Lekai Luo1, Lizhou Chen1, Qian Li1, Ning He2, Yuanyuan Li2, Wanfang You1, Yuxia Wang1, Yaxuan Wang1, John A. Sweeney1,3, Lanting Guo2, Qiyong Gong1, and Fei Li1
1Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China, 2Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China, 3Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
Synopsis
Sparse
canonical correlation analysis (sCCA) was used to delineate multivariate
relationship between dynamic functional connectivity (dFC) and behavior or
cognition scores in a cohort of children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). We identified
four distinct patterns of dFC, each corresponded to a specific dimension of
behavior (inattention/hyperactivity, somatization) or cognitive function
(inhibition and flexibility, fluency and memory). Altered dFC within the default mode network (DMN) and between DMN and sensorimotor
network (SMN) were common to all dimensions.
Introduction
ADHD is a clinically heterogeneous neurodevelopmental disorder with
characteristic behavioral and cognitive features. These problems are believed to
be driven by atypical brain network organization1. Abnormal static
functional connectivity (FC) within and between default-mode, cognitive
control networks2, 3 have been identified in ADHD. In addition, the dynamic fluctuation of FC is a topic of developing
interest. Some studies have found children with ADHD show abnormal dFC4-6. However, these studies of dFC in ADHD mainly rely on case-control
study designs, which may not well capture the full spectrum of ADHD-related
variation of brain function and its association with behavioral and cognitive
features. Methods
A total of 122 right-handed
children (63 with ADHD) participated in this study (Table 1). Clinical measures
for all participants including behavior and cognition (Table 1). All
participants underwent resting-state functional
magnetic resonance imaging (rfMRI) by using a 3-T Siemens Trio MRI scanner (TR/TE=2000/30ms,
flip angle=90°, slice thickness=5mm with no gap, voxel size=3.75×3.75×5mm3). After rfMRI data preprocessing, the dFC networks were built using sliding-window
approach (window size=22TR, step=1TR)7 with Power atlas8, where brain regions were assigned to ten large-scale resting-state networks (Fig. 1A).
Temporal variability of FC was
estimated by the standard deviation across all sliding windows between each
pair of brain regions (Fig. 1B). Then we performed sparse canonical correlation analysis (sCCA)9 to find
multivariate relationships between brain imaging data and behavior
or cognition, respectively (Fig. 1C). Permutation
tests (1000 times) were used to assess the statistical significance of the canonical
correlation, and false discovery rate (FDR) correction was used to preserve the
Type I error at P<0.05. Finally, bootstrapping procedure was used to
estimate mean and standard error for canonical correlation coefficients and to
identify reliable features that consistently contributed to the correlation. Results
We
identified four distinct patterns of dFC, each corresponding to a specific
dimension of behavior (inattention/hyperactivity, somatization) or cognitive
function (inhibition and flexibility, fluency and memory) (r=0.811 - 0.879, PFDR<0.05)
(Fig. 2). Specially, the higher inattention/hyperactivity dimension scores mainly
correlated with higher dFC within DMN and lower dFC between DMN and other
networks (e.g. SMN, FPN). While the higher somatization dimension scores
mainly correlated with higher dFC within DMN and lower dFC between SMN and
other networks (e.g. DMN, VIS). Better cognitive functions for inhibition and
flexibility as well as fluency and memory were correlated with a similar dFC
pattern characterized by higher dFC between DMN and SMN/VIS as
well as lower dFC between DMN and FPN (Fig. 3, Fig. 4A-B).
While each dimension
was comprised of unique patterns of dFC, there were several features shared
across all dimensions. Shared dFCs were mainly located within and between DMN
and other networks. At the link level, these dFCs could be mapped to specific
nodes, and 16 brain regions consistently contributed to all of the four
dimensions, in which most regions belonged to DMN (Fig. 4C-D).Discussion
In this study, we applied dimensional
approach and identified specific
dFC patterns linked to four interpretable dimensions of behavior or cognitive
function in a population including both typically developing children and children with ADHD. The inattention/hyperactivity dimension represents the core behavioral abnormalities of ADHD. The dFC
pattern that was most strongly expressed by this dimension included positive loadings of dFC within DMN and
negative loadings of dFC between DMN and task-positive networks. Mounting evidence indicates that ADHD can in part be
regarded as a DMN disorder10, considering DMN dysfunctions as a primary cause of attention
lapses2,
11, 12. The instability
of DMN may reduce its temporal coherence with task-positive networks, as we
observed less variable dynamic cross-network interaction between DMN and
task-positive networks related with severer
inattention/hyperactivity. The somatization dimension was composed of factors including
psychosomatic problems, somatic complaints, and internalizing. Higher somatization dimension scores were related to higher
dFC within DMN and lower dFC between SMN and other networks. Similarly, Ernst et al. found lower static
connectivity of DMN predicted higher internalizing symptoms in adolescent
population13. Moreover, previous studies have shown that connections between SMN and
DMN are related to somatization14, 15. Therefore, we inferred abnormal dynamic interactions between DMN and
SMN may induce endogenous feeling of bodily symptoms without sufficient
explanatory peripheral pathology. For dFC-cognition sCCA, we found both of the
significant cognitive dimensions correlated with a similar dFC pattern mainly
characterized by dFC within SMN, VIS, and DMN, as well as among
the three networks. In support of our findings,
previous studies have found dynamic cooperation of these networks correlated
with cognitive function16-18.
While each
behavior or cognitive dimension was associated with a unique pattern of dFC,
dFCs within and between DMN and other networks (dominantly between DMN and SMN)
were common to all dimensions. This finding provided evidence that behavior problems and cognition deficits in
ADHD may have some shared neural bases.Conclusion
In summary, we identified
multivariate patterns of dFC that were highly correlated with four dimensions
of behaviors and cognitive functions. Each identified multivariate dimension
displayed specific dFC features, while altered dFC within and between DMN and
other networks was common to all dimensions. Our findings present evidence of common and distinct
alterations of brain dynamics linked to specific ADHD-related behavior or cognition
dimensions. Acknowledgements
No acknowledgement found.References
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