Orbitofrontal signaling of future reward is associated with hyperactivity in attention-deficit/hyperactivity disorder

Jana Tegelbeckers, Martin Kanowski, Kerstin Krauel, John Dylan Haynes, Carolin Breitling, Hans Henning Flechtner, Thorsten Kahnt*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Alterations in motivated behavior are a hallmark of attention-deficit/hyperactivity disorder (ADHD), one of the most common psychiatric disorders in children and adolescents. The orbitofrontal cortex (OFC) plays a key role in controlling goal-directed behavior, but the link between OFC dysfunction and behavioral deficits in ADHD, particularly in adolescence, remains poorly understood. Here we used advanced high-resolution functional magnetic resonance imaging(fMRI) of the human OFC in adolescents with ADHD and typically developing (TD) controls (N = 39, age 12–16, all male except for one female per group) to study reward-related OFC responses and how they relate to behavioral dysfunction in ADHD. During fMRI data acquisition, participants performed a simple decision-making task, allowing us to image expectation-related responses to small and large monetary outcomes. Across all participants, we observed significant signal increases to large versus small expected rewards in the OFC. These responses were significantly enhanced in ADHD relative to TD participants. Moreover, stronger reward-related activity was correlated with individual differences in hyperactive/impulsive symptoms in the ADHD group, whereas high cognitive ability was associated with normalized OFC responses. These results provide evidence for the importance of OFC dysfunctions in the neuropathology of ADHD, highlighting the role of OFC-dependent goal-directed control mechanisms in this disorder.

Original languageEnglish (US)
Pages (from-to)6779-6786
Number of pages8
JournalJournal of Neuroscience
Issue number30
StatePublished - Jul 25 2018


  • ADHD
  • Goal-directed behavior
  • Motivation
  • Orbitofrontal cortex
  • Reward
  • fMRI

ASJC Scopus subject areas

  • Neuroscience(all)

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