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Elucidating Distinct and Common fMRI-Complexity Patterns in Preadolescent Children With

Ru Zhang1, Steven Cen2, Dilmini Wijesinghe2

  • 1University of California San Francisco, San Francisco, California.

JAACAP Open
|April 6, 2026
PubMed
Summary

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) show reduced brain complexity in executive function networks. Comorbid ADHD amplifies these neural deficits, while obsessive-compulsive disorder (OCD) shows no significant alterations.

Keywords:
attention-deficit/hyperactivity disorder (ADHD)obsessive-compulsive disorder (OCD)oppositional defiant disorder (ODD)resting-state fMRIsample entropy

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Area of Science:

  • Neuroscience
  • Child Psychiatry
  • Developmental Psychology

Background:

  • Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with other psychiatric conditions, complicating the understanding of its unique brain alterations.
  • Delineating shared versus distinct neural deficits in ADHD, oppositional defiant disorder (ODD), and obsessive-compulsive disorder (OCD) is crucial for understanding their pathophysiology.

Purpose of the Study:

  • To investigate alterations in resting-state functional magnetic resonance imaging (rsfMRI) complexity within executive function (EF) networks in children with ADHD, ODD, and OCD.
  • To compare neural complexity deficits in children with single diagnoses versus those with comorbid conditions.

Main Methods:

  • Utilized baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study for children aged 9-10.
  • Calculated voxel-wise sample entropy (SampEn) to measure neural complexity in executive function networks.
  • Employed hierarchical models to compare SampEn between comorbidity-free and comorbid ADHD, ODD, and OCD groups against a healthy control sample.

Main Results:

  • Reduced SampEn was observed in comorbidity-free ADHD and ODD within overlapping EF network regions, including the superior frontal gyrus, cingulate gyrus, and caudate.
  • ADHD also showed complexity reductions in the inferior/middle frontal gyrus and frontal orbital cortex.
  • Comorbid ADHD presentations exhibited significantly lower SampEn across all EF network regions compared to controls.

Conclusions:

  • ADHD and ODD share common executive function network impairments, with ADHD demonstrating more widespread complexity deficits.
  • Comorbidities, particularly when ADHD is present, exacerbate neural complexity deficits in executive function networks.
  • Obsessive-compulsive disorder (OCD) did not show significant SampEn alterations, irrespective of comorbidity.