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. 2012 Nov;51(11):1197-1207.e4.
doi: 10.1016/j.jaac.2012.08.013. Epub 2012 Sep 30.

Atypical pulvinar-cortical pathways during sustained attention performance in children with attention-deficit/hyperactivity disorder

Xiaobo Li  1 , Ariane Sroubek, Mary S Kelly, Iris Lesser, Elyse Sussman, Yong He, Craig Branch, John J Foxe
Affiliations

Atypical pulvinar-cortical pathways during sustained attention performance in children with attention-deficit/hyperactivity disorder

Xiaobo Li et al. J Am Acad Child Adolesc Psychiatry. 2012 Nov.

Abstract

Objective: The neurobiological basis of inattentiveness, a core feature of attention-deficit/hyperactivity disorder (ADHD), is not yet well understood. Structural abnormalities in thalamus, especially the pulvinar nuclei, have recently been reported in ADHD. Pulvinar nuclei maintain reciprocal connections with cortical/subcortical areas, and play a central coordinating role during visual attention processing. The objective of this study was to test the hypothesis that children and young adolescents with ADHD would show atypical pulvinar-cortical functional pathways during sustained attention performance, and that these functional abnormalities would be associated with the inattentive symptoms of the disorder.

Method: Visual attention task-based functional magnetic resonance imaging (fMRI) data from 22 children and young adolescents with ADHD and 22 demographically matched, normal control subjects were analyzed. Cortical activation maps and temporal correlations of activity patterns between pulvinar nuclei and the remainder of brain were constructed for each participant. Correlations between activation magnitude of pulvinar and diagnostic measures were calculated in subjects with ADHD.

Results: Compared to controls, subjects with ADHD showed significantly reduced pulvinar activations bilaterally, significantly decreased functional connectivity between bilateral pulvinar and right prefrontal regions, and significantly increased connectivity between the right pulvinar and bilateral occipital regions. In addition, the activation magnitude in the left pulvinar was negatively correlated with the DSM-IV inattentive index in ADHD group.

Conclusions: Allied with previous evidence of structural abnormalities in pulvinar, the current data suggest that inappropriate development of pulvinar may lead to disrupted functional circuits for visual attention processing, and that these disruptions contribute significantly to the pathophysiological mechanisms of the inattentiveness symptoms in ADHD.

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Figures

FIGURE 1
FIGURE 1
Block design structure and the sequence of one task block of the visual attention task. Note: O = 8 seconds’ initial fixation period; R = 30 seconds’ rest block; s = seconds; T = 30 seconds task block.
FIGURE 2
FIGURE 2
Within-group averages and between-group differences of whole brain functional activations. Note: Images A and B show the group averages of the task-responsive brain activations in controls and patients, respectively; C shows the locations of the bilateral pulvinar seed regions; D and E showed the between-group differences of the task-negative and task-positive brain activations, respectively. ADHD = attention-deficit/hyperactivity disorder; L = left hemisphere; NC = normal controls; R = right hemisphere.
FIGURE 3
FIGURE 3
Images A–D show the within-group averages and between-group differences of functional connectivity between the left pulvinar nuclei and the remainder of whole brain, whereas images E–J show those of the right pulvinar nuclei and the reminder of the whole brain in controls and patients. Note: ADHD = Attention-Deficit/Hyperactivity Disorder; L = Left hemisphere; NC = Controls; R = Right hemisphere.
FIGURE 4
FIGURE 4
Significant negative correlation between left pulvinar activation and inattentive index in the patient group.
See this image and copyright information in PMC

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