Abstract

Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, with a shift of symptoms including less hyperactivity/impulsivity and more co-morbidity of affective disorders in ADHDadult. Many studies have questioned the stability in diagnosing of ADHD from childhood to adulthood, and the shared and distinct aberrant functional connectivities (FCs) between ADHDchild and ADHDadult remain unidentified. We aim to explore shared and distinct FC patterns in ADHDchild and ADHDadult, and further investigated the cross-cohort predictability using the identified FCs. After investigating the ADHD-discriminative FCs from healthy controls (HCs) in both child (34 ADHDchild, 28 HCs) and adult (112 ADHDadult,77 HCs) cohorts, we identified both shared and distinct aberrant FC patterns between cohorts and their association with clinical symptoms. Moreover, the cross-cohort predictability using the identified FCs were tested. The ADHD-HC classification accuracies were 84.4% and 81.0% for children and male adults, respectively. The ADHD-discriminative FCs shared in children and adults lie in the intra-network within default mode network (DMN) and the inter-network between DMN and ventral attention network, positively correlated with total scores of ADHD symptoms. Particularly, inter-network FC between somatomotor network and dorsal attention network was uniquely impaired in ADHDchild, positively correlated with hyperactivity index; whereas the aberrant inter-network FC between DMN and limbic network exhibited more adult-specific ADHD dysfunction. And their cross-cohort predictions were 70.4% and 75.6% between each other. This work provided imaging evidence for symptomatic changes and pathophysiological continuity in ADHD from childhood to adulthood, suggesting that FCs may serve as potential biomarkers for ADHD diagnosis.

Highlights

  • Attention-deficit/hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders, is characterized by symptoms of age-inappropriate inattention, hyperactivity, and impulsivity

  • A new feature selection method based on relative importance and ensemble learning (FS_RIEL) we proposed was used to identify both shared and age-specific functional connectivities (FCs) patterns impaired in ADHD in this study

  • Besides the appreciable classification accuracy achieved (ADHDchild: 84.4%, ADHDadult 81.0%, and >70% for cross-cohort prediction), results further indicated that there are shared ADHD-discriminative FCs between children and adults, which lie in the intra-network within default mode network (DMN) and the internetwork between DMN and ventral attention network (vATN), and is positively correlated with total ADHD symptoms score

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Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders, is characterized by symptoms of age-inappropriate inattention, hyperactivity, and impulsivity. Relative to healthy controls (HCs), ADHD patients were significantly impaired in psychosocial, educational, and neuropsychological affects ~5% of children and adolescents,two-thirds of children with ADHD continue to have persistent, impairing symptoms in adulthood[2]. Extant imaging studies have reported brain structural and functional differences between patients with ADHD and HCs, both in childhood and adulthood. Many functional magnetic resonance imaging (fMRI) findings heavily support that ADHD involves a distributed pattern of brain alterations[3,4]. Functional abnormalities in fronto-cortical and fronto-subcortical networks are core deficits in both children and adults with ADHD5.

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