What question did this study set out to answer?

This research aims to evaluate neurovascular coupling and glymphatic system functions in children with ADHD and their relationship with executive function.

May 31, 2026BMC Psychiatry1 citationsOpen Access

The cerebral neurovascular coupling and glymphatic circulation dysfunction in children with attention deficit/hyperactivity disorder

RHRui HuHubei University of Medicine FTFan TanHubei University of Medicine CDCaohui DuanChinese PLA General Hospital

Key Points

This research aims to evaluate neurovascular coupling and glymphatic system functions in children with ADHD and their relationship with executive function.
Sixty-six children diagnosed with ADHD and forty-one healthy controls were enrolled.
MRI assessed differences in neurovascular coupling and ALPS between ADHD and control groups.
Logistic regression analysis and partial correlation were used to explore associations among clinical data and diagnostic performance.
ADHD participants showed significantly reduced neurovascular coupling across 19 brain regions compared to controls.
Partial correlations revealed associations between neurovascular coupling values, ALPS index, executive function, and sleep duration.
A combined model demonstrated good diagnostic efficacy with AUC of 0.863, sensitivity of 0.864, and specificity of 0.683.

Abstract

Abstract Background Based on the executive dysfunction hypothesis, the deficiency of executive function is the basis of the core symptoms of attention deficit/hyperactivity disorder (ADHD). This study aims to apply MRI to evaluate changes in neurovascular coupling (NVC) and glymphatic system functions in patients with ADHD and to explore the relationship between these changes and executive function, in order to reveal the potential neural mechanisms underlying ADHD symptomatology. Methods This study enrolled sixty-six individuals diagnosed with ADHD and forty-one healthy control participants (HC). We compared the differences in NVC and the index along the perivascular space (ALPS) between the two groups. Partial correlation analysis was employed to examine the associations among clinical data, executive function, the ALPS index, and NVC alterations in ADHD patients. Furthermore, a combined diagnostic model was developed using NVC, the ALPS index, and sleep duration, and its diagnostic performance was assessed through logistic regression analysis. The robustness of the joint diagnostic model was subsequently evaluated using a five-fold cross-validation approach. Results In comparison to the HC group, patients with ADHD exhibited a significant reduction in NVC and alterations in the ALPS. Specifically, the ADHD group demonstrated decreased NVC across 19 brain regions, encompassing 8 regions within the frontal lobe, 5 within the parietal lobe, 4 within the occipital lobe, and 2 within the temporal lobe. Partial correlation analysis revealed an association between NVC values and the ALPS index, executive function, and sleep duration. Furthermore, receiver operating characteristic (ROC) analysis demonstrated good diagnostic efficacy of the combined model, validated through five-fold cross-validation, yielding an area under the curve (AUC) of 0.863, 95% CI: (0.790, 0.926), with a sensitivity of 0.864 and a specificity of 0.683. Conclusion Children with ADHD exhibit impairments in the NVC and the glymphatic system function, with NVC dysfunction linked to glymphatic impairment and executive function deficits. This study offers novel insights into ADHD-related brain dysfunction through the perspectives of NVC and the glymphatic system. Clinical trial number Not applicable.

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