The clinical, neuropsychological, and brain functional characteristics of the ADHD restrictive inattentive presentation

Frontiers in Psychiatry

Psychiatry

Peng Wang¹  Lu Liu²  Qing-Jiu Cao²  Li Sun²  Yu-Feng Wang²  Li Yang²  Juan Liu³  Xiao-Lan Cao³  Zhao-Min Wu³  Bin-Rang Yang³ 

[1] Cardiac Rehabilitation Center, Fuwai Hospital, CAMS and PUMC, Beijing, China;Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China;Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China;Shenzhen Children's Hospital, Shenzhen, China;

关键词: ADHD–RI;    behavior;    cognition;    brain imaging;    functional connectivity;   

DOI  :  10.3389/fpsyt.2023.1099882

 received in 2022-11-16, accepted in 2023-02-07,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesThere is an ongoing debate about the restrictive inattentive (RI) presentation of attention deficit hyperactivity disorder (ADHD). The current study aimed to systematically investigate the clinical, neuropsychological, and brain functional characteristics of children with ADHD restrictive inattentive presentation.MethodsA clinical sample of 789 children with or without ADHD participated in the current study and finished clinical interviews, questionnaires, and neuropsychological tests. Those individuals with a diagnosis of ADHD were further divided into three subgroups according to the presentation of inattentive and/or hyperactive/impulsive symptoms, the ADHD-RI, the ADHD-I (inattentive), and the ADHD-C (combined) groups. Between-group comparisons were carried out on each clinical and neuropsychological measure using ANCOVA, with age and sex as covariates. Bonferroni corrections were applied to correct for multiple comparisons. Two hundred twenty-seven of the subjects also went through resting-state functional magnetic resonance imaging scans. Five ADHD-related brain functional networks, including the default mode network (DMN), the dorsal attention network (DAN), the ventral attention network, the executive control network, and the salience network, were built using predefined regions of interest (ROIs). Voxel-based group-wise comparisons were performed.ResultsCompared with healthy controls, all ADHD groups presented more clinical problems and weaker cognitive function. Among the ADHD groups, the ADHD-C group had the most clinical problems, especially delinquent and aggressive behaviors. Regarding cognitive function, the ADHD-RI group displayed the most impaired sustained attention, and the ADHD-C group had the worst response inhibition function. In terms of brain functional connectivity (FC), reduced FC in the DMN was identified in the ADHD-C and the ADHD-I groups but not the ADHD-RI group, compared to the healthy controls. Subjects with ADHD-I also presented decreased FC in the DAN in contrast to the control group. The ADHD-RI displayed marginally significantly lower FC in the salience network compared to the ADHD-I and the control groups.ConclusionThe ADHD-RI group is distinguishable from the ADHD-I and the ADHD-C groups. It is characterized by fewer externalizing behaviors, worse sustained attention, and better response inhibition function. The absence of abnormally high hyperactive/impulsive symptoms in ADHD-RI might be related to less impaired brain function in DMN, but potentially more impairment in the salience network.

【 授权许可】

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Copyright © 2023 Wu, Wang, Liu, Liu, Cao, Sun, Yang, Cao, Wang and Yang.