Sex Differences in the Functional Neuroanatomy of Working Memory in Adults With ADHD
Publication: American Journal of Psychiatry
Abstract
Objective
Although attention deficit hyperactivity disorder (ADHD) in adults is associated with significant morbidity and dysfunction and afflicts both sexes, relatively few imaging studies have examined female subjects and none have had sufficient power to adequately examine sex differences. The authors examined sex differences in the neural functioning of adults with ADHD during performance of a verbal working memory task.
Method
The participants were 44 adults with ADHD matched on age, sex, and estimated IQ to 49 comparison subjects. Accuracy and reaction time on an N-back task were measured to assess working memory. The blood-oxygen-level-dependent functional MRI response was used as a measure of neural activity.
Results
A group-by-sex analysis of variance showed no between-group differences in either reaction time or percent correct for the working memory task. For both sexes combined, the adults with ADHD showed less activity than comparison subjects in prefrontal regions. However, sex-by-group analyses revealed an interaction, such that male ADHD subjects showed significantly less activity in right frontal, temporal, and subcortical regions and left occipital and cerebellar regions relative to male comparison subjects, whereas female ADHD subjects showed no differences from female comparison subjects. Exploratory correlation analyses revealed negative associations between working-memory-related activation and number of hyperactive symptoms for men and number of inattentive symptoms for women.
Conclusions
Male but not female adults with ADHD showed significantly altered patterns of neural activity during a verbal working memory task. Men and women showed different associations between neural activity and ADHD symptoms.
Formats available
You can view the full content in the following formats:
Information & Authors
Information
Published In
History
Received: 18 February 2009
Accepted: 20 July 2009
Published online: 1 January 2010
Published in print: January 2010
Authors
Competing Interests
In the past 12 months, Dr. Valera has received travel support and/or honoraria from divisions of Ortho-McNeil-Janssen Pharmaceuticals, honoraria from Massachusetts General Hospital, Reed Exhibitions, and Boston University, research support from NIH, and reimbursements from Veritas Institute; in the past, she has received travel support from Eli Lilly and Shire, honoraria from Shire, Remedica Medical Education and Publishing, Massachusetts General Hospital, Reed Exhibitions, Boston University, and Partners Healthcare, and research support from NIH. Dr. Biederman is currently receiving research support from Alza, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, McNeil, Merck, Organon, Otsuka, Shire, NIMH, and the National Institute of Child Health and Human Development; in 2009 he received speaking fees from the Fundación Ramón Areces, Medice Pharmaceuticals, and the Spanish Child Psychiatry Association; in previous years he received research support, consultation fees, or speaking fees from Abbott, AstraZeneca, Celltech, Cephalon, Eli Lilly, Esai, Forest, Glaxo, Gliatech, Janssen, McNeil, NARSAD, the National Institute on Drug Abuse, New River, Novartis, Noven, Neurosearch, Pfizer, Pharmacia, the Prechter Foundation, Shire, the Stanley Foundation, UCB Pharma, and Wyeth. In the past year, Dr. Faraone has received consulting fees and been on advisory boards for Eli Lilly and Shire and has received research support from Eli Lilly, NIH, Pfizer, and Shire; in previous years, he received consulting fees, was on advisory boards, or was a speaker for Eli Lilly, Janssen, McNeil, Novartis, Pfizer, and Shire and received research support from Eli Lilly, NIH, Pfizer, and Shire. The other authors report no financial relationships with commercial interests.
Funding Information
Supported in part by National Research Service award F32 MH-065040 from NIMH (Dr. Valera); by Clinical Research Training Program Fellowship in Biological and Social Psychiatry MH-16259 from NIMH (Dr. Valera); by NIMH grants MH-57934 (Dr. Faraone), MH-62152 (Dr. Seidman), MH-071535 (Dr. Valera), and MH-084041 (Dr. Makris); by National Center for Research Resources grant P41 RR-14075; by ARRA-NIH-NCCAM grant 1PO1 AT-002048-06 from the National Center for Complementary and Alternative Medicine (Dr. Makris); by a Livingston Fellowship through Harvard Medical School (Dr. Valera); by the National Alliance for Research on Schizophrenia and Depression (Dr. Biederman); by research grants from Janssen and McNeil (Dr. Biederman); by the Research Council for Pediatric Psychopharmacology at the Massachusetts General Hospital; and by the Mental Illness and Neuroscience Discovery (MIND) Institute, March of Dimes Foundation and the Commonwealth Research Center, Massachusetts Department of Mental Health (Dr. Seidman). These funders had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of the manuscript.
Metrics & Citations
Metrics
Citations
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
View Options
Get Access
Login options
Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.
Personal login Institutional Login Open Athens loginNot a subscriber?
PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).