Understanding the neural processes tied to the adult outcome of childhood attention deficit hyperactivity disorder (ADHD) could guide novel interventions to improve its clinical course. It has been argued that normalization of prefrontal cortical activity drives remission from ADHD, while anomalies in subcortical processes are “fixed,” present even in remission. Using multimodal neuroimaging of inhibitory processes, the authors tested these hypotheses in adults followed since childhood, contrasting remitted against persistent ADHD.

Adult participants (persistent ADHD, N=35; remit-ted ADHD, N=47; never affected, N=99) were scanned with functional MRI (fMRI) (N=85), magnetoencephalography (N=33), or both (N=63) during a response inhibition task.

In fMRI analyses, during inhibition, right caudate anomalies reflected a childhood ADHD history and were present even among those who remitted. By contrast, differences related to adult outcome emerged in cortical (right inferior frontal and inferior parietal/precuneus) and cerebellar regions. The persistent ADHD group showed under-activation, whereas the remitted ADHD group did not differ significantly from the never-affected group. Magnetoencephalography showed that the association between adult symptom severity and prefrontal neuronal activity was confined to the time window covering the act of inhibition (300 ms–350 ms). Group differences in cerebellar and parietal neuronal activity occurred during the time window of performance monitoring processes (500 ms–600 ms).

By combining fMRI and magnetoencephalography, the location and time window of neuronal activity that underpins the adult outcome of ADHD was pinpointed. Thus, the cortico-cerebellar processes tied to the clinical course of ADHD are separated from the subcortical processes that are not.

了解与儿童注意缺陷多动障碍（ADHD）的成人结局相关的神经过程，可以指导新颖的干预措施以改善其临床过程。有人认为前额叶皮层活动的正常化会促使多动症的缓解，而皮层下突的异常是“固定的”，甚至在缓解中也存在。使用抑制过程的多模态神经影像学，作者在儿童期开始的成年人中检验了这些假说，将其与持续性多动症进行了对比。

使用功能性MRI（fMRI）（N = 85），脑磁图（N = 33）或同时使用这两种方法对成年参与者（持续性ADHD，N = 35;缓解性ADHD，N = 47;从未受影响，N = 99）进行扫描N = 63）。

在功能磁共振成像分析中，在抑制过程中，右尾状畸形反映了儿童多动症的病史，甚至在那些缓解者中也存在。相比之下，与成人结局相关的差异出现在皮质（右下额叶和顶下壁/前神经下突）和小脑区域。持续性ADHD组显示出激活不足，而缓解的ADHD组与从未受影响的组没有显着差异。脑磁图显示，成人症状严重程度与额叶前额神经元活动之间的关联仅限于涵盖抑制行为的时间窗（300 ms–350 ms）。小脑和顶叶神经元活动的组差异发生在性能监测过程的时间窗口内（500毫秒至600毫秒）。

通过结合功能磁共振成像和脑磁图，可以确定支持多动症成人预后的神经元活动的位置和时间窗。因此，与ADHD的临床过程相关的皮质-小脑过程与没有的皮质下过程是分开的。