Abnormal functional connectivity associated with emotional dysregulation in children with attention-deficit/hyperactivity disorder

Objective Emotional dysregulation(ED) is very common in children with Attention-Deficit/Hyperactivity Disorder (ADHD), ADHD children with ED experience more severe academic, social and quality-of-life dysfunction. Understanding of the neurobiological mechanisms and processes underpinning the ADHD with ED is sparse, this study aims to explore the distinct functional connectivity in specific group of ADHD children with ED by comparing with ADHD children without ED as well as typical development controls (TDCs). Method A total of 77 ADHD with ED, 53 ADHD without ED and 55 matched typical TDCs were recruited. All participants completed clinical assessments and underwent resting-state functional MRI. Seed-based analysis was used to define the dorsolateral prefrontal cortex (DLPFC) and the amygdala, and resting-state functional connectivity (RSFC) analysis was then performed using DPABI software. We employed one-way analysis of covariance (ANCOVA) and post-hoc tests to identify the main RSFC differences among these three groups. Pearson correlation was used to analyze the relationship between RSFC and ED scores in the ADHD with ED group. Results ADHD Children with ED exhibited increased RSFC between the DLPFC and the orbitofrontal middle gyrus (OFC)/precuneus, alongside decreased RSFC between the DLPFC and the triangular part of the inferior frontal gyrus (IFG), as well as between the amygdala and the left middle occipital gyrus/superior occipital gyrus/postcentral gyrus (GRF correction, voxel level p < 0.001, cluster level p < 0.05, two-tailed). Additionally, RSFC between the DLPFC and OFC was found to be negatively correlated with ED symptom severity in the ADHD with ED group (r = -0.32, p = 0.005), while no significant association was found between ED symptoms and amygdala-seeded RSFC in this group. Conclusion We demonstrated abnormal functional connectivity between the DLPFC and the OFC, and between the amygdala and the left middle occipital gyrus/superior occipital. These findings may provide theoretical support for early identification of ADHD children with ED and intervention targets for future neuromodulation.