Mind wandering perspective on attention-deficit/hyperactivity disorder

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder associated with a range of mental health, neurocognitive and functional problems. Although the diagnosis is based on descriptions of behaviour, individuals with ADHD characteristically describe excessive spontaneous mind wandering (MW). MW in individuals with ADHD reflects constant mental activity which lacks topic stability and content consistency. Based on this review of the neural correlates of ADHD and MW, we outline a new perspective on ADHD: the MW hypothesis. We propose that altered deactivation of the default mode network, and dysfunctional interaction with the executive control network, leads to excessive and spontaneous MW, which underpins symptoms and impairments of ADHD. We highlight that processes linked to the normal neural regulation of MW (context regulation, sensory decoupling, salience thresholds) are deficient in ADHD. MW-related measures could serve as markers of the disease process, as MW can be experimentally manipulated, as well as measured using rating scales, and experience sampling during both cognitive tasks and daily life. MW may therefore be a potential endophenotype.

Mind‐wandering in children with and without ADHD

“…First, on a conceptual level, the question has been raised as to what extent MW is theoretically different from inattentive symptoms. It has been proposed that MW might be a direct consequence of neurobiology (i.e., deficient DMN deactivation and executive control network), which in turn leads to inattentive symptoms and behaviours (Bozhilova et al , ). However, it is not yet established whether MW mediates the effects of brain function on inattention.…”

“…An experimental design including ADHD medication could bring more insights into the causal relations between brain function, MW and ADHD symptoms. Another important study, although not so easily implemented, would be to experimentally induce MW and observe the effect on inattention and hyperactivity/impulsivity (Bozhilova et al , ).…”

“…On a conceptual and empirical level, MW is related to constructs such as inattention, daydreaming, and self‐absorption (Soffer‐Dudek, ). Taking these findings together, a recently proposed model suggests that altered activation of the DMN in ADHD might lead to excessive MW that in turn may lead to the inattentive symptoms of ADHD (Bozhilova, Michelini, Kuntsi, & Asherson, ).…”

Commentary: “Transcranial stimulation of the frontal lobes increases propensity of mind-wandering without changing meta-awareness”

“…Given that activity in the dorsolateral prefrontal cortex (DLPFC) has been linked to the onset and maintenance of MW episodes (Christoff et al, 2009;Smallwood et al, 2011;Mittner et al, 2014Mittner et al, , 2016, non-invasive brain stimulation over that structure seems to be a suitable technique to interfere with MW. This approach can provide a causal link between DLPFC activity and MW, which in turn has the potential for developing new interventions to influence attentional lapses in health and disease (Berman et al, 2010;He et al, 2011;Bozhilova et al, 2018).…”

Working memory training restores aberrant brain activity in adult attention‐deficit hyperactivity disorder

“…Overall, aberrant activity in the so‐called task‐positive brain networks appears to be a robust neural marker in ADHD, despite the lack of group differences in task performance (e.g., Massat et al, 2012; Valera et al, 2005). ADHD has also often been associated with DMN activity (see Brown et al, 2012 for a study with the n‐back task, and Sonuga‐Barke & Castellanos, 2007, and Bozhilova, Michelini, Kuntsi, & Asherson, 2018 for general reviews). So far, brain imaging research of ADHD has largely focused on studies in children and adolescents, while the adult research remains underexploited (Cortese et al, 2012).…”