Cognitive deficit in adults with ADHD lies in the cognitive state disorder rather than the working memory deficit: A functional near-infrared spectroscopy study

This study tested whether cognitive deficit in patients with adult attention deficit hyperactivity disorder (ADHD) is a working memory deficit or cognitive state disorder during the N-back task. Twenty-two adults with ADHD and twenty-four healthy controls participated in the N-back task. The functional near-infrared spectroscopy (fNIRS) was combined with three perspectives from behavioral and spatial and temporal activation characteristics of blood oxygen levels in the prefrontal cortex to examine the psychological and neuroprocessing characteristics of adult ADHD. Data were acquired using a block design during an N-back task with three memory loads. Visual stimuli were presented on a computer monitor. Behaviorally, response time and accuracy showed no significant differences between the two groups. Spatially, in the left orbitofrontal area and the left frontopolar area (Channels 4 and 11), adult ADHD had significantly higher activation levels of oxyHb in the 2-back task and lower activation levels of deoxyHb in the 3-back task than healthy controls (corrected p < 0.05). Therefore, Channel 4 in the 2-back condition and Channel 11 in the 3-back condition were used as the regions of interest (ROI). Temporally, adults with ADHD peaked earlier in the ROIs than healthy controls. Furthermore, working memory deficit was not found directly from the behavioral performance in adult ADHD. However, adult ADHD can be affected by memory load, task duration, and novelty stimulus. Our findings suggest that patients with adult ADHD have cognitive state disorder instead of working memory deficit.