Emotional-motivational deficits in attention-deficit/hyperactivity disorder
Final Report Abstract
ADHD etiology is explained by the presence of different endophenotypes linked to genetics and brain mechanisms and underlying clinical subgroups. Emotional–motivational deficits as endophenotype are considered as very relevant. With our preliminary work on ADHD we could verify the existence of this endophenotype in ADHD. We could already publish our results in high-standard journals and are still in progress to publish our data. In our previous work on ADHD, we investigated several hundreds of participants (children and adults with and without ADHD). We used state of the art biopsychological methods and variables to probe these processes; specifically we measured the acoustic startle response, heart rate and electrodermal responses. We were able to reveal and replicate that in ADHD adults the combined and hyperactive-impulsive subtypes but not the inattentive subtype are marked by a reduced responsiveness towards emotional stimuli. We found hypoarousal towards emotional stimuli in ADHD children and demonstrated that methylphenidate normalized this hypoarousal. In addition, we found that methylphenidate normalized emotional-motivational dysfunctions. We could also detect gene influences on emotionalmotivational reactivity with respect to biopsychological and rating data. We could show that aversiveness in ADHD patients increased with an increase in delay (delay aversion). We found that ADHD patients are marked by deficits in early but not late attentional processes and investigated influences of incentives and genotypes on these dysfunctions. Studies revealed that motivational factors seem to ameliorate cognitive dysfunctions. We established a virtual classroom requiring children to make a cognitive task and could indicate more dysfunctions in ADHD children. These were again ameliorated by methylphenidate. Finally, we found a link of ADHD subgroups with psychopathy, anxiety and alexithymia. Additionally, we collected normative data for IAPS pictures and gathered important knowledge on emotional-motivational processes in healthy people. Accordingly, our results could show the relevance of the emotional-motivational endophenotype in ADHD. With the new proposal we want to finish this work and to complement knowledge on the whole endophenotype pathway from genetic and environmental factors over brain abnormalities to the endophenotype underlying clinical subgroups. This will be done with fMRI studies with ADHD patients and controls investigating emotion processing and regulation. In addition, we intend to investigate influences of the emotional-motivational endophenotype on cognitive endophenotypes using again the virtual classroom. Here, we also want to investigate the underlying mechanism of the expected positive impact of motivation on cognitive performance and suggest that motivation increases hypoarousal in ADHD patients. These paradigms are already established with pilot studies. Therefore, studies could start immediately.
Publications
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(2008) Psychopathic traits in adult ADHD patients. Personality and Individual Differences. 45: 468 –472
Eisenbarth H, Alpers G, Conzelmann A, Weyers P, Pauli P
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(2009) Abnormal affective responsiveness in Attention-Defict/Hyperactivity Disorder: Subtype differences. Biological Psychiatry, 65: 578-585
Conzelmann A, Mucha RF, Jacob CP, Weyers P, Romanos J, Gerdes ABM, Baehne CG, Boreatti-Hümmer A, Heine M, Alpers GW, Warnke A, Fallgatter AJ, Lesch KP, Pauli P
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(2009) Delay aversion in ADHD assessed with a startle conditioning paradigm. ADHD Attention Deficit and Hyperactivity Disorders 1: 113
Conzelmann A, Woidich E, Mucha RF, Jacob C, Weyers P, Pauli P
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(2009) Tph2 gene variants modulate response control processes in adult ADHD patients and healthy individuals. Molecular Psychiatry 14: 1032-1039
Baehne CG, Ehlis AC, Plichta MM, Conzelmann A, Pauli P, Jacob C, Gutknecht L, Lesch KP, Fallgatter AJ
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(2010) Affect-modulated startle reflex and dopamine D4 receptor gene variation. Psychophysiology 47: 25-33
Pauli P, Conzelmann A, Mucha RF, Weyers P, Baehne CG, Fallgatter AJ, Jacob CP, Lesch KP
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(2010) Brain activations to emotional pictures are differentially associated with valence and arousal. Frontiers in Human Neuroscience 4: 175
Gerdes ABM, Wieser MJ, Mühlberger A, Weyers P, Alpers G W, Plichta MM, Breuer F, Pauli, P
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(2010) Early Attentional Deficits in an Attention-to-Prepulse-Paradigm in ADHD patients. Journal of Abnormal Psychology 119: 594-603
Conzelmann A, Pauli P, Mucha RF, Jacob, CP, Gerdes ABM, Romanos J, Baehne CG, Heine M, Boreatti-Hümmer A, Alpers GW, Fallgatter AJ, Warnke A, Lesch KP, Weyers P
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(2011) Methylphenidate normalizes emotional processing in adult patients with attention deficit hyperactivity disorder: Preliminary findings. Brain Research 1381: 159-166
Conzelmann A, Woidich E, Mucha RF, Weyers P, Jacob CP, Pauli P
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(2013) A polymorphism in the gene of the endocannabinoid degrading enzyme FAAH (FAAH C385A) is associated with emotional-motivational reactivity. Psychopharmacology 224: 573-9
Conzelmann A, Reif A, Jacob C, Weyers P, Lesch KP, Lutz B, Pauli P
