Effects of substance misuse on reward-processing in patients with attention-deficit/hyperactivity disorder
Paraskevopoulou, Maria; van Rooij, Daan; Batalla, Albert; Chauvin, Roselyne; Luijten, Maartje; Schene, Aart H.; Buitelaar, Jan K.; Schellekens, Arnt F.A.
(2021) Neuropsychopharmacology, volume 46, issue 3, pp. 622 - 631
(Article)
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use Disorder (SUD) often co-occur and are associated with treatment resistance. Both disorders are characterized by similar reward-processing deficits with decreased striatal responses to reward anticipation, though literature is inconsistent. It is unclear whether substance misuse exaggerates reward-processing deficits observed in ADHD. The aim of
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this study was to examine substance misuse effects on reward-processing in ADHD. Functional MRI data in a Monetary Incentive Delay (MID) task from a multi-site study were compared across ADHD groups with and without substance misuse (ADHD + SM and ADHD-only, respectively) and healthy controls (n = 40/group, 74 males and 46 females, aged 13.7–25.9 years). Substance misuse was defined as misuse of alcohol, nicotine, or drugs. Groups were matched with presence/absence of parental SUD to avoid interference with SUD trait effects. Compared to ADHD-only and controls, ADHD + SM showed hyperactivation in putamen during reward anticipation. Compared to controls, the ADHD groups showed hypoactivation in motor/sensory cortices and hyperactivation in frontal pole and OFC during reward outcome. ADHD + SM also showed hyperactivation in frontal pole during neutral outcome. Moreover, ADHD + SM patients showed higher callous-unemotional (CU) traits that were positively correlated with putamen responses to reward anticipation. Our results show distinct condition-independent neural activation profile for ADHD + SM compared to ADHD-only and controls. Effects of comorbid substance misuse and variability of its prevalence across ADHD studies might have contributed to inconsistencies in ADHD literature. Contrasted with findings for reward-processing in SUD literature, results potentially suggest distinct underlying mechanisms for SUD subgroups with different characteristics, like antisocial/psychopathic traits.
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Keywords: Pharmacology, Psychiatry and Mental health
ISSN: 0893-133X
Publisher: Springer Nature
Note: Funding Information: This work was supported by VENI Grant 916.15.101 (to AFAS) from the Netherlands Organisation for Scientific Research (NWO) and grants from Radboud University Nijmegen Medical Center. The NeuroIMAGE project was supported by NIH Grant R01MH62873 (to Stephen V. Faraone), NWO Large Investment Grant 1750102007010 and ZonMw Grant 60-60600-97-193 (to JKB), grants from Radboud University Nijmegen Medical Center, University Medical Center Groningen and Accare, and VU University Amsterdam and an unrestricted grant from Shire Pharmaceuticals (to Stephen V. Faraone). The work is further supported by the Horizon2020 programme of the European Union (grant number 667302 for the Comorbid Conditions of Attention-deficit/ Hyperactivity Disorder (CoCA) consortium). JKB has been a consultant to/member of advisory board of and/or speaker for Janssen Cilag BV, Eli Lilly, Roche, Medice, Takeda/Shire, Novartis and Servier. He is not an employee or a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents, and royalties. The other authors declare no biomedical financial interests or potential conflicts of interest. Publisher Copyright: © 2020, The Author(s), under exclusive licence to American College of Neuropsychopharmacology.
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