Brain-behavior patterns define a dimensional biotype in medication-naïve adults with attention-deficit hyperactivity disorder
Journal
Psychological Medicine
Journal Volume
48
Journal Issue
14
Date Issued
2018-10-01
Author(s)
HSIANG-YUAN LIN
Cocchi, Luca
Zalesky, Andrew
Lv, Jinglei
Perry, Alistair
Kundu, Prantik
Breakspear, Michael
Abstract
© Copyright Cambridge University Press 2018. Background Childhood-onset attention-deficit hyperactivity disorder (ADHD) in adults is clinically heterogeneous and commonly presents with different patterns of cognitive deficits. It is unclear if this clinical heterogeneity expresses a dimensional or categorical difference in ADHD.Methods We first studied differences in functional connectivity in multi-echo resting-state functional magnetic resonance imaging (rs-fMRI) acquired from 80 medication-naïve adults with ADHD and 123 matched healthy controls. We then used canonical correlation analysis (CCA) to identify latent relationships between symptoms and patterns of altered functional connectivity (dimensional biotype) in patients. Clustering methods were implemented to test if the individual associations between resting-state brain connectivity and symptoms reflected a non-overlapping categorical biotype.Results Adults with ADHD showed stronger functional connectivity compared to healthy controls, predominantly between the default-mode, cingulo-opercular and subcortical networks. CCA identified a single mode of brain-symptom co-variation, corresponding to an ADHD dimensional biotype. This dimensional biotype is characterized by a unique combination of altered connectivity correlating with symptoms of hyperactivity-impulsivity, inattention, and intelligence. Clustering analyses did not support the existence of distinct categorical biotypes of adult ADHD.Conclusions Overall, our data advance a novel finding that the reduced functional segregation between default-mode and cognitive control networks supports a clinically important dimensional biotype of childhood-onset adult ADHD. Despite the heterogeneity of its presentation, our work suggests that childhood-onset adult ADHD is a single disorder characterized by dimensional brain-symptom mediators.
Subjects
Adult attention-deficit hyperactivity disorder | biotype | canonical correlation | dimensions | functional connectivity | multi-echo fMRI
Adult attention-deficit hyperactivity disorder; biotype; canonical correlation; dimensions; functional connectivity; multi-echo fMRI
SDGs
Other Subjects
adolescent; adult; attention deficit disorder; brain; classification; connectome; diagnostic imaging; female; human; male; nerve cell network; nuclear magnetic resonance imaging; onset age; pathophysiology; procedures; young adult; Adolescent; Adult; Age of Onset; Attention Deficit Disorder with Hyperactivity; Brain; Connectome; Female; Humans; Magnetic Resonance Imaging; Male; Nerve Net; Young Adult
Type
journal article