Disorder-Specific Dysfunction in Right Inferior Prefrontal Cortex During Two Inhibition Tasks in Boys with Attention-Deficit Hyperactivity Disorder Compared to Boys with Obsessive-Compulsive Disorder

Background: Inhibitory dysfunction is a key behavioral and cognitive phenotype of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Both disorders show neuropsychological deficits and fronto-striatal dysfunction during tasks of motor response inhibition and cognitive flexibility. This study investigates differences and commonalities in functional neural networks mediating inhibitory control between adolescents with ADHD and those with OCD to identify disorder-specific neurofunctional markers that distinguish these two inhibitory disorders. Methods: Event-related fMRI was used to compare brain activation between 20 healthy boys, IS (Stop task) or 12 boys (Switch task) with ADHD, and 10 boys with OCD during a tracking Stop task that measures inhibition and stopping failure and during a visual-spatial switching task measuring cognitive flexibility. Results: Both patient groups shared brain dysfunction compared to healthy controls in right orbitofrontal (successful inhibition) and left dorsolateral prefrontal cortices (failed inhibition). Right inferior prefrontal dysfunction, however, was disorder-specific to ADHD during both tasks. Left inferior prefrontal dysfunction during the Switch task was significant in children with ADHD relative to controls, but only reached a trend in patients with OCD. Patients with ADHD furthermore showed disorder-specific dysfunction in left basal ganglia and cingulate gyrus during the Switch task. Conclusions: Patients with ADHD compared to those with OCD have both common and distinct dysfunctions during inhibitory control. The most consistently reported functional abnormality in children with ADHD in right inferior prefrontal cortex during inhibitory control appears to be disorder-specific when compared to patients with OCD and may be a specific neurofunctional biomarker of ADHD. Hum Brain Mapp 31:287-299, 2010. (C) 2009 Wiley-Liss, Inc.