Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study

Rui Hu; Fan Tan; Wen Chen; Yong Wu; Yuhan Jiang; Wei Du; Yuchen Zuo; Bingbing Gao; Qingwei Song; Yanwei Miao

doi:10.3389/fpsyt.2023.1237113

Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study

Front Psychiatry. 2023 Aug 22:14:1237113. doi: 10.3389/fpsyt.2023.1237113. eCollection 2023.

Authors

Rui Hu^{1

2}, Fan Tan³, Wen Chen², Yong Wu⁴, Yuhan Jiang¹, Wei Du¹, Yuchen Zuo⁴, Bingbing Gao¹, Qingwei Song¹, Yanwei Miao¹

Affiliations

¹ Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
² Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
³ Department of Nuclear Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
⁴ Department of Paediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

Abstract

Objective: To explore the specific alterations of white matter microstructure in children with attention-deficit/hyperactivity disorder (ADHD) by automated fiber quantification (AFQ) and tract-based spatial statistics (TBSS), and to analyze the correlation between white matter abnormality and impairment of executive function.

Methods: In this prospective study, a total of twenty-seven patients diagnosed with ADHD (20 males, 7 females; mean age of 8.89 ± 1.67 years) and twenty-two healthy control (HC) individuals (11 males, 11 females, mean age of 9.82 ± 2.13 years) were included. All participants were scanned with diffusion kurtosis imaging (DKI) and assessed for executive functions. AFQ and TBSS analysis methods were used to investigate the white matter fiber impairment of ADHD patients, respectively. Axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA) of 17 fiber properties were calculated using the AFQ. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MD_DKI), axial diffusivity (AD_DKI), radial diffusivity (RD_DKI) and fractional anisotropy (FA_DKI) of DKI and AD, RD, MD, and FA of diffusion tensor imaging (DTI) assessed the integrity of the white matter based on TBSS. Partial correlation analyses were conducted to evaluate the correlation between white matter abnormalities and clinical test scores in ADHD while taking age, gender, and education years into account. The analyses were all family-wise error rate (FWE) corrected.

Results: ADHD patients performed worse on the Behavior Rating Inventory of Executive Function (BRIEF) test (p < 0.05). Minor variances existed in gender and age between ADHD and HC, but these variances did not yield statistically significant distinctions. There were no significant differences in TBSS for DKI and DTI parameters (p > 0.05, TFCE-corrected). Compared to HC volunteers, the mean AD value of right cingulum bundle (CB_R) fiber tract showed a significantly higher level in ADHD patients following the correction of FWE. As a result of the point-wise comparison between groups, significant alterations (FWE correction, p < 0.05) were mainly located in AD (nodes 36-38, nodes 83-97) and MD (nodes 92-95) of CB_R. There was no significant correlation between white matter diffusion parameters and clinical test scores in ADHD while taking age, gender, and education years into account.

Conclusion: The AFQ method can detect ADHD white matter abnormalities in a specific location with greater sensitivity, and the CB_R played a critical role. Our findings may be helpful in further studying the relationship between focal white matter abnormalities and ADHD.

Keywords: attention-deficit/hyperactivity disorder; automated fiber quantification; diffusion kurtosis imaging; right cingulum bundle; white matter microstructure.