Correlation between PERG contrast gain and BDI for the two study groups.

<p>The p-values are indicated per group, the line represents a linear regression, the gray area indicates ±SEM of the regression line.</p

Schematic diagram of the recording setup.

<p>Schematic diagram of the recording setup.</p

Comparison of contrast gain between patients and controls.

<p><b>Left</b>. PERG magnitude versus contrast for patient and controls. The antennas represent ± SEM. The dotted line connects the origin and the mean of the amplitudes at 80% stimulus contrast. <b>Right</b>. Group PERG-contrast gain, grand average. Normal controls (left) and patients with ADD (right) do not differ significantly. [Box-plot details on the right: the median is indicated by the thick horizontal lines, the notches represent a 95% confidence interval for the medians, the box covers the 25–75% percentile range, the “antennas” indicate the range, and outliers are indicated by circles.].</p

Neural response during anticipation of monetary loss is elevated in adult attention deficit hyperactivity disorder

<p><i>Objectives</i>: Risky behaviour seriously impacts the life of adult patients with attention deficit hyperactivity disorder (ADHD). Such behaviours have often been attributed to their exaggerated reward seeking, but dysfunctional anticipation of negative outcomes might also play a role. <i>Methods</i>: The present study compared adult patients with ADHD (<i>n</i> = 28) with matched healthy controls (<i>n</i> = 28) during anticipation of monetary losses versus gains while undergoing functional magnetic resonance imaging (fMRI) and skin conductance recording. <i>Results</i>: Skin conductance was higher during anticipation of losses compared to gains in both groups. Affective ratings of predictive cues did not differ between groups. ADHD patients showed increased activity in bilateral amygdalae, left anterior insula (region of interest analysis) and left temporal pole (whole brain analysis) compared to healthy controls during loss versus gain anticipation. In the ADHD group higher insula and temporal pole activations went along with more negative affective ratings. <i>Conclusions</i>: Neural correlates of loss anticipation are not blunted but rather increased in ADHD, possibly due to a life history of repeated failures and the respective environmental sanctions. Behavioural adaptations to such losses, however, might differentiate them from controls: future research should study whether negative affect might drive more risk seeking than risk avoidance.</p

Group comparison of mean neuronal noise.

<p>Boxplot showing the comparison of background noise in μV (y axis) between healthy control subjects (HC) and patients with ADHD; noise was averaged across all contrast levels per subject. Patients presented with a significant elevated background noise (p<0.005). Left: control group; right: patients with ADHD. Small disks or triangles, respectively, represent the individual data points. Boxplot details as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118271#pone.0118271.g001" target="_blank">Fig. 1</a>, the notches represent a 95% confidence interval for the medians.</p

Relationship of PERG background noise to stimulus contrast.

<p>Controls are displayed in blue, patients with ADHD in red. The thick, nearly horizontal lines represent a first-order model fit to the pertinent data points, the gray-shaded areas indicate its ±SEM interval. The distribution of the original data points can be gleaned from the box plots, where the median is indicated by short thick horizontal lines, the box covers the 25–75% percentile range, the whiskers indicate the range, outliers are indicated with dots. The background noise is markedly higher (138%) in patients with ADHD (red) compared to the controls (blue, p<0.005) and does not depend on stimulus contrast (lines are almost horizontal). This differs from the PERG stimulus response, which we added for comparison as dashed lines (data from [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118271#pone.0118271.ref026" target="_blank">26</a>]); the PERG response amplitude rises linearly with stimulus contrast.</p

Group comparison for psychometric characteristics and Correlation with noise.

<p>Group comparison for psychometric characteristics and Correlation with noise.</p

Correlation between background noise and DSM-IV inattentive symptoms, measured with the CAARS-S-L.

<p>Healthy controls are represented by blue disks, patients with ADHD by red triangles. Higher ADHD symptoms of inattention are associated with higher background noise (r = 0.44; p = 0.004). The correlation is represented by the line, while the gray-shaded area indicates its ±SEM interval.</p

Clarifying the Role of the Rostral dmPFC/dACC in Fear/Anxiety: Learning, Appraisal or Expression?

<div><p>Recent studies have begun to carve out a specific role for the rostral part of the dorsal medial prefrontal cortex (dmPFC) and adjacent dorsal anterior cingulate cortex (dACC) in fear/anxiety. Within a novel general framework of dorsal mPFC/ACC areas subserving the appraisal of threat and concomitant expression of fear responses and ventral mPFC/ACC areas subserving fear regulation, the rostral dmPFC/dACC has been proposed to specifically mediate the conscious, negative appraisal of threat situations including, as an extreme variant, catastrophizing. An alternative explanation that has not been conclusively ruled out yet is that the area is involved in fear learning. We tested two different fear expression paradigms in separate fMRI studies (study 1: instructed fear, study 2: testing of Pavlovian conditioned fear) with independent groups of healthy adult subjects. In both paradigms the absence of reinforcement precluded conditioning. We demonstrate significant BOLD activation of an identical rostral dmPFC/dACC area. In the Pavlovian paradigm (study 2), the area only activated robustly once prior conditioning had finished. Thus, our data argue against a role of the area in fear learning. We further replicate a repeated observation of a dissociation between peripheral-physiological fear responding and rostral dmPFC/dACC activation, strongly suggesting the area does not directly generate fear responses but rather contributes to appraisal processes. Although we succeeded in preventing extinction of conditioned responding in either paradigm, the data do not allow us to definitively exclude an involvement of the area in fear extinction learning. We discuss the broader implications of this finding for our understanding of mPFC/ACC function in fear and in negative emotion more generally.</p> </div

Additional file 1: of ESCAlate – Adaptive treatment approach for adolescents and adults with ADHD: study protocol for a randomized controlled trial

Spirit 2013 Checklists. (DOC 121 kb