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Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway


Attention-deficit hyperactivity disorder (ADHD) is typically characterized as a disorder of inattention and hyperactivity/impulsivity but there is increasing evidence of deficits in motivation. Using positron emission tomography (PET), we showed decreased function in the brain dopamine reward pathway in adults with ADHD, which, we hypothesized, could underlie the motivation deficits in this disorder. To evaluate this hypothesis, we performed secondary analyses to assess the correlation between the PET measures of dopamine D2/D3 receptor and dopamine transporter availability (obtained with [11C]raclopride and [11C]cocaine, respectively) in the dopamine reward pathway (midbrain and nucleus accumbens) and a surrogate measure of trait motivation (assessed using the Achievement scale on the Multidimensional Personality Questionnaire or MPQ) in 45 ADHD participants and 41 controls. The Achievement scale was lower in ADHD participants than in controls (11±5 vs 14±3, P<0.001) and was significantly correlated with D2/D3 receptors (accumbens: r=0.39, P<0.008; midbrain: r=0.41, P<0.005) and transporters (accumbens: r=0.35, P<0.02) in ADHD participants, but not in controls. ADHD participants also had lower values in the Constraint factor and higher values in the Negative Emotionality factor of the MPQ but did not differ in the Positive Emotionality factor—and none of these were correlated with the dopamine measures. In ADHD participants, scores in the Achievement scale were also negatively correlated with symptoms of inattention (CAARS A, E and SWAN I). These findings provide evidence that disruption of the dopamine reward pathway is associated with motivation deficits in ADHD adults, which may contribute to attention deficits and supports the use of therapeutic interventions to enhance motivation in ADHD.

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  1. National Institutes of Health Consensus Development Conference Statement: diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD). J Am Acad Child Adolesc Psychiatry 2000; 39: 182–193.

  2. Dopheide JA, Pliszka SR . Attention-deficit-hyperactivity disorder: an update. Pharmacotherapy 2009; 29: 656–679.

    Article  PubMed  Google Scholar 

  3. Haenlein M, Caul WF . Attention deficit disorder with hyperactivity: a specific hypothesis of reward dysfunction. J Am Acad Child Adolesc Psychiatry 1987; 26: 356–362.

    CAS  Article  PubMed  Google Scholar 

  4. Johansen EB, Killeen PR, Russell VA, Tripp G, Wickens JR, Tannock R et al. Origins of altered reinforcement effects in ADHD. Behav Brain Funct 2009; 5: 7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kollins SH, Lane SD, Shapiro SK . The experimental analysis of childhood psychopathology: a matching analysis of the behavior of children diagnosed with attention deficit hyperactivity disorder. Psychol Rec 1997; 47: 25–44.

    Article  Google Scholar 

  6. Sonuga-Barke EJ . The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics. Neurosci Biobehav Rev 2003; 27: 593–604.

    Article  PubMed  Google Scholar 

  7. Tripp G, Wickens JR . Research review: dopamine transfer deficit: a neurobiological theory of altered reinforcement mechanisms in ADHD. J Child Psychol Psychiatry 2008; 49: 691–704.

    Article  PubMed  Google Scholar 

  8. Wise RA . Brain reward circuitry: insights from unsensed incentives. Neuron 2002; 36: 229–240.

    CAS  Article  PubMed  Google Scholar 

  9. Sonuga-Barke EJ . Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry 2005; 57: 1231–1238.

    Article  PubMed  Google Scholar 

  10. Volkow ND, Wang GJ, Kollins SH, Wigal TL, Newcorn JH, Telang F et al. Evaluating dopamine reward pathway in ADHD: clinical implications. JAMA 2009; 302: 1084–1091.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  11. Volkow ND, Fowler JS, Wang GJ, Dewey SL, Schlyer D, MacGregor R et al. Reproducibility of repeated measures of carbon-11-raclopride binding in the human brain. J Nucl Med 1993; 34: 609–613.

    CAS  PubMed  Google Scholar 

  12. Fowler JS, Volkow ND, Wolf AP, Dewey SL, Schlyer DJ, Macgregor RR et al. Mapping cocaine binding sites in human and baboon brain in vivo. Synapse 1989; 4: 371–377.

    CAS  Article  PubMed  Google Scholar 

  13. Tellegen A, Waller NG . Exploring personality through test construction: development of the Multidimensional Personality Questionnaire. In: Boyle GJ, Matthews G, Saklofske DH (eds). Handbook of Personality Theory and Testing: Vol. II. Personality Measurement and Assessment. JAI Press: Greenwich, CT, 2008.

    Google Scholar 

  14. Guy W . Clinical Global Impression (CGI) scale. In: Rush AJ, First MB, Blacker D (eds). Handbook of Psychiatric Measures. American Psychiatric Publishing: Washington, DC, 2000.

    Google Scholar 

  15. Young DJ, Levy F, Martin NC, Hay DA . Attention deficit hyperactivity disorder: a Rasch analysis of the SWAN rating scale. Child Psychiatry Hum Dev 2009; 40: 543–549.

    Article  PubMed  Google Scholar 

  16. Conners CK . Rating scales in attention-deficit/hyperactivity disorder: use in assessment and treatment monitoring. J Clin Psychiatry 1998; 59 (Suppl 7): 24–30.

    PubMed  Google Scholar 

  17. Krueger RF, Caspi A, Moffitt TE, Silva PA, McGee R . Personality traits are differentially linked to mental disorders: a multitrait-multidiagnosis study of an adolescent birth cohort. J Abnorm Psychol 1996; 105: 299–312.

    CAS  Article  PubMed  Google Scholar 

  18. Arvey RD, Rotundo M, Johnson W, Zhang Z, McGue M . The determinant of leadership role occupancy: genetic and personality factors. Leadership Q 2006; 17: 1–20.

    Article  Google Scholar 

  19. Judge TA, Bono JE, Ilies R, Gerhardt MW . Personality and leadership: a qualitative and quantitative review. J Appl Psychol 2002; 87: 765–780.

    Article  PubMed  Google Scholar 

  20. Depue RA, Collins PF . Neurobiology of the structure of personality: dopamine, facilitation of incentive motivation, and extraversion. Behav Brain Sci 1999; 22: 491–517.

    CAS  Article  PubMed  Google Scholar 

  21. Logan J, Fowler JS, Volkow ND, Wolf AP, Dewey SL, Schlyer DJ et al. Graphical analysis of reversible radioligand binding from time–activity measurements applied to [N-11C-methyl]-(−)-cocaine PET studies in human subjects. J Cereb Blood Flow Metab 1990; 10: 740–747.

    CAS  Article  PubMed  Google Scholar 

  22. Wise RA, Rompre PP . Brain dopamine and reward. Ann Rev Psychol 1989; 40: 191–225.

    CAS  Article  Google Scholar 

  23. Barkley RA . Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. The Guilford Press: New York, NY, 1990.

    Google Scholar 

  24. Plichta MM, Vasic N, Wolf RC, Lesch KP, Brummer D, Jacob C et al. Neural hyporesponsiveness and hyperresponsiveness during immediate and delayed reward processing in adult attention-deficit/hyperactivity disorder. Biol Psychiatry 2009; 65: 7–14.

    Article  PubMed  Google Scholar 

  25. Barkley RA . Adolescents with attention-deficit/hyperactivity disorder: an overview of empirically based treatments. J Psychiatr Pract 2004; 10: 39–56.

    Article  PubMed  Google Scholar 

  26. Volkow ND, Wang GJ, Fowler JS, Telang F, Maynard L, Logan J et al. Evidence that methylphenidate enhances the saliency of a mathematical task by increasing dopamine in the human brain. Am J Psychiatry 2004; 161: 1173–1180.

    Article  PubMed  Google Scholar 

  27. Martel MM, Nigg JT . Child ADHD and personality/temperament traits of reactive and effortful control, resiliency, and emotionality. J Child Psychol Psychiatry 2006; 47: 1175–1183.

    Article  PubMed  Google Scholar 

  28. Nigg JT . Temperament and developmental psychopathology. J Child Psychol Psychiatry 2006; 47: 395–422.

    Article  PubMed  Google Scholar 

  29. De Quiros GB, Kinsbourne M . Adult ADHD. Analysis of self-ratings on a behavior questionnaire. Ann NY Acad Sci 2001; 931: 140–147.

    CAS  Article  PubMed  Google Scholar 

  30. Lampe K, Konrad K, Kroener S, Fast K, Kunert HJ, Herpertz SC . Neuropsychological and behavioural disinhibition in adult ADHD compared to borderline personality disorder. Psychol Med 2007; 37: 1717–1729.

    CAS  Article  PubMed  Google Scholar 

  31. Tomer R, Goldstein RZ, Wang GJ, Wong C, Volkow ND . Incentive motivation is associated with striatal dopamine asymmetry. Biol Psychol 2008; 77: 98–101.

    Article  PubMed  Google Scholar 

  32. Gjedde A, Wong DF, Rosa-Neto P, Cumming P . Mapping neuroreceptors at work: on the definition and interpretation of binding potentials after 20 years of progress. Int Rev Neurobiol 2005; 63: 1–20.

    CAS  Article  PubMed  Google Scholar 

  33. Volkow ND, Wang GJ, Newcorn J, Telang F, Solanto MV, Fowler JS et al. Depressed dopamine activity in caudate and preliminary evidence of limbic involvement in adults with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 2007; 64: 932–940.

    CAS  Article  PubMed  Google Scholar 

  34. Goldstein RZ, Alia-Klein N, Tomasi D, Zhang L, Cottone LA, Maloney T et al. Is decreased prefrontal cortical sensitivity to monetary reward associated with impaired motivation and self-control in cocaine addiction? Am J Psychiatry 2007; 164: 43–51.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Satoh T, Nakai S, Sato T, Kimura M . Correlated coding of motivation and outcome of decision by dopamine neurons. J Neurosci 2003; 23: 9913–9923.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

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This research was carried out at Brookhaven National Laboratory (BNL) and was supported in part by the Intramural Research Program of the National Institutes of Health (NIH), the National Institute of Mental Health (MH66961-02) and infrastructure support from the Department of Energy. We thank the following BNL employees: Donald Warner for PET operations; David Schlyer and Michael Schueller for cyclotron operations; Pauline Carter, Millard Jayne and Barbara Hubbard for nursing care; Payton King for plasma analysis and Lisa Muench, Youwen Xu and Colleen Shea for radiotracer preparation; Karen Appelskog for protocol coordination; to the following Duke employees: Joseph English and Allan Chrisman, for subject recruitment and evaluation; to the following NIH employee: Linda Thomas for editorial assistance. We also thank the individuals who volunteered for these studies.

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Correspondence to N D Volkow.

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Dr Newcorn reported being a recipient of research support from Eli Lilly and Ortho-McNeil Janssen, and serves as a consultant, advisor or both for Astra Zeneca, BioBehavioral Diagnostics, Eli Lilly, Novartis, Ortho-McNeil Janssen and Shire, and as a speaker for Ortho-McNeil Janssen. Dr Kollins reported receiving research support, consulting fees or both from Addrenex Pharmaceuticals, Otsuka Pharmaceuticals and Shire Pharmaceuticals. Dr Wigal reported receiving support from Eli Lilly, McNeil, Novartis and Shire. Dr Swanson reported receiving support from Alza, Richwood, Shire, Celgene, Novartis, Celltech, Gliatech, Cephalon, Watson, CIBA, Janssen and McNeil; has been on the advisory boards of Alza, Richwood, Shire, Celgene, Novartis, Celltech, UCB, Gliatech, Cephalon, McNeil and Eli Lilly; has been on the speaker's bureaus of Alza, Shire, Novartis, Cellthech, UCB, Cephalon, CIBA, Janssen and McNeil; and has consulted to Alza, Richwood, Shire, Clegene, Novarits, Celltech, UCB, Gliatech, Cephalon, Watson, CIBA, Jansen, McNeil and Eli Lilly. The other authors declare no conflict of interest.

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Volkow, N., Wang, GJ., Newcorn, J. et al. Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Mol Psychiatry 16, 1147–1154 (2011).

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  • attention
  • brain imaging
  • catecholamines
  • personality
  • psychiatric disorder
  • PET

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