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. 2017 Oct 11:8:200.
doi: 10.3389/fpsyt.2017.00200. eCollection 2017.

Abnormal Resting-State Functional Connectivity of Insular Subregions and Disrupted Correlation with Working Memory in Adults with Attention Deficit/Hyperactivity Disorder

Qihua Zhao  1   2 , Hui Li  1   2 , Xiaoyan Yu  1   2 , Fang Huang  1   2 , Yanfei Wang  1   2 , Lu Liu  1   2 , Qingjiu Cao  1   2 , Qiujin Qian  1   2 , Yufeng Zang  3   4 , Li Sun  1   2 , Yufeng Wang  1   2
Affiliations

Abnormal Resting-State Functional Connectivity of Insular Subregions and Disrupted Correlation with Working Memory in Adults with Attention Deficit/Hyperactivity Disorder

Qihua Zhao et al. Front Psychiatry. .

Abstract

Objectives: Executive function (EF) deficits are major impairments in adults with attention deficit/hyperactivity disorder (ADHD). Previous studies have shown that the insula is involved in cognitive and EFs. However, the insula is highly heterogeneous in function, and few studies have focused on functional networks which related to specific insular subregions in adults with ADHD. We explored the functional networks of the insular subregions [anterior insula (AI), mid-insula (MI), and posterior insula (PI)]. Furthermore, their correlations with self-ratings of ecological EFs, including inhibition, shifting, and working memory were investigated.

Methods: Resting-state functional magnetic resonance imaging data in 28 adults with ADHD and 30 matched healthy controls (HCs) were analyzed. The seed-based resting-state functional connectivity (RSFC) of the insular subregions was evaluated. We also investigated their associations with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) inhibition, working memory, and shifting factor scores.

Results: Compared with HCs, adults with ADHD showed altered RSFC of the AI, with the precuneus, precentral gyrus, and inferior temporal gyrus extended to the middle temporal gyrus, lingual gyrus, and superior occipital gyrus, respectively. There were no significant differences in RSFC of the MI and PI between the two groups. Within the HC group, working memory scores were associated with the RSFC of AI with precuneus and temporal gyrus. However, there was no correlation between these variables in the ADHD group.

Conclusion: The study evaluated RSFC patterns of the insular subregions in adults with ADHD for the first time. Altered RSFC of the AI which is a crucial region of salience network (SN) and part of regions in default mode network (DMN), were detected in adults with ADHD in both results with and without global signal regression (GSR), suggesting that disrupted SN-DMN functional connectivity may be involved in EF impairments in adults with ADHD, especially with respect to working memory. Deficits of the AI which is involved in salient stimuli allocation, might be associated with the pathophysiology of ADHD. The inconsistent results of MI and PI between analyses with and without GSR need further exploration.

Keywords: attention deficit/hyperactivity disorder; default mode network; executive function; insular subregions; resting-state functional connectivity; salience network.

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Figures

Figure 1
Figure 1
Significant resting-state functional connectivity (RSFC) patterns of the bilateral anterior insula of the attention deficit/hyperactivity disorder (ADHD) and healthy control (HC) groups. The yellow-red colors indicate that the brain regions were positively correlated with the insular subregions and the blue colors indicate that the brain regions were negatively correlated with insular subregions.
Figure 2
Figure 2
Group differences in RSFC of the left AI. Yellow color (ADHD > HC) indicates an increased functional connectivity with the insular subregions in the ADHD group, and blue color (ADHD < HC) indicates a decreased functional connectivity. (A) The clusters show significant differences in the RSFC of the left AI between the two groups. (B) Mean functional connectivity z-scores in clusters showing significant differences in the RSFC between the ADHD and HC groups. Numbers 1–5 marked in (A) refer to the brain regions in (B). RSFC, resting-state functional connectivity; AI, anterior insula; HC, healthy control; ADHD, attention deficit/hyperactivity disorder.
Figure 3
Figure 3
Group differences in the RSFC of the right AI. Yellow color (ADHD > HC) indicates an increased functional connectivity with the insular subregions in the ADHD group and blue color (ADHD < HC) indicates a decreased functional connectivity. (A) The clusters show significant differences in the RSFC of the left AI between the two groups. (B) Mean functional connectivity z-scores in clusters showing significant differences in the RSFC between the ADHD and HC groups. Numbers 1–5 marked in (A) refer to the brain regions in (B). RSFC, resting-state functional connectivity; AI, anterior insula; HC, healthy control; ADHD, attention deficit/hyperactivity disorder.
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References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Text Revision. 4th ed Washington, DC: American Psychiatric Association; (2000).
    1. Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics (2015) 135(4):e994–1001.10.1542/peds.2014-3482 - DOI - PubMed
    1. Karam RG, Breda V, Picon FA, Rovaris DL, Victor MM, Salgado CA, et al. Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study. Psychol Med (2015) 45(10):2045–56.10.1017/S0033291714003183 - DOI - PubMed
    1. Moffitt TE, Houts R, Asherson P, Belsky DW, Corcoran DL, Hammerle M, et al. Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. Am J Psychiatry (2015) 172(10):967–77.10.1176/appi.ajp.2015.14101266 - DOI - PMC - PubMed
    1. Uchida M, Spencer TJ, Faraone SV, Biederman J. Adult outcome of ADHD: an overview of results from the MGH longitudinal family studies of pediatrically and psychiatrically referred youth with and without ADHD of both sexes. J Atten Disord (2015).10.1177/1087054715604360 - DOI - PubMed