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Title: Comparison of brain function and structure between paediatric OCD and ADHD patients
Author: Norman, Luke Joseph
ISNI:       0000 0004 7223 9184
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2017
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This thesis examined whether the neural underpinnings of common deficits in inhibitory control, sustained attention, and decision-making are the same or disorder-specific in ADHD and OCD. It contains a comparative multi-modal meta-analysis of voxel-based morphometry (VBM) studies of grey matter volume and functional magnetic resonance imaging (fMRI) studies of inhibitory control in ADHD and OCD and a fMRI study comparing adolescents with ADHD, adolescents with OCD and healthy control adolescents during (i) sustained attention (ii) temporal discounting and (iii) gambling. The meta-analysis showed disorder-specific functional and structural abnormalities in basal ganglia and insula, which were reduced in ADHD but increased in OCD relative to controls, and in frontal regions, where rostro-dorsal medial frontal regions were disorder-specifically decreased in structure and function in OCD, but where inferior lateral prefrontal regions were disorder-specifically underactive in ADHD. During sustained attention, patients showed disorder-specific abnormalities in task-relevant and default mode networks. ADHD patients showed disorder-specific lateral prefrontal while OCD patients showed disorder-specific medial frontal deficits. In the default mode network, patients with OCD showed disorder-specific abnormalities in ventromedial and patients with ADHD in rostromedial regions. During temporal discounting, both patient groups shared underactivation in fronto-striato-insular-cerebellar regions responsible for self-control and temporal foresight, suggesting that choice impulsivity is mediated by largely shared neural dysfunctions in both disorders. OCD patients showed disorder-exclusive dysfunction in orbitofrontal and rostrolateral prefrontal cortex. During a gambling task, patients with ADHD and OCD showed shared underactivation in the ventral striatum during advantageous choices, but OCD patients showed disorder-specific underactivation in ventromedial orbitofrontal cortex. Patient groups shared underactivation in medial prefrontal cortex to loss outcomes, and in putamen and precueus to wins, relative to controls. In conclusion, findings suggest partially shared but largely disorder-specific neural dysfunction during in ADHD and OCD.
Supervisor: Rubia, Katya ; Mataix-Cols, David Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available