An fMRI examination of the role of the Locus Coeruleus in state regulation in ADHD

Drescher, LH, Hall, JM, Eayrs, JO ORCID: 0000-0001-8598-6064, Krebs, RM ORCID: 0000-0002-0676-7611, Boehler, N and Wiersema, JR ORCID: 0000-0001-5875-2051 An fMRI examination of the role of the Locus Coeruleus in state regulation in ADHD. Imaging Neuroscience. ISSN 2837-6056 (Accepted)

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Abstract

The state regulation deficit account of ADHD posits that symptoms and performance deficits associated with ADHD are context-dependent and explained by a deficit in arousal regulation. Research into this topic has often used event rate manipulations to induce different arousal states, and has demonstrated deficits at both overstimulating and understimulating event rate levels. Although existing research has provided strong support for the state regulation deficit account, little is known about the neurobiological substrate of state regulation deficits. An important candidate brain network is the Locus Coeruleus-noradrenergic (LC-NE) system, which has been hypothesized by several researchers to play a key role in state regulation deficits in ADHD. In the current study, we examined, for the first time, the role of the LC in state regulation deficits in ADHD using high-resolution fMRI scans. We presented a target detection task at three event rate levels (fast, moderate, slow) to adults with (n = 27) and without ADHD (n = 28), with 20-s resting intervals at the start and the middle of each event rate condition. No group difference was found for performance, whereas results indicated significantly higher self-reports of state regulation deficits in daily life in the ADHD group. Anatomically guided region-of-interest analyses based on a high-resolution turbo-spin-echo anatomical scan of the pons region indicated an overall lower LC activity during resting intervals in the ADHD group, irrespective of event rate. Event-related LC activity was not impacted by Event Rate or by Group. Our results therefore support the notion of a general “underarousal” in ADHD, but do not confirm a relationship between LC activity and behavior, raising doubts on a direct implication of the LC-NE system in state regulation deficits in ADHD.

Item Type:	Article
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Psychology (from Sep 2019)
Publisher:	The MIT Press
Date of acceptance:	16 March 2026
Date of first compliant Open Access:	26 March 2026
Date Deposited:	26 Mar 2026 15:34
Last Modified:	26 Mar 2026 15:34
DOI or ID number:	10.1162/IMAG.a.1200
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28301

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