Differential structure-function network coupling in the inattentive and combined types of attention deficit hyperactivity disorder.

Dongha Lee,Chongwon Pae,Elizabeth Quattrocki Knight,Hyunjoo Song,Sol Yoo,Hae-Jeong Park,Saebyul Lee,Alessandro Gozzi

doi:10.1371/journal.pone.0260295

Abstract

The heterogeneous presentation of inattentive and hyperactive-impulsive core symptoms in attention deficit hyperactivity disorder (ADHD) warrants further investigation into brain network connectivity as a basis for subtype divisions in this prevalent disorder. With diffusion and resting-state functional magnetic resonance imaging data from the Healthy Brain Network database, we analyzed both structural and functional network efficiency and structure-functional network (SC-FC) coupling at the default mode (DMN), executive control (ECN), and salience (SAN) intrinsic networks in 201 children diagnosed with the inattentive subtype (ADHD-I), the combined subtype (ADHD-C), and typically developing children (TDC) to characterize ADHD symptoms relative to TDC and to test differences between ADHD subtypes. Relative to TDC, children with ADHD had lower structural connectivity and network efficiency in the DMN, without significant group differences in functional networks. Children with ADHD-C had higher SC-FC coupling, a finding consistent with diminished cognitive flexibility, for all subnetworks compared to TDC. The ADHD-C group also demonstrated increased SC-FC coupling in the DMN compared to the ADHD-I group. The correlation between SC-FC coupling and hyperactivity scores was negative in the ADHD-I, but not in the ADHD-C group. The current study suggests that ADHD-C and ADHD-I may differ with respect to their underlying neuronal connectivity and that the added dimensionality of hyperactivity may not explain this distinction.

Highlights

Attention deficit hyperactivity disorder (ADHD) remains one of the most prevalent neurobehavioral disorders of childhood and adolescence, affecting social, emotional, and academic functioning
Two-sample ttests demonstrated significantly lower connectivity across a wide range of structural regions in contrast to the lack of functional connectivity differences in ADHD-I and ADHD-C subjects compared to typically developing children (TDC)
In the whole brain analysis, neither the functional efficiency nor the structurefunctional network (SC-FC) couplings significantly differed between children with ADHD and TDC

Summary

Introduction

Attention deficit hyperactivity disorder (ADHD) remains one of the most prevalent neurobehavioral disorders of childhood and adolescence, affecting social, emotional, and academic functioning. Work on intrinsic networks have singled out the subnetworks associated with the behavioral, cognitive, and emotional symptoms related to ADHD. Findings of reduced connectivity within the DMN [19], and diminished anti-correlations of the DMN with task specific networks both at rest [20,21,22] and during tasks in ADHD [23, 24] support this hypothesis, but many of the studies have not differentiated between subtype. We intended to build on previous network studies in ADHD by incorporating subtype analysis and focusing on three specific subnetworks (DMN, ECN, and SAN) involved in the core symptom domains of ADHD

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Discussion

Conclusion