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Meta-Analysis
. 2020 Apr;50(6):894-919.
doi: 10.1017/S0033291720000574. Epub 2020 Mar 27.

Comparative meta-analyses of brain structural and functional abnormalities during cognitive control in attention-deficit/hyperactivity disorder and autism spectrum disorder

Steve Lukito  1 , Luke Norman  1   2   3 , Christina Carlisi  1   4 , Joaquim Radua  5   6   7 , Heledd Hart  1 , Emily Simonoff  1 , Katya Rubia  1
Affiliations
Meta-Analysis

Comparative meta-analyses of brain structural and functional abnormalities during cognitive control in attention-deficit/hyperactivity disorder and autism spectrum disorder

Steve Lukito et al. Psychol Med. 2020 Apr.

Abstract

Background: People with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have abnormalities in frontal, temporal, parietal and striato-thalamic networks. It is unclear to what extent these abnormalities are distinctive or shared. This comparative meta-analysis aimed to identify the most consistent disorder-differentiating and shared structural and functional abnormalities.

Methods: Systematic literature search was conducted for whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies of cognitive control comparing people with ASD or ADHD with typically developing controls. Regional gray matter volume (GMV) and fMRI abnormalities during cognitive control were compared in the overall sample and in age-, sex- and IQ-matched subgroups with seed-based d mapping meta-analytic methods.

Results: Eighty-six independent VBM (1533 ADHD and 1295 controls; 1445 ASD and 1477 controls) and 60 fMRI datasets (1001 ADHD and 1004 controls; 335 ASD and 353 controls) were identified. The VBM meta-analyses revealed ADHD-differentiating decreased ventromedial orbitofrontal (z = 2.22, p < 0.0001) but ASD-differentiating increased bilateral temporal and right dorsolateral prefrontal GMV (zs ⩾ 1.64, ps ⩽ 0.002). The fMRI meta-analyses of cognitive control revealed ASD-differentiating medial prefrontal underactivation but overactivation in bilateral ventrolateral prefrontal cortices and precuneus (zs ⩾ 1.04, ps ⩽ 0.003). During motor response inhibition specifically, ADHD relative to ASD showed right inferior fronto-striatal underactivation (zs ⩾ 1.14, ps ⩽ 0.003) but shared right anterior insula underactivation.

Conclusions: People with ADHD and ASD have mostly distinct structural abnormalities, with enlarged fronto-temporal GMV in ASD and reduced orbitofrontal GMV in ADHD; and mostly distinct functional abnormalities, which were more pronounced in ASD.

Keywords: Attention-deficit/hyperactivity disorder; autism spectrum disorder; cognitive control; fMRI; meta-analysis; voxel-based morphometry.

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Conflict of interest statement

Conflicts of interest: KR has received grants from Lilly and Shire pharmaceuticals and speaker’s bureau from Shire, Lilly and Medice. Other authors report no biomedical financial interests or potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Brain abnormalities in the ADHD and ASD groups. Abnormalities in the (A) gray matter volume and brain activations during (B) cognitive control and (C) motor response inhibition. Rows (i) and (ii) show abnormalities in ADHD and ASD relative to typically developing (TD) controls. Abnormalities in ADHD versus ASD, each relative to TD controls are shown in (iii) overall samples and (iv) age-, sex-, and IQ-matched subgroups. In the overall sample, shared reduced rACC/mPFC GMV (MNI coordinates: 0,46,12; 119 voxels), and subthreshold overactivation in ADHD and underactivation in ASD in dmPFC (MNI coordinates: -2, 34, 36; 82 voxels) were observed but did not survive sensitivity analysis. A statistical threshold of p < .005 with a cluster extent of 20 voxels were used in all analyses.
Fig. 2
Fig. 2
Summary of consistent disorder-differentiating and shared brain abnormalities in ADHD and ASD. Findings of (A) gray matter volume abnormalities and brain activation abnormalities during (B) cognitive control and (C) motor response inhibition. A statistical threshold of p < .005 with a cluster extent of 20 voxels were used in all analyses.
See this image and copyright information in PMC

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