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Published on: June 12, 2020
Brain-behavior patterns define a dimensional biotype in medication-naïve adults with attention-deficit hyperactivity
Hsiang-Yuan Lin1, Luca Cocchi2, Andrew Zalesky3
1Department of Psychiatry,National Taiwan University Hospital, and College of Medicine,Taipei,Taiwan.
Childhood-onset attention-deficit hyperactivity disorder (ADHD) in adults presents as a single disorder with a dimensional biotype. Altered brain connectivity patterns correlate with ADHD symptoms, suggesting shared underlying mechanisms.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Childhood-onset attention-deficit hyperactivity disorder (ADHD) in adults is clinically diverse, with varied cognitive deficits.
- The underlying nature of this heterogeneity (dimensional vs. categorical) in adult ADHD remains unclear.
Purpose of the Study:
- To investigate the neurobiological basis of clinical heterogeneity in adult ADHD.
- To determine if adult ADHD presents as a dimensional or categorical disorder using functional connectivity data.
Main Methods:
- Multi-echo resting-state functional magnetic resonance imaging (rs-fMRI) was used to assess functional connectivity in adults with ADHD and healthy controls.
- Canonical correlation analysis (CCA) identified relationships between brain connectivity and ADHD symptoms.
- Clustering methods were employed to test for categorical biotypes.
Main Results:
- Adults with ADHD exhibited heightened functional connectivity, particularly between default-mode, cingulo-opercular, and subcortical networks.
- CCA revealed a single dimensional biotype characterized by altered connectivity linked to hyperactivity-impulsivity, inattention, and intelligence.
- Clustering analyses did not support distinct categorical biotypes.
Conclusions:
- Reduced functional segregation between default-mode and cognitive control networks supports a dimensional biotype of childhood-onset adult ADHD.
- Despite varied presentations, adult ADHD appears to be a single disorder mediated by dimensional brain-symptom relationships.
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