Observation of Brain Functional Connectivity and Activation Characteristics in Children with Attention Deficit and Hyperactivity Disorder Based on Functional Near-Infrared Spectroscopy

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Objective To explore the characteristics of functional connectivity in the prefrontal cortex of children with attention deficit hyperactivity disorder (ADHD) at rest and the level of brain functional activation during the Go/No-go task using functional near and infrared spectroscopy (fNIRS). Methods Twenty-one children with ADHD who visited Kunming Children's Hospital from January 2022 to August 2023 were selected as the study subjects, namely the ADHD group. Meanwhile, 20 typically deve-loping children matched in age, intelligence quotient (IQ), and gender were selected as the typically developing group (TD group). The scores of the SNAP-Ⅳ Scale (Parent Version) were compared between the two groups, and fNIRS was used to collect 10-minute resting-state data of the prefrontal cortex of the children. Based on the concentrations of oxyhemoglobin (HbO2), deoxyhemoglobin (HbR) and total hemoglobin (HbT) collected, the functional connectivity strength at rest was calculated for both groups. Meanwhile, the Go/No-go task was selected to evaluate children's response inhibition function, and fNIRS was applied to detect the changes blood oxygen concentration levels in prefrontal cortex of the two groups of children during the Go/No-go task, and the brain functional activation levels of the two groups during the task were calculated. Results Compared with the TD group, the attention deficit score, hyperactivity-impulsivity score, and oppositional defiant score of the ADHD group were higher, and the differences were statistically significant (P<0.05). The fNIRS findings revealed that compared with the TD group, the functional connectivity strength among all channels and the resting-state brain functional connectivity strength of the left dorsolateral prefrontal cortex, right dorsola-teral prefrontal cortex, left medial prefrontal cortex, and right medial prefrontal cortex in the ADHD group were lower (P<0.05). By comparing the behavioral performance scores during the Go/No-go task, the ADHD group had lower accuracy in the No-go block compared with the TD group (P<0.05). There were no statistically significant differences in the accuracy rate and reaction time during the Go block and the reaction time of the No-go block between the two groups (P>0.05). During the Go/No-go task, compared with the TD group, the average HbO2 concentrations of the left dorsolateral prefrontal cortex, right dorsolateral prefrontal cortex, left medial prefrontal cortex, and right medial prefrontal cortex in the ADHD group were lower (P<0.05). The SNAP-Ⅳ Scale scores of the two groups were negatively correlated with the average HbO2 concentration of the prefrontal lobe in the Go/No-go task (P<0.05). Conclusion fNIRS can effectively detect the abnormal characteristics of the prefrontal cortex in children with ADHD at rest and during the task state. The main abnormalities appear in the left and right dorsolateral prefrontal cortices and the left and right medial prefrontal cortices. These findings provide imaging evidence for an in-depth understanding of the neuropathological mechanism of ADHD and are expected to provide new ideas and targets for the subsequent formulation of precise diagnosis and intervention strategies.

fNIRS may detect prefrontal connectivity and activation deficits in children with ADHD; leaves open its diagnostic or monitoring utility pending larger controlled studies.