Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Neuropsychiatry, University of Fukui, Fukui, Japan.
Autism Res. 2019 Jul;12(7):1057-1068. doi: 10.1002/aur.2120. Epub 2019 May 10.
Children with autism spectrum disorder (ASD) present with a high co-occurrence of anxiety and attention-deficit/hyperactivity disorder (ADHD). However, it remains unclear how the co-occurrence of anxiety and ADHD in children with ASD alters whole-brain functional networks. Here, we aimed to examine anxiety- and ADHD-related brain network centrality in children with ASD separately and their relationships with ASD symptoms. Clinical anxiety and ADHD levels in children with ASD, aged 6-13 years old, were assessed. Participants were categorized into four groups: ASD only (n = 28), ASD + anxiety (n = 19), ASD + ADHD (n = 25), and ASD + both anxiety and ADHD (n = 28). Subsequently, we compared voxel-wise network degree centrality (DC) among the four groups. We found that: (a) compared with ASD only, children with ASD + anxiety showed higher DC in the left middle temporal gyrus, right lingual gyrus, and left cuneus, and lower DC in the right precuneus; (b) children with ASD + ADHD presented higher DC in the right calcarine and left superior frontal gyrus (SFG) compared with ASD only; (c) children with ASD + both displayed higher DC in the right calcarine and lower centrality in the right middle occipital gyrus compared with ASD only; and (d) across all children with ASD, there was a positive correlation between DC of the right calcarine with nonverbal behavior scores, and DC of the left SFG was negatively correlated with social scores. Our findings suggest that the right calcarine, left SFG, and default mode network nodes play important roles in the co-occurrence of anxiety and ADHD among children with ASD. Autism Res 2019, 12: 1057-1068. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The co-occurrence of anxiety and attention-deficit/hyperactivity disorder (ADHD) has been shown to influence the brain function of children with ASD. In order to gain a better understanding of this, the present study compared degree centrality, the amount of effective brain functional connectivity that reflects the characteristics of brain networks, among four groups: ASD only, ASD + anxiety, ASD + ADHD, and ASD + both anxiety and ADHD. We found that some areas located in the language processing network and primary visual cortex were associated with the co-occurrence of ADHD, and some other areas located in the default mode network were associated with the co-occurrence of both anxiety and ADHD. These findings provide more knowledge about the neural basis underlying behavioral changes related to the co-occurrence of anxiety and ADHD in children with ASD.
患有自闭症谱系障碍（ASD）的儿童同时伴有较高的焦虑和注意力缺陷/多动障碍（ADHD）共病率。然而，目前尚不清楚 ASD 儿童中焦虑和 ADHD 的共病如何改变全脑功能网络。在这里，我们旨在分别检查 ASD 儿童的焦虑和 ADHD 相关脑网络中枢，并研究其与 ASD 症状的关系。我们评估了年龄在 6-13 岁之间的 ASD 儿童的临床焦虑和 ADHD 水平。将参与者分为四组：仅 ASD（n = 28）、ASD+焦虑（n = 19）、ASD+ADHD（n = 25）和 ASD+焦虑和 ADHD 共病（n = 28）。随后，我们比较了四组之间的体素水平网络度中心性（DC）。我们发现：（a）与仅 ASD 相比，ASD+焦虑组儿童的左侧颞中回、右侧舌回和左侧楔前叶的 DC 更高，右侧楔前叶的 DC 更低；（b）与仅 ASD 相比，ASD+ADHD 组儿童的右侧距状回和左侧额上回（SFG）的 DC 更高；（c）与仅 ASD 相比，ASD+共病组儿童的右侧距状回 DC 更高，右侧中枕叶的 DC 更低；（d）在所有 ASD 儿童中，右侧距状回的 DC 与非言语行为评分呈正相关，左侧 SFG 的 DC 与社会评分呈负相关。我们的研究结果表明，右侧距状回、左侧 SFG 和默认模式网络节点在 ASD 儿童焦虑和 ADHD 共病中起着重要作用。自闭症研究 2019, 12: 1057-1068. © 2019 自闭症国际研究协会，威利期刊，公司。 要点总结：焦虑和注意力缺陷/多动障碍（ADHD）的共病已被证明会影响 ASD 儿童的大脑功能。为了更好地了解这一点，本研究比较了四个组之间的度中心性（反映脑网络特征的有效脑功能连接量）：仅 ASD、ASD+焦虑、ASD+ADHD 和 ASD+焦虑和 ADHD 共病。我们发现，一些位于语言处理网络和初级视觉皮层的区域与 ADHD 的共病有关，而一些位于默认模式网络的其他区域与焦虑和 ADHD 的共病有关。这些发现为 ASD 儿童焦虑和 ADHD 共病相关行为变化的神经基础提供了更多的知识。
