Cerebral Blood Flow Characteristics and Executive Function in Different Subtypes of Attention Deficit Hyperactivity Disorder

ZHANG Xinyi; LIU Ningning; LI Haimei; WANG Yufeng; LIU Lu; QIAN Qiujin

doi:10.12290/xhyxzz.2024-0510

Turn off MathJax

Article Contents

Abstract

References

ZHANG Xinyi, LIU Ningning, LI Haimei, WANG Yufeng, LIU Lu, QIAN Qiujin. Cerebral Blood Flow Characteristics and Executive Function in Different Subtypes of Attention Deficit Hyperactivity Disorder[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0510

Citation:

PDF (796 KB)

Cerebral Blood Flow Characteristics and Executive Function in Different Subtypes of Attention Deficit Hyperactivity Disorder

ZHANG Xinyi^1,2,
LIU Ningning^1,2,
LI Haimei^1,2,
WANG Yufeng^1,2,
LIU Lu^1,2, ,,
QIAN Qiujin^1,2, ,

1 Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China;
2 NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China

Funds:

National Natural Science Foundation of China (81571340, 81873802, 82271575)

Capital’s Funds for Health Improvement and Research (2022-2-4114)

Beijing Science and Technology Nova Program (20220484061)

Peking University Clinical Medicine + X Young Scholars Program (PKU2023LCXQ043)

Beijing Municipal Health Commission Research Ward Programme (3rd batch)

More Information

Received Date: July 08, 2024
Accepted Date: September 10, 2024
Available Online: December 12, 2024

Graphical Abstract

Abstract

Abstract

Objective: This study aims to explore the differences in cerebral blood flow (CBF) among different subtypes of Attention Deficit and Hyperactivity Disorder (ADHD) [predominantly inattentive type (ADHD-I) and combined type (ADHD-C)] in children using Arterial Spin Labeling (ASL). Furthermore, it investigates the relationship between these differences and executive functions to gain a deeper understanding of the neurobiological basis of ADHD. Methods: The study included 159 male participants who completed pseudo-continuous ASL (pcASL) scans, comprising 83 children with ADHD-I, 51 children with ADHD-C, and 25 healthy controls (HC). The ecological executive function of the patients was assessed using the Behavior Rating Inventory of Executive Function-Parent Form (BRIEF). Analysis of covariance (ANCOVA) was used to explore differences in CBF among the three groups, with post hoc tests conducted using Dunn’s test. For brain regions showing intergroup differences, the corresponding CBF values were extracted and regression models were constructed with the BRIEF scores to further clarify the relationship between regional CBF differences and executive function. Results: Significant differences in CBF were observed in the left middle temporal gyrus among the ADHD-I, ADHD-C, and HC groups (Gaussian Random Field， GRF correction: voxel-level P <0.001, cluster-level P <0.05, bilateral test). Dunn’s post hoc test (Bonferroni correction P <0.05) showed significant differences between the ADHD-C and HC groups (P = 0.000) and between the ADHD-C and ADHD-I groups (P = 0.01), with the ADHD-I group showing lower local CBF compared to the other two groups. However, no significant differences were found between the ADHD-I and HC groups. Regression analysis with the BRIEF scores revealed a significant correlation between CBF in the ADHD-C group and planning/organization scores (b = -0.062, P = 0.03).Conclusion: There are significant differences in local cerebral blood flow between the ADHD-I and ADHD-C subtypes. The CBF in the left middle temporal gyrus is significantly lower in the ADHD-C group compared to the ADHD-I and HC groups. The reduced local CBF may be related to the executive function deficits in the ADHD-C subtype, particularly in organizational and planning abilities. No significant differences in local CBF were found between the ADHD-I and HC groups. These findings provide new insights into the neurobiological mechanisms of ADHD subtypes.
- Attention Deficit and Hyperactivity Disorder,
- subtypes,
- cerebral blood flow,
- executive function,
- magnetic resonance imaging

FullText(HTML)

References (36)

References

[1]	Faraone S V, Banaschewski T, Coghill D, et al. The World Federation of ADHD International Consensus Statement:208 Evidence-based conclusions about the disorder[J/OL]. Neuroscience&Biobehavioral Reviews, 2021, 128:789-818. DOI: 10.1016/j.neubiorev.2021.01.022.
[2]	Ayano G, Demelash S, Gizachew Y, et al. The global prevalence of attention deficit hyperactivity disorder in children and adolescents:An umbrella review of meta-analyses[J/OL]. Journal of Affective Disorders, 2023, 339:860-866. DOI: 10.1016/j.jad.2023.07.071.
[3]	Skounti M, Giannoukas S, Dimitriou E, et al. Prevalence of attention deficit hyperactivity disorder in schoolchildren in Athens, Greece. Association of ADHD subtypes with social and academic impairment[J/OL]. ADHD Attention Deficit and Hyperactivity Disorders, 2010, 2(3):127-132. DOI: 10.1007/s12402-010-0029-8.
[4]	Solanto M V, Gilbert S N, Raj A,等. Neurocognitive functioning in AD/HD, predominantly inattentive and combined subtypes[J/OL]. Journal of Abnormal Child Psychology, 2007, 35(5):729-744. DOI: 10.1007/s10802-007-9123-6.
[5]	Bambach S, Smith M, Morris P P,等. Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders[J/OL]. Journal of magnetic resonance imaging:JMRI, 2022, 55(3):698-719. DOI: 10.1002/jmri.27438.
[6]	Baytunca M B, de Frederick B, Bolat G U,等. Increased cerebral blood flow in the right anterior cingulate cortex and fronto-orbital cortex during go/no-go task in children with ADHD[J/OL]. Nordic Journal of Psychiatry, 2021, 75(3):224-233. DOI: 10.1080/08039488.2020.1864775.
[7]	Gonchigsuren O, Harada M, Hisaoka S, et al. Brain abnormalities in children with attentiondeficit/hyperactivity disorder assessed by multi-delay arterial spin labeling perfusion and voxelbased morphometry[J/OL]. Japanese Journal of Radiology, 2022, 40(6):568-577. DOI: 10.1007/s11604-021-01239-w.
[8]	Tang S, Liu X, Nie L,等. Three-dimensional pseudocontinuous arterial spin labeling perfusion imaging shows cerebral blood flow perfusion decline in attention-deficit/hyperactivity disorder children[J/OL]. Frontiers in Psychiatry, 2023, 14:1064647. DOI: 10.3389/fpsyt.2023.1064647.
[9]	Zhang K, Yuan J, Pei X,等. Cerebral blood flow characteristics of drug-naïve attentiondeficit/hyperactivity disorder with social impairment:Evidence for region-symptom specificity[J/OL]. Frontiers in Neuroscience, 2023, 17:1149703. DOI: 10.3389/fnins.2023.1149703.
[10]	Tan Y W, Liu L, Wang Y F,等. Alterations of cerebral perfusion and functional brain connectivity in medication-naïve male adults with attention-deficit/hyperactivity disorder[J/OL]. CNS neuroscience&therapeutics, 2020, 26(2):197-206. DOI: 10.1111/cns.13185.
[11]	DOI: 10.1007/s00787-023-02238-0.
[12]	Lace J W, Seitz D J, Austin T A,等. The dimensionality of the Behavior Rating Inventory of Executive Function, Second Edition in a clinical sample[J/OL]. Applied Neuropsychology. Child, 2022, 11(4):579-590. DOI: 10.1080/21622965.2021.1910950.
[13]	Davidson F, Cherry K, Corkum P. Validating the Behavior Rating Inventory of Executive Functioning for Children With ADHD and Their Typically Developing Peers[J/OL]. Applied Neuropsychology. Child, 2016, 5(2):127-137. DOI: 10.1080/21622965.2015.1021957.
[14]	McCandless S, O'Laughlin L. The Clinical Utility of the Behavior Rating Inventory of Executive Function (BRIEF) in the diagnosis of ADHD[J/OL]. Journal of Attention Disorders, 2007, 10(4):381-389. DOI: 10.1177/1087054706292115.
[15]	Faul F, Erdfelder E, Buchner A,等. Statistical power analyses using G*Power 3.1:tests for correlation and regression analyses[J/OL]. Behavior Research Methods, 2009, 41(4):1149-1160. DOI: 10.3758/BRM.41.4.1149.
[16]	祝雨,罗翔升,郭晓杰,等.注意缺陷多动障碍儿童选择性注意受损的脑影像学特征[J].中国心理卫生杂志, 2021, 35(11):947-953.
[17]	谢娆,高煦平,赵驿鹭,等.注意缺陷多动障碍儿童动态功能连接的功能磁共振成像研究[J].中国心理卫生杂志, 2022, 36(1):80-86.
[18]	傅朝,袁靖,裴栩瑶,等.托莫西汀治疗注意缺陷多动障碍的脑效应连接机制[J].中国心理卫生杂志, 2023, 37(2):97-102.
[19]	Kaufman J, Birmaher B, Brent D, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL):Initial Reliability and Validity Data[J/OL]. Journal of the American Academy of Child&Adolescent Psychiatry, 1997, 36(7):980-988. DOI: 10.1097/00004583-199707000-00021.
[20]	Hendrickson N K, McCrimmon A W. Test Review:Behavior Rating Inventory of Executive Function^®, Second Edition (BRIEF^®2) by Gioia, G. A., Isquith, P. K., Guy, S. C.,&Kenworthy, L[J/OL]. Canadian Journal of School Psychology, 2019, 34(1):73-78. DOI: 10.1177/0829573518797762.
[21]	钱英,王玉凤.学龄儿童执行功能行为评定量表父母版的信效度[J/OL].北京大学学报(医学版), 2007(3):277-283. DOI: 10.19723/j.issn.1671-167x.2007.03.015.
[22]	O'Gorman R L, Mehta M A, Asherson P, et al. Increased cerebral perfusion in adult attention deficit hyperactivity disorder is normalised by stimulant treatment:A non-invasive MRI pilot study[J/OL]. NeuroImage, 2008, 42(1):36-41. DOI: 10.1016/j.neuroimage.2008.04.169.
[23]	Kim B N, Lee J S, Shin M S,等. Regional cerebral perfusion abnormalities in attention deficit/hyperactivity disorder. Statistical parametric mapping analysis[J/OL]. European Archives of Psychiatry and Clinical Neuroscience, 2002, 252(5):219-225. DOI: 10.1007/s00406-002-0384-3.
[24]	Kim B N, Kim J W, Kang H, et al. Regional differences in cerebral perfusion associated with the α-2A-adrenergic receptor genotypes in attention deficit hyperactivity disorder[J/OL]. Journal of Psychiatry and Neuroscience, 2010, 35(5):330-336. DOI: 10.1503/jpn.090168.
[25]	DOI: 10.1007/978-3-540-36841-0_420.
[26]	Lee J S, Kim B N, Kang E, et al. Regional cerebral blood flow in children with attention deficit hyperactivity disorder:Comparison before and after methylphenidate treatment[J/OL]. Human Brain Mapping, 2005, 24(3):157-164. DOI: 10.1002/hbm.20067.
[27]	Schweitzer J B, Faber T L, Grafton S T,等. Alterations in the functional anatomy of working memory in adult attention deficit hyperactivity disorder[J/OL]. The American Journal of Psychiatry, 2000, 157(2):278-280. DOI: 10.1176/appi.ajp.157.2.278.
[28]	Stretton J, Thompson P J. Frontal lobe function in temporal lobe epilepsy[J/OL]. Epilepsy Research, 2012, 98(1):1-13. DOI: 10.1016/j.eplepsyres.2011.10.009.
[29]	Kobel M, Bechtel N, Specht K, et al. Structural and functional imaging approaches in attention deficit/hyperactivity disorder:Does the temporal lobe play a key role?[J/OL]. Psychiatry Research:Neuroimaging, 2010, 183(3):230-236. DOI: 10.1016/j.pscychresns.2010.03.010.
[30]	Rubia K, Smith A B, Brammer M J, et al. Temporal Lobe Dysfunction in Medication-Naïve Boys With Attention-Deficit/Hyperactivity Disorder During Attention Allocation and Its Relation to Response Variability[J/OL]. Biological Psychiatry, 2007, 62(9):999-1006. DOI: 10.1016/j.biopsych.2007.02.024.
[31]	Yao X, Yu Q, Yang E, et al.[Executive dysfunction in patients with temporal lobe epilepsy and its correlation with P300] [J]. Zhonghua Yi Xue Za Zhi, 2014, 94(7):521-524.
[32]	Gonchigsuren O, Harada M, Hisaoka S, et al. Brain abnormalities in children with attentiondeficit/hyperactivity disorder assessed by multi-delay arterial spin labeling perfusion and voxelbased morphometry[J/OL]. Japanese Journal of Radiology, 2022, 40(6):568-577. DOI: 10.1007/s11604-021-01239-w.
[33]	Dupont G, Van Rooij D, Buitelaar J K, et al. Sex-related differences in adult attention-deficit hyperactivity disorder patients-An analysis of external globus pallidus functional connectivity in resting-state functional MRI[J/OL]. Frontiers in Psychiatry, 2022, 13:962911. DOI: 10.3389/fpsyt.2022.962911.
[34]	Valera E M, Brown A, Biederman J, et al. Sex differences in the functional neuroanatomy of working memory in adults with ADHD[J/OL]. The American Journal of Psychiatry, 2010, 167(1):86-94. DOI: 10.1176/appi.ajp.2009.09020249.
[35]	Villemonteix T, De Brito S A, Slama H, et al. Grey matter volume differences associated with gender in children with attention-deficit/hyperactivity disorder:A voxel-based morphometry study[J/OL]. Developmental Cognitive Neuroscience, 2015, 14:32-37. DOI: 10.1016/j.dcn.2015.06.001.
[36]	Semrud-Clikeman M, Fine J G, Bledsoe J, et al. Regional Volumetric Differences Based on Structural MRI in Children With Two Subtypes of ADHD and Controls[J/OL]. Journal of Attention Disorders, 2017, 21(12):1040-1049. DOI: 10.1177/1087054714559642.

Cited By

Get Citation

PDF

XML

Article Metrics

Article views (41) PDF downloads (5)

Address：	Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
Tel：	010-69154261/4262
E - mail：	medj@pumch.cn mjpumch@126.com
Copyright of website：	Editorial Office of Medical Journal of Peking Union Medical College Hospital

Cerebral Blood Flow Characteristics and Executive Function in Different Subtypes of Attention Deficit Hyperactivity Disorder

Abstract

References

Catalog

Article Metrics

Related

Cerebral Blood Flow Characteristics and Executive Function in Different Subtypes of Attention Deficit Hyperactivity Disorder

Abstract

References

Catalog

Article Metrics

Related

Export File

Citation

Format

Content