Dynamic Functional Connectivity Reveals Abnormal Variability in the Amygdala Subregions of Children With Attention-Deficit/Hyperactivity Disorder

Functional and structural connectivity of the subregions of the amygdala in ADHD children with or without ODD

OBJECTIVES

The current study aimed to investigate the structural and functional connectivity of the subregions of the amygdala in children with Attention Deficit/Hyperactivity Disorder (ADHD) only or comorbid with Oppositional Defiant Disorder (ODD).

METHODS

A total of 354 children with ADHD-only, 161 children with ADHD and ODD (ADHD + ODD), and 100 healthy controls were enrolled. The Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function (BRIEF) were filled out by caregivers. Analysis of covariance (ANCOVA) was performed to test group-wise differences in these behavioral measures. A subsample comprising 209 participants underwent a resting-state functional MRI scan and a diffusion-weighted imaging (DWI) scan. Functional connectivity and structural connectivity were calculated using bilateral subregions of the Amygdala as seeds. Between-group voxel-wise comparisons were conducted.

RESULTS

The ADHD + ODD group had more anxious/depressed moods, more delinquent and aggressive behaviors, more emotional control problems, and more inhibition deficits than the ADHD-only group (all PBonferroni-corrected < 0.05). Compared with the control and ADHD + ODD groups, the ADHD-only group displayed increased FC strength between the amygdala subregions and the left caudate, left putamen, and frontal cortex. Regarding structural connectivity (SC), the ADHD-only group demonstrated higher streamline density in the left internal capsule, corpus callosum, and the right superior corona radiata. The altered SC was associated with emotional problems in children with ADHD, while the altered FC was associated with other ADHD-related clinical features.

CONCLUSIONS

Altered structural and functional connectivity of the subregions of the amygdala in children with ADHD compared with their healthy counterparts were respectively associated with ADHD-related behavioral and emotional problems.

CLINICAL TRIAL NUMBER

not applicable.

Emotion regulation strategy and its relationship with emotional dysregulation in children with attention-deficit/hyperactivity disorder: behavioral and brain findings

Important associations between emotional dysregulation (ED) and ADHD have been identified in adults, with a key manifestation of this being differential use of emotion regulation strategies: reduced use of cognitive reappraisal (CR), but elevated expressive suppression (ES). These associations have been observed at both behavioral and neuroimaging levels. The present study aims to explore the use of CR and ES in children with ADHD, and their relationship to ED. 148 children with ADHD and 265 healthy controls (age 9-16 years) were recruited and evaluated and correlated their ED, CR, and ES. Resting-state fMRI functional connectivity, with 6 amygdala subregions as regions-of-interest, were analyzed in a subsample to identify potential neural correlates. Children with ADHD showed significant higher ED, and lower use of both CR and ES. A significant negative correlation was found between CR and ED. Mediation analysis indicated that CR has an indirect influence on the relationship between ADHD diagnosis and ED. In the neuroimaging analyses, the functional connectivity between the right superficial amygdala and left middle occipital gyrus showed a significant group-by-ES interaction, highlighting potential neural correlates for elevated ED in children with ADHD. Children with ADHD expressed elevated levels of ED, and used less CR and ES compared to healthy controls. The lower use of ES may relate to abnormal amygdala connectivity in children with ADHD. This finding suggested that brain immaturity in children may preclude effective deployment of ES in emotion regulation processes.

Abnormal stability of dynamic functional architecture in drug-naïve children with attention-deficit/hyperactivity disorder

BACKGROUND AND AIMS

Attention-deficit/hyperactivity disorder (ADHD) is most commonly diagnosed neurodevelopmental disorder in childhood, characterized by developmentally inappropriate inattention and/or hyperactivity/impulsivity symptoms. Static and dynamic functional connectivity (FC) studies have revealed brain dysfunction in ADHD. However, few studies have estimated the stability of dynamic functional architecture of children with ADHD. The present study attempted to identify the functional stability (FS) abnormalities associated with ADHD in drug-naïve children.

MATERIALS AND METHODS

The resting-state fMRI of 42 children with ADHD and 30 healthy controls (HCs) were collected. Using the sliding window approach, FS of each voxel was obtained by measuring the concordance of dynamic FC over time. Further, the seed based dynamic FC (dFC) was conducted to explore the specific brain regions with dFC alteration related to these brain regions with altered FS. Then, the inter-group comparison and correlation analysis were performed.

RESULTS

We found that children with ADHD exhibited (1) decreased FS in the bilateral superior frontal gyrus (SFG) and increased FS in the right middle temporal gyrus (MTG), which both belong to the default mode network (DMN); (2) increased dFC between the bilateral SFG of DMN and the left insula of salience networks (SN) (GRF, voxel-wise p < 0.001, cluster-wise p < 0.05); (3) decreased dFC between the right MTG and the left cerebellum posterior lobe, and (3) worse performance in the Stroop test that significantly correlate with decreased FS in the bilateral SFG (p = 0.043, FDR corrected).

CONCLUSIONS

Our findings showed that the abnormal functional architecture involved the DMN (the bilateral SFG and right MTG) and SN (left insula) regions in children with ADHD. This preliminary study provides novel insight into the dynamic brain functional networks in ADHD.

Functional connectivity of cognition-related brain networks in adults with fetal alcohol syndrome

BACKGROUND

Fetal alcohol syndrome (FAS) can result in cognitive dysfunction. Cognitive functions affected are subserved by few functional brain networks. Functional connectivity (FC) in these networks can be assessed with resting-state functional MRI (rs-fMRI). Alterations of FC have been reported in children and adolescents prenatally exposed to alcohol. Previous reports varied substantially regarding the exact nature of findings. The purpose of this study was to assess FC of cognition-related networks in young adults with FAS.

METHODS

Cross-sectional rs-fMRI study in participants with FAS (n = 39, age: 20.9 ± 3.4 years) and healthy participants without prenatal alcohol exposure (n = 44, age: 22.2 ± 3.4 years). FC was calculated as correlation between cortical regions in ten cognition-related sub-networks. Subsequent modelling of overall FC was based on linear models comparing FC between FAS and controls. Results were subjected to a hierarchical statistical testing approach, first determining whether there is any alteration of FC in FAS in the full cognitive connectome, subsequently resolving these findings to the level of either FC within each network or between networks based on the Higher Criticism (HC) approach for detecting rare and weak effects in high-dimensional data. Finally, group differences in single connections were assessed using conventional multiple-comparison correction. In an additional exploratory analysis, dynamic FC states were assessed.

RESULTS

Comparing FAS participants with controls, we observed altered FC of cognition-related brain regions globally, within 7 out of 10 networks, and between networks employing the HC statistic. This was most obvious in attention-related network components. Findings also spanned across subcomponents of the fronto-parietal control and default mode networks. None of the single FC alterations within these networks yielded statistical significance in the conventional high-resolution analysis. The exploratory time-resolved FC analysis did not show significant group differences of dynamic FC states.

CONCLUSIONS

FC in cognition-related networks was altered in adults with FAS. Effects were widely distributed across networks, potentially reflecting the diversity of cognitive deficits in FAS. However, no altered single connections could be determined in the most detailed analysis level. Findings were pronounced in networks in line with attentional deficits previously reported.

Specific brain imaging alterations underlying autistic traits in children with attention-deficit/hyperactivity disorder

BACKGROUND

Autistic traits (ATs) are frequently reported in children with Attention-Deficit/Hyperactivity Disorder (ADHD). This study aimed to examine ATs in children with ADHD from both behavioral and neuroimaging perspectives.

METHODS

We used the Autism Spectrum Screening Questionnaire (ASSQ) to assess and define subjects with and without ATs. For behavioral analyses, 67 children with ADHD and ATs (ADHD + ATs), 105 children with ADHD but without ATs (ADHD - ATs), and 44 typically developing healthy controls without ATs (HC - ATs) were recruited. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data and analyzed the mean amplitude of low-frequency fluctuation (mALFF) values (an approach used to depict different spontaneous brain activities) in a sub-sample. The imaging features that were shared between ATs and ADHD symptoms or that were unique to one or the other set of symptoms were illustrated as a way to explore the "brain-behavior" relationship.

RESULTS

Compared to ADHD-ATs, the ADHD + ATs group showed more global impairment in all aspects of autistic symptoms and higher hyperactivity/impulsivity (HI). Partial-correlation analysis indicated that HI was significantly positively correlated with all aspects of ATs in ADHD. Imaging analyses indicated that mALFF values in the left middle occipital gyrus (MOG), left parietal lobe (PL)/precuneus, and left middle temporal gyrus (MTG) might be specifically related to ADHD, while those in the right MTG might be more closely associated with ATs. Furthermore, altered mALFF in the right PL/precuneus correlated with both ADHD and ATs, albeit in diverse directions.

CONCLUSIONS

The co-occurrence of ATs in children with ADHD manifested as different behavioral characteristics and specific brain functional alterations. Assessing ATs in children with ADHD could help us understand the heterogeneity of ADHD, further explore its pathogenesis, and promote clinical interventions.

Effect of Mahjong on children's intelligence quotient

This study investigated the effect of Mahjong, which is a table game played by three or four players and involves intellectual activity, on the intelligence quotient (IQ) of children. The participants were children between the age of 6 and 15 years, and their IQ was assessed immediately after enrolling in children's Mahjong classes and 1 year after the enrollment using the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). Twenty children were included in the analysis. Their mean age at the time of the initial evaluation was 9 years and 6 months. In addition, we conducted a 1-year post-examination. The change in the IQ of this group was compared to that of a historical control group with a similar age range and test–retest interval. The mean overall full-scale IQ of the 20 children during the initial and post-1-year examinations was 106.05 and 113.75, respectively, and showed a statistically significant increase (p < 0.01). Based on the subscale index, the verbal comprehension index (VCI) and processing speed index (PSI) scores both showed a statistically significant increase from 100.6 to 106.75 and from 108.05 to 119.05 (p < 0.01), respectively. The PSI of the children included in the analysis showed a statistically significant increase compared to the historical control group. This study suggests that children who participate in Mahjong classes during their childhood have increased PSI scores of WISC-IV.