Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China.
Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
J Child Psychol Psychiatry. 2023 Feb;64(2):244-253. doi: 10.1111/jcpp.13689. Epub 2022 Aug 24.
Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous neurodevelopmental disorder. Integrity of white matter microstructure plays a key role in the neural mechanism of ADHD presentations. However, the relationships between specific behavioural dimensions and white matter microstructure are less well known. This study aimed to identify associations between white matter and a broad set of clinical features across children and adolescent with and without ADHD using a data-driven multivariate approach.
We recruited a total of 130 children (62 controls and 68 ADHD) and employed regularized generalized canonical correlation analysis to characterize the associations between white matter and a comprehensive set of clinical measures covering three domains, including symptom, cognition and behaviour. We further applied linear discriminant analysis to integrate these associations to explore potential developmental effects.
We delineated two brain-behaviour dimensional associations in each domain resulting a total of six multivariate patterns of white matter microstructural alterations linked to hyperactivity-impulsivity and mild affected; executive functions and working memory; externalizing behaviour and social withdrawal, respectively. Apart from executive function and externalizing behaviour sharing similar white matter patterns, all other dimensions linked to a specific pattern of white matter microstructural alterations. The multivariate dimensional association scores showed an overall increase and normalization with age in ADHD group while remained stable in controls.
We found multivariate neurobehavioral associations exist across ADHD and controls, which suggested that multiple white matter patterns underlie ADHD heterogeneity and provided neural bases for more precise diagnosis and individualized treatment.
注意缺陷多动障碍(ADHD)是一种异质性神经发育障碍。白质微观结构的完整性在 ADHD 表现的神经机制中起着关键作用。然而,特定行为维度与白质微观结构之间的关系还不太清楚。本研究旨在使用数据驱动的多元方法,确定 ADHD 和非 ADHD 儿童和青少年的广泛临床特征与白质之间的关联。
我们共招募了 130 名儿童(62 名对照和 68 名 ADHD),并采用正则化广义典型相关分析来描述白质与涵盖三个领域(包括症状、认知和行为)的全面临床测量之间的关联。我们进一步应用线性判别分析来整合这些关联,以探索潜在的发育影响。
我们在每个领域都描绘了两个大脑-行为维度的关联,总共得出了六个与多动-冲动和轻度受影响、执行功能和工作记忆、外化行为和社交退缩相关的白质微观结构改变的多元模式。除了执行功能和外化行为具有相似的白质模式外,所有其他维度都与特定的白质微观结构改变模式相关。ADHD 组的多维关联得分总体上随着年龄的增长而增加和正常化,而对照组则保持稳定。
我们发现 ADHD 和对照组之间存在多维神经行为关联,这表明多种白质模式是 ADHD 异质性的基础,并为更精确的诊断和个体化治疗提供了神经基础。