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Proc Natl Acad Sci U S A. 2017 Oct 31;114(44):11787-11792. doi: 10.1073/pnas.1705229114. Epub 2017 Oct 16.

Multimodal mapping of the brain's functional connectivity and the adult outcome of attention deficit hyperactivity disorder.

Author information

1
Section on Neurobehavioral and Clinical Research, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892.
2
Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892.
3
Section on Neurobehavioral and Clinical Research, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892; shawp@mail.nih.gov.

Abstract

We have a limited understanding of why many children with attention deficit hyperactivity disorder do not outgrow the disorder by adulthood. Around 20-30% retain the full syndrome as young adults, and about 50% show partial, rather than complete, remission. Here, to delineate the neurobiology of this variable outcome, we ask if the persistence of childhood symptoms into adulthood impacts on the brain's functional connectivity. We studied 205 participants followed clinically since childhood. In early adulthood, participants underwent magnetoencephalography (MEG) to measure neuronal activity directly and functional MRI (fMRI) to measure hemodynamic activity during a task-free period (the "resting state"). We found that symptoms of inattention persisting into adulthood were associated with disrupted patterns of typical functional connectivity in both MEG and fMRI. Specifically, those with persistent inattention lost the typical balance of connections within the default mode network (DMN; prominent during introspective thought) and connections between this network and those supporting attention and cognitive control. By contrast, adults whose childhood inattentive symptoms had resolved did not differ significantly from their never-affected peers, both hemodynamically and electrophysiologically. The anomalies in functional connectivity tied to clinically significant inattention centered on midline regions of the DMN in both MEG and fMRI, boosting confidence in a possible pathophysiological role. The findings suggest that the clinical course of this common childhood onset disorder impacts the functional connectivity of the adult brain.

KEYWORDS:

attention deficit hyperactivity disorder; brain systems; default mode network; neuroimaging; outcome

PMID:
29078281
PMCID:
PMC5676882
DOI:
10.1073/pnas.1705229114
[Indexed for MEDLINE]
Free PMC Article

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