Brain activation gradients in ventrolateral prefrontal cortex related to persistence of ADHD in adolescent boys.

OBJECTIVE To explore the possible role that functional abnormalities of the prefrontal cortex and basal ganglia play in the persistence of attention-deficit/hyperactivity disorder (ADHD) in adolescents aged 15 to 19 years. METHOD Ten male adolescents who were diagnosed with ADHD during childhood were grouped into those who continued to meet full diagnostic criteria for DSM-IV ADHD (persisters; n = 5) and those in whom symptoms had remitted sufficiently to warrant a diagnosis of ADHD in partial remission (remitters; n = 5). Persisters, remitters, and five carefully matched controls with no history of ADHD were scanned using functional magnetic resonance imaging while performing a go/no-go task. RESULTS Parallel linear trends were found in performance on the go/no-go task and activation of ventrolateral prefrontal cortex, such that persisters made the most commission errors (33%) and showed the greatest activation, remitters made fewer commission errors (24%) and had lower activity, and activation was lowest in controls who made the fewest errors (13%). CONCLUSIONS These preliminary results suggest that developmental changes in ADHD symptomatology are associated with functional changes in ventrolateral prefrontal cortex activity.