Key result
Children with combined type ADHD had significantly higher structure-function network coupling in the default mode network compared to those with inattentive type ADHD (0.37 vs 0.27, p=0.0237).
Why the study?
The heterogeneous presentation of inattentive and hyperactive-impulsive core symptoms in ADHD warrants further investigation into brain network connectivity as a basis for subtype divisions.
Cross-Sectional (n=201)
Yes
Absolute Event Rate: 0.37% vs 0.27%
p-value: p=0.0237
ADHD combined and inattentive subtypes exhibit distinct underlying neuronal connectivity, particularly in structure-function coupling within the default mode network.
DMN coupling differences by ADHD subtype should not yet change practice; hypothesis-generating for connectivity biomarkers in longitudinal studies.
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.
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Lee et al. (2021) conducted a cross-sectional in Attention deficit hyperactivity disorder (ADHD) (n=201). ADHD-Combined subtype (ADHD-C) vs. ADHD-Inattentive subtype (ADHD-I) and Typically Developing Children (TDC) was evaluated on Structure-function (SC-FC) coupling in the default mode network (p=0.0237). Children with combined type ADHD had significantly higher structure-function network coupling in the default mode network compared to those with inattentive type ADHD (0.37 vs 0.27, p=0.0237).
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