustained attention in youth with Attention Deficit Hyperactivity Disorder (ADHD) and with autism. Mol Psychiatry 2013; 18:236-44. [PMID: 22290121 PMCID: PMC3554878 DOI: 10.1038/mp.2011.185] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are often comorbid and share behavioural-cognitive abnormalities in sustained attention. A key question is whether this shared cognitive phenotype is based on common or different underlying pathophysiologies. To elucidate this question, we compared 20 boys with ADHD to 20 age and IQ matched ASD and 20 healthy boys using functional magnetic resonance imaging (fMRI) during a parametrically modulated vigilance task with a progressively increasing load of sustained attention. ADHD and ASD boys had significantly reduced activation relative to controls in bilateral striato-thalamic regions, left dorsolateral prefrontal cortex (DLPFC) and superior parietal cortex. Both groups also displayed significantly increased precuneus activation relative to controls. Precuneus was negatively correlated with the DLPFC activation, and progressively more deactivated with increasing attention load in controls, but not patients, suggesting problems with deactivation of a task-related default mode network in both disorders. However, left DLPFC underactivation was significantly more pronounced in ADHD relative to ASD boys, which furthermore was associated with sustained performance measures that were only impaired in ADHD patients. ASD boys, on the other hand, had disorder-specific enhanced cerebellar activation relative to both ADHD and control boys, presumably reflecting compensation. The findings show that ADHD and ASD boys have both shared and disorder-specific abnormalities in brain function during sustained attention. Shared deficits were in fronto-striato-parietal activation and default mode suppression. Differences were a more severe DLPFC dysfunction in ADHD and a disorder-specific fronto-striato-cerebellar dysregulation in ASD.
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Affiliation(s)
- A Christakou
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Centre for Integrative Neuroscience and Neurodynamics and School of Psychology and Clinical Language Sciences, University of Reading, London, UK
| | - C M Murphy
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - K Chantiluke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A I Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - A B Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - V Giampietro
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - E Daly
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - C Ecker
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - D Robertson
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | | | - D G Murphy
- Department of Forensic and Developmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - K Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK,Department of Child Psychiatry/MRC Center for Social, Genetic and Developmental Psychiatry (SGDP), PO46, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK. E-mail:
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