Intrinsic Brain Abnormalities in Attention Deficit Hyperactivity Disorder: A Resting-State Functional MR Imaging Study

Fei Li

Ning He

Yuanyuan Li

Lizhou Chen

Published Online:Apr 14 2014https://doi.org/10.1148/radiol.14131622

Abstract

We found that children and adolescents with attention deficit hyperactivity disorder (ADHD) have altered regional brain function and aberrant functional connectivity in large-scale networks that were associated with executive dysfunction, suggesting that the characteristics of the brain’s resting-state functional architecture are relevant to understanding relationships between neural substrate and executive function in ADHD.

Purpose

To explore alterations of regional and network-level neural function using resting-state functional magnetic resonance (MR) imaging in children and adolescents with attention deficit hyperactivity disorder (ADHD) and to assess the association between these alterations of intrinsic neural activity and executive dysfunction in ADHD.

Materials and Methods

This prospective study was approved by the local ethical committee, and written informed consent was obtained from guardians of all participants. Thirty-three boys with ADHD who were not receiving medication and who were without comorbidity (aged 6–16 years) and 32 healthy control subjects (aged 8–16 years) underwent imaging by using resting-state functional MR imaging. Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) were calculated to examine regional neural function and functional integration, respectively, and were compared between patients and control subjects by using the voxel-based two-sample t test, while Pearson correlation analyses were performed to identify neural correlates of executive function measured with the Wisconsin Card Sorting Test and the Stroop Color-Word Test.

Results

Relative to healthy control subjects, patients with ADHD showed impaired executive function (P < .05), along with the following: lower ALFF in the left orbitofrontal cortex (P = .004) and the left ventral superior frontal gyrus (P = .003); higher ALFF in the left globus pallidus (P = .004), the right globus pallidus (P = .002), and the right dorsal superior frontal gyrus (P = .025); lower long-range FC in the frontoparietal and frontocerebellar networks; and higher FC in the frontostriatal circuit that correlated across subjects with ADHD with the degree of executive dysfunction (P < .05).

Conclusion

These findings of focal spontaneous hyper- and hypofunction, together with altered brain connectivity in the large-scale resting-state networks, which correlates with executive dysfunction, point to a connectivity-based pathophysiologic process in ADHD.

Online supplemental material is available for this article.

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Article History

Received July 11, 2013; revision requested September 26; final revision received January 8, 2014; accepted February 3; final version accepted February 18.
Published online: Apr 14 2014
Published in print: Aug 2014

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Supplemental Material
Funding/Support
Supported by the National Natural Science Foundation (grants 81030027, 81227002, 30970903, and 81220108013), National Key Technologies R&D Program (Program No. 2012BAI01B03), and Program for Changjiang Scholars and Innovative Research Team in University of China. Q.G. supported by a CMB Distinguished Professorship Award (Award No. F510000/G16916411) administered by the Institute of International Education, USA.

Abbreviations
Abbreviations:
ADHD
attention deficit hyperactivity disorder
ALFF
amplitude low-frequency fluctuation
BA
Brodmann area
FC
functional connectivity
WCST
Wisconsin Card Sorting Test

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Abbreviations:
ADHD	attention deficit hyperactivity disorder
ALFF	amplitude low-frequency fluctuation
BA	Brodmann area
FC	functional connectivity
WCST	Wisconsin Card Sorting Test