Dysfunctional Modulation of Default Mode Network Activity in
Attention-Deficit/Hyperactivity Disorder
Baris Metin, Ruth M. Krebs, Jan R. Wiersema,
Tom Verguts, and Roos Gasthuys
Ghent University
Jacob J. van der Meere
University of Groningen
Eric Achten and Herbert Roeyers
Ghent University
Edmund Sonuga-Barke
Ghent University and University of Southampton
The state regulation deficit model posits that individuals with attention-deficit/hyperactivity disorder
(ADHD) have difficulty applying mental effort effectively under suboptimal conditions such as very fast
and very slow event rates (ERs). ADHD is also associated with diminished suppression of default mode
network (DMN) activity and related performance deficits on tasks requiring effortful engagement. The
current study builds on these 2 literatures to test the hypothesis that failure to modulate DMN activity in
ADHD might be especially pronounced at ER extremes. Nineteen adults with ADHD and 20 individuals
without any neuropsychiatric condition successfully completed a simple target detection task under 3 ER
conditions (2-, 4-, and 8-s interstimulus intervals) inside the scanner. Task-related DMN deactivations
were compared between 2 groups. There was a differential effect of ER on DMN activity for individuals
with ADHD compared to controls. Individuals with ADHD displayed excessive DMN activity at the fast
and slow, but not at the moderate ER. The results indicate that DMN attenuation in ADHD is disrupted
in suboptimal energetic states where additional effort is required to optimize task engagement. DMN
dysregulation may be an important element of the neurobiological underpinnings of state regulation
deficits in ADHD.
Keywords: ADHD, default mode network, event rate, fMRI, state regulation deficit
Supplemental materials: http://dx.doi.org/10.1037/abn0000013.supp
Efficient performance depends on the ability to maintain an
optimal energetic state despite changing environmental demands
(Sanders, 1983). The performance of individuals with attention-
deficit/hyperactivity disorder (ADHD) is hyper-sensitive to exper-
imentally induced changes in certain aspects of the task context
(see Sonuga-Barke, Wiersema, van der Meere, & Roeyers, 2010
for a review). For instance, task performance in ADHD is dis-
rupted at extreme event rates (ERs). A meta-analysis of ER effects
on Go/No-Go tasks demonstrated that individuals with ADHD
make more impulsive errors under fast ER conditions and respond
slower under slow ER conditions (Metin, Roeyers, Wiersema, van
der Meere, & Sonuga-Barke, 2012). The state regulation deficit
(SRD) model applies the framework of Sanders (Sanders, 1983) to
explain these effects in terms of deficient management of energetic
resources to maintain optimal task engagement under nonoptimal
conditions (Sergeant, 2005). It has been hypothesized that individ-
uals with ADHD have a problem in applying the required effort to
actively modulate extreme ER-related changes in activation states
This article was published Online First October 13, 2014.
Baris Metin, Department of Experimental-Clinical and Health Psychology,
Ghent University; Ruth M. Krebs, Department of Experimental Psychology,
Ghent University; Jan R. Wiersema, Department of Experimental-Clinical and
Health Psychology, Ghent University; Tom Verguts, Department of Experimental
Psychology, Ghent University; Roos Gasthuys, Department of Experimental-
Clinical and Health Psychology, Ghent University; Jacob J. van der Meere,
Department of Clinical and Developmental Neuropsychology, University of Gro-
ningen; Eric Achten, Department of Radiology, Ghent University; Herbert Roey-
ers, Department of Experimental-Clinical and Health Psychology, Ghent Univer-
sity; Edmund Sonuga-Barke, Developmental Brain-Behaviour Unit, School of
Psychology, University of Southampton and Department of Experimental-Clinical
and Health Psychology, Ghent University.
Baris Metin is now in the Department of Psychology, Uskudar University.
The study presented in this article was conducted at Ghent University,
Faculties of Psychology and Medicine. Herbert Roeyers received research
support from Shire. Edmund Sonuga-Barke declares the following com-
peting interests during the last 3 years—fees for speaking, consultancy,
research funding and conference support from Shire; speaker fees from
Janssen Cilag, Medice & Obtech, book royalties from Oxford University
Press and Jessica Kingsley; conference support from Shire. All other
authors report no biomedical financial interests or potential conflicts of
interest during the last 3 years. This study was supported by the Fund for
Scientific Research-Flanders (grant number G.0310.09N).
Correspondence concerning this article should be addressed to Baris Metin,
Uskudar University, Department of Psychology, Altunizade Mh., Haluk
Turksoy Sk. 14, 34662, Uskudar, I
˙
stanbul, Turkey. E-mail: drbarismetin@
gmail.com
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Journal of Abnormal Psychology © 2014 American Psychological Association
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