Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review

Andrei A Puiu; Olga Wudarczyk; Katharina S Goerlich; Mikhail Votinov; Beate Herpertz-Dahlmann; Bruce Turetsky; Kerstin Konrad

doi:10.1016/j.neubiorev.2018.04.016

Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review

Neurosci Biobehav Rev. 2018 Jul:90:231-246. doi: 10.1016/j.neubiorev.2018.04.016. Epub 2018 Apr 22.

Authors

Andrei A Puiu¹, Olga Wudarczyk², Katharina S Goerlich³, Mikhail Votinov⁴, Beate Herpertz-Dahlmann⁵, Bruce Turetsky⁶, Kerstin Konrad⁷

Affiliations

¹ Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany. Electronic address: [email protected].
² Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany. Electronic address: [email protected].
³ Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany; Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: [email protected].
⁴ Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany; JARA-Institute Brain Structure-Function Relationship, Research Center Jülich and RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine 10, Research Center Jülich, Aachen, Germany. Electronic address: [email protected].
⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany. Electronic address: [email protected].
⁶ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: [email protected].
⁷ Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany. Electronic address: [email protected].

PMID: 29689282
DOI: 10.1016/j.neubiorev.2018.04.016

Abstract

Background: Although impulsive aggression (IA) and dysfunctional response inhibition (RI) are hallmarks of attention-deficit/hyperactivity disorder (ADHD) and disrupted behavioral disorders (DBDs), little is known about their shared and distinct deviant neural mechanisms.

Aims and methods: Here, we selectively reviewed s/fMRI ADHD and DBD studies to identify disorder-specific and shared IA and RI aberrant neural mechanisms.

Results: In ADHD, deviant prefrontal and cingulate functional activity was associated with increased IA. Structural alterations were most pronounced in the cingulate cortex. Subjects with DBDs showed marked cortico-subcortical dysfunctions. ADHD and DBDs share similar cortico-limbic structural and functional alterations. RI deficits in ADHD highlighted hypoactivity in the dorso/ventro-lateral PFC, insula, and striatum, while the paralimbic system was primarily dysfunctional in DBDs. Across disorders, extensively altered cortico-limbic dysfunctions underlie IA, while RI was mostly associated with aberrant prefrontal activity.

Conclusion: Control network deficits were evidenced across clinical phenotypes in IA and RI. Dysfunctions at any level within these cortico-subcortical projections lead to deficient cognitive-affective control by ascribing emotional salience to otherwise irrelevant stimuli. The clinical implications of these findings are discussed.

Keywords: ADHD; Cingulate cortex; Control; DBDs; Emotional salience; Impulsive aggression; Paralimbic system; Prefrontal cortex; Response inhibition; Top-Down; fMRI; sMRI.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Attention Deficit Disorder with Hyperactivity / physiopathology*
Behavior / physiology*
Brain / physiopathology
Brain Mapping
Emotions / physiology*
Humans
Obsessive-Compulsive Disorder / physiopathology*