Abstract
The current study aimed to explore the behavioral, daily-life executive functional, and brain functional connectivity patterns in children with attention-deficit/hyperactivity disorder (ADHD) and anxiety. A total of 246 children with non-comorbid ADHD and 91 healthy controls (HCs) participated in the current study, among whom 175 subjects went through resting-state functional magnetic resonance imaging (fMRI) scans. The ADHD participants were divided into two subgroups: ADHD with a high level of anxiety (ADHD + ANX) and ADHD with a low level of anxiety (ADHD-ANX). The Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function (BRIEF) were used to capture the behavioral and daily-life executive functional characteristics. Independent component analysis with dual regression models was applied to the fMRI data. All statistical models were estimated with age and sex as covariates. Compared with the ADHD-ANX group, the ADHD + ANX group showed more withdrawn, somatic, social, thought, attention, delinquent, and aggressive problems (all corrected p < 0.05). The ADHD + ANX group also displayed more impaired emotional control and working memory than the ADHD-ANX (all corrected p < 0.05). The ADHD-ANX group, but not the ADHD + ANX group, showed elevated functional connectivity within the default mode network compared with the HC group. The mean function connectivity within the default mode network significantly mediated the correlation between anxiety level and attention problems. In sum, anxiety in children with ADHD was associated with more social, emotional, and behavioral problems, more impaired daily-life executive function, and altered brain function. Our work provides important information on the heterogeneity of ADHD.
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Change history
21 October 2022
A Correction to this paper has been published: https://doi.org/10.1007/s11682-022-00730-w
Abbreviations
- ADHD:
-
attention-deficit/hyperactivity disorder.
- ANX:
-
anxiety.
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Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Sanming Project of Medicine in Shenzhen “The ADHD research group from Peking University Sixth Hospital” (SZSM201612036), the Basic and Applied Basic Research Project of Guangdong Province of China (2019A1515110700 to Zhao-Min Wu), and the National Natural Science Foundation of China (82071537, 82101613).
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Zhao-Min Wu and Peng Wang contributed significantly to the data collection, data analysis, and manuscript preparation. Juan Liu and Xiao-Lan Cao helped conduct the study. Lu Liu, Sun Li, and Qing-Jiu Cao helped with the data analysis, as well as the writing and reviewing of the manuscript. Li Yang, Bin-Rang Yang, and Yu-Feng Wang contributed to the design of the study, the data analysis, and the manuscript preparation.
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Zhao-Min Wu, Peng Wang, Juan Liu, Lu Liu, Xiao-Lan Cao, Li Sun, Qing-Jiu Cao, Li Yang, Yu-Feng Wang, and Bin-Rang Yang do not have any conflicts of interest.
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This work was approved by the Ethics Committee of Shenzhen Children’s Hospital (identification number: 202005702). Informed consent was obtained from parents of children prior to the study.
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Wu, ZM., Wang, P., Liu, J. et al. Behavioral and brain functional characteristics of children with Attention-Deficit/Hyperactivity disorder and anxiety trait. Brain Imaging and Behavior 16, 2657–2665 (2022). https://doi.org/10.1007/s11682-022-00722-w
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DOI: https://doi.org/10.1007/s11682-022-00722-w