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. 2023 Nov 20;19(1):20.
doi: 10.1186/s12993-023-00222-x.

Specific brain imaging alterations underlying autistic traits in children with attention-deficit/hyperactivity disorder

Juan Liu  1 , Qian-Rong Liu  2 , Zhao-Min Wu  1 , Qiao-Ru Chen  1 , Jing Chen  1 , Yuan Wang  1 , Xiao-Lan Cao  1 , Mei-Xia Dai  1 , Chao Dong  1 , Qiao Liu  1 , Jun Zhu  1 , Lin-Lin Zhang  1 , Ying Li  1 , Yu-Feng Wang  2 , Lu Liu  3 , Bin-Rang Yang  4
Affiliations

Specific brain imaging alterations underlying autistic traits in children with attention-deficit/hyperactivity disorder

Juan Liu et al. Behav Brain Funct. .

Abstract

Background: Autistic traits (ATs) are frequently reported in children with Attention-Deficit/Hyperactivity Disorder (ADHD). This study aimed to examine ATs in children with ADHD from both behavioral and neuroimaging perspectives.

Methods: We used the Autism Spectrum Screening Questionnaire (ASSQ) to assess and define subjects with and without ATs. For behavioral analyses, 67 children with ADHD and ATs (ADHD + ATs), 105 children with ADHD but without ATs (ADHD - ATs), and 44 typically developing healthy controls without ATs (HC - ATs) were recruited. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data and analyzed the mean amplitude of low-frequency fluctuation (mALFF) values (an approach used to depict different spontaneous brain activities) in a sub-sample. The imaging features that were shared between ATs and ADHD symptoms or that were unique to one or the other set of symptoms were illustrated as a way to explore the "brain-behavior" relationship.

Results: Compared to ADHD-ATs, the ADHD + ATs group showed more global impairment in all aspects of autistic symptoms and higher hyperactivity/impulsivity (HI). Partial-correlation analysis indicated that HI was significantly positively correlated with all aspects of ATs in ADHD. Imaging analyses indicated that mALFF values in the left middle occipital gyrus (MOG), left parietal lobe (PL)/precuneus, and left middle temporal gyrus (MTG) might be specifically related to ADHD, while those in the right MTG might be more closely associated with ATs. Furthermore, altered mALFF in the right PL/precuneus correlated with both ADHD and ATs, albeit in diverse directions.

Conclusions: The co-occurrence of ATs in children with ADHD manifested as different behavioral characteristics and specific brain functional alterations. Assessing ATs in children with ADHD could help us understand the heterogeneity of ADHD, further explore its pathogenesis, and promote clinical interventions.

Keywords: ADHD; Autistic traits; Behavior; Resting-state functional MRI.

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Conflict of interest statement

The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as potential competing interests.

Figures

Fig. 1
Fig. 1
Differences in mALFF values among the three groups (three-dimensional [3D] view; N = 102). A Significant brain regions in the three groups. B Brain regions specifically related to ADHD. C Brain regions specifically related to ATs. D Brain regions involved in both ADHD and ATs, with analysis of covariance (ANCOVA) and post hoc group comparisons of mALFF values after controlling for FSIQ, age, and gender; or establishing multiple-regression equation by multiple linear-regression analyses between mALFF clusters and behaviors in ADHD. Cluster 1 (red): left MTG; Cluster 2 (orange): right MTG; Cluster 3 (yellow): left MOG; Cluster 4 (dark blue): right PL/precuneus; Cluster 5 (light blue): left PL/precuneus. mALFF mean amplitude of low-frequency fluctuations. MTG left middle temporal gyrus. MOG middle occipital gyrus. PL parietal lobe
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