Brain Connectivity Mediates Heartbeat-Evoked Potential Alterations Between Children With ADHD and Comorbid ADHD-ASD
IEEE Transactions on Bio-Medical Engineering
|June 9, 2026
Summary
Children with ADHD and comorbid ADHD-ASD show distinct brain-heart interaction patterns. Enhanced brain network efficiency in the comorbid group suggests unique neural reorganizations, challenging simple additive models of comorbidity.
Area of Science:
- Neuroscience
- Developmental Psychology
- Psychophysiology
Background:
- Comorbidity between Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) is common but poorly understood.
- Existing research often treats these conditions additively, potentially overlooking unique pathophysiological mechanisms.
Purpose of the Study:
- To investigate the neural mechanisms underlying ADHD-ASD comorbidity by examining brain-heart interactions.
- To differentiate neurophysiological patterns between ADHD, comorbid ADHD-ASD, and pure ASD.
Main Methods:
- Resting-state electroencephalography (EEG) and electrocardiography (ECG) were recorded from children with ADHD, comorbid ADHD-ASD, and pure ASD.
- Heartbeat-Evoked Potentials (HEP) and Heartbeat-Induced Networks (HINs) were computed.
- Mediation analysis explored the role of brain connectivity in observed HEP differences.
Main Results:
- The ADHD group showed attenuated negative HEP amplitudes compared to the comorbid group.
- The comorbid ADHD-ASD group exhibited distinct path lengths in theta and alpha bands and higher theta global efficiency.
- Theta global efficiency mediated group differences in HEP amplitudes, indicating its role in brain-heart coupling.
Conclusions:
- Distinct resting-state brain-heart interaction patterns differentiate pure ADHD from comorbid ADHD-ASD.
- Enhanced brain network efficiency in the comorbid group suggests unique neural reorganizations.
- Findings challenge the simple additive model of comorbidity and highlight potential biomarkers for diagnosis and intervention.
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