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Sensation‐to‐cognition cortical streams in attention‐deficit/hyperactivity disorder
Authors:Susana Carmona  Elseline Hoekzema  Francisco X. Castellanos  David García‐García  Agustín Lage‐Castellanos  Koene R.A. Van Dijk  Francisco J. Navas‐Sánchez  Kenia Martínez  Manuel Desco  Jorge Sepulcre
Affiliation:1. Department of Psychology, Harvard University, Center for Brain Science, Cambridge, Massachusetts;2. Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Mara?ón, Madrid, Spain;3. Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain;4. Neuroendocrinology Bakker Group, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands;5. Center for Neurodevelopmental Disorders, The Child Study Center at NYU Langone Medical Center, New York, New York;6. Division of Child and Adolescent Psychiatric Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York;7. Department of Neurostatistics, Cuba Neuroscience Center, Habana, Cuba;8. Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts;9. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain;10. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Abstract:We sought to determine whether functional connectivity streams that link sensory, attentional, and higher‐order cognitive circuits are atypical in attention‐deficit/hyperactivity disorder (ADHD). We applied a graph‐theory method to the resting‐state functional magnetic resonance imaging data of 120 children with ADHD and 120 age‐matched typically developing children (TDC). Starting in unimodal primary cortex—visual, auditory, and somatosensory—we used stepwise functional connectivity to calculate functional connectivity paths at discrete numbers of relay stations (or link‐step distances). First, we characterized the functional connectivity streams that link sensory, attentional, and higher‐order cognitive circuits in TDC and found that systems do not reach the level of integration achieved by adults. Second, we searched for stepwise functional connectivity differences between children with ADHD and TDC. We found that, at the initial steps of sensory functional connectivity streams, patients display significant enhancements of connectivity degree within neighboring areas of primary cortex, while connectivity to attention‐regulatory areas is reduced. Third, at subsequent link‐step distances from primary sensory cortex, children with ADHD show decreased connectivity to executive processing areas and increased degree of connections to default mode regions. Fourth, in examining medication histories in children with ADHD, we found that children medicated with psychostimulants present functional connectivity streams with higher degree of connectivity to regions subserving attentional and executive processes compared to medication‐naïve children. We conclude that predominance of local sensory processing and lesser influx of information to attentional and executive regions may reduce the ability to organize and control the balance between external and internal sources of information in ADHD. Hum Brain Mapp 36:2544–2557, 2015. © 2015 Wiley Periodicals, Inc .
Keywords:attention‐deficit/hyperactivity disorder  resting‐state functional magnetic resonance imaging  ventral attention network  default mode network  sensorimotor network
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