Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review

Andrei A Puiu*, Olga Wudarczyk, Katharina S Goerlich, Mikhail Votinov, Beate Herpertz-Dahlmann, Bruce Turetsky, Kerstin Konrad

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


BACKGROUND: Although impulsive aggression (IA) and dysfunctional response inhibition (RI) are hallmarks of attention-deficit/hyperactivity disorder (ADHD) and disrupted behavioral disorders (DBDs), little is known about their shared and distinct deviant neural mechanisms.

AIMS AND METHODS: Here, we selectively reviewed s/fMRI ADHD and DBD studies to identify disorder-specific and shared IA and RI aberrant neural mechanisms.

RESULTS: In ADHD, deviant prefrontal and cingulate functional activity was associated with increased IA. Structural alterations were most pronounced in the cingulate cortex. Subjects with DBDs showed marked cortico-subcortical dysfunctions. ADHD and DBDs share similar cortico-limbic structural and functional alterations. RI deficits in ADHD highlighted hypoactivity in the dorso/ventro-lateral PFC, insula, and striatum, while the paralimbic system was primarily dysfunctional in DBDs. Across disorders, extensively altered cortico-limbic dysfunctions underlie IA, while RI was mostly associated with aberrant prefrontal activity.

CONCLUSION: Control network deficits were evidenced across clinical phenotypes in IA and RI. Dysfunctions at any level within these cortico-subcortical projections lead to deficient cognitive-affective control by ascribing emotional salience to otherwise irrelevant stimuli. The clinical implications of these findings are discussed.

Original languageEnglish
Pages (from-to)231-246
Number of pages16
JournalNeuroscience and Biobehavioral Reviews
Publication statusPublished - Jul 2018
Externally publishedYes


  • Attention Deficit Disorder with Hyperactivity/physiopathology
  • Behavior/physiology
  • Brain/physiopathology
  • Brain Mapping
  • Emotions/physiology
  • Humans
  • Obsessive-Compulsive Disorder/physiopathology

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