Association Study On Executive Function And Brain Imaging In Children With Attention Deficit Hyperactivity Disorder

Objectives This study aimed to investigate the characteristics of resting-state functional magnetic resonance imaging in children with attention deficit hyperactivity disorder(ADHD),and to explore the correlation between the symptomatic changes and executive functions by neuropsychological tests and resting-state functional magnetic resonance imaging.Methods1.Children aged 6-14 years who met the DSM-5 diagnostic criteria for ADHD,were investigated by a battery of neuropsychological tests,the results of which were compared with typical developed children,matched by age,gender and educational level.Behavioral feature and executive function in daily situations of children with ADHD were collected by parents reported questionnaires.2.Resting-state f MRI of all subjects were collected to investgate the Per AF,Re Ho and DC of the brain,and compare the differences in two group children of ADHD and TD.To aynalyse the correlation between the changes and executive functions,as well as symptoms of children with ADHD.3.The functional connectivity of the brain was also investgated and compared in two groups of ADHD and TD.The correlation between the changes and executive functions was analyzed,as well as symptoms of children with ADHD.ResultsPart One1.Comparison of the Per AF values between the two groups Compared with TD group,ADHD group demonstrated incresed Per AF value in bilateral inferior temporal gyrus and left rectus,and decreased Per AF value in bilateral superior frontal gyrus,left medial superior frontal gyrus,left precentral gyrus,left supramarginal gyrus,left pallidum,right triangular inferior frontal gyrus,right angular and right precuneus.2.Comparison of the Re Ho values between the two groups Compared with TD group,ADHD group demonstrated incresed Re Ho value in right superior parietal gyrus,right cerebellum and left caudate nucleus,and decreased Re Ho value in left inferior temporal gyrus,left precentral gyrus,left rectus,left angular and right putamen.3.Comparison of the DC values between the two groups Compared with the TD group,ADHD group demonstrated incresed DC value in bilateral superior frontal gyrus and right insula.The brain regions with decreased DC value include bilateral inferior temporal gyrus,bilateral middle temporal gyrus,right superior temporal gyrus,left orbital superior frontal gyrus,left pars opercularis of the inferior frontal gyrus,left insula and left supramarginal gyrus.4.Correlation between Per AF value changes and symptoms,executive functions in ADHD groupThere was no significant correlation between Per AF value changes and symptoms reported by SNAP-IV and PSQ(r=-0.37?0.39,P=0.09?0.98>0.05).The correlation between Per AF value and executive functions showed that,the Per AF value of the left medial superior frontal gyrus was positively correlated with the dorsal digit span(WISC-IV)(r=0.46,P=0.04),the Per AF value of the left supramarginal gyrus was positively correlated with the correct number in test A of Stroop test(r=0.52,p=0.02),the correct number in test B of Stroop test(r=0.47,p= 0.04),and the backward digit span(WISC-IV)(r=0.74,p= 0.00).The right triangle inferior frontal gyrus was negatively correlated with sustained error number(WCST)(r=-0.50,P=0.03).The left rectus gyrus was positively correlated with the “conversion” factor in the BRIEF scale(r=0.47,P=0.04).The left inferior temporal gyrus was positively correlated with the correct number in test A of Stroop test(r=0.50,P=0.03)and the correct number in test B of Stroop test(r=0.55,P=0.01).Part Two1.Comparison of functional connectivity between the two groups Compared with TD group,hyperconnectivity was observed in ADHD group between the left orbital superior frontal gyrus and the left cerebellum,the right triangle inferior frontal gyrus and the left parahippocampal gyrus,the right triangle inferior frontal gyrus and the left thalamus,the right triangle inferior frontal gyrus and bilateral caudate nucleus,the left rectus gyrus and the left cerebellum 7 b area,the left rectus gyrus and the left cerebellum Crus I,the left rectus gyrus and the middle frontal gyrus.Weaker functional connectivity was observed in the left orbital superior frontal gyrus and the left medial superior frontal gyrus,the left medial superior frontal gyrus and the right rectus gyrus,the left medial superior frontal gyrus and the papillary body,the left rectus gyrus and the bilateral middle temporal gyrus,the left rectus gyrus and the bilateral medial orbital superior frontal gyrus,the left rectus gyrus and the left medial frontal gyrus.2.Correlation between FC changes and symptoms,executive functions in ADHD groupThe functional connectivity between the left orbital superior frontal gyrus and left medial superior frontal gyrus were positively correlated with“learning” factor and “psychosomatic” factor in PSQ.The functional connectivity between the left rectus and the left cerebellum Crus I was positively correlated with the “learning” factor and “hyperactivity index”of the PSQ,and the “planning organization” and “supervision” factor of the BRIEF scale.The functional connectivity between the left medial superior frontal gyrus and the papillary body was negatively correlated with sustained error number(WCST).The functional connectivity between the left rectus gyrus and the left medial orbital superior frontal gyrus was positively correlated with the dorsal digital span(WISC-IV).Conclusions1.Children with ADHD have abnormal spontaneous activities in cerebellum,frontal lobe(precentral gyrus,medial prefrontal lobe,orbitofrontal lobe,inferior frontal gyrus),temporal lobe,parietal lobe,striatum and insula.The abnormal function of these regions is correlated with the deficits of executive functions in children with ADHD.2.Children with ADHD have abnormal functional connectivity in the brain regions of frontal lobe-striatum,frontal lobe-cerebellum,frontal lobe-limbic system,frontotemporal lobe,frontal lobe-thalamus and different parts of frontal lobe,involving DMN,executive and attention network,and these abnormal connectivities are related to the symptoms and the deficits of executive functions in children with ADHD.