Brain network structural connectome abnormalities among youth with attention-deficit/hyperactivity disorder at varying risk for bipolar I disorder: a cross-sectional graph-based magnetic resonance imaging study

Ziyu Zhu; Du Lei; Kun Qin; Xiuli Li; Wenbin Li; Maxwell J Tallman; L Rodrigo Patino; David E Fleck; Veronica Aghera; Qiyong Gong; John A Sweeney; Robert K McNamara; Melissa P DelBello

doi:10.1503/jpn.220209

Brain network structural connectome abnormalities among youth with attention-deficit/hyperactivity disorder at varying risk for bipolar I disorder: a cross-sectional graph-based magnetic resonance imaging study

J Psychiatry Neurosci. 2023 Aug 29;48(4):E315-E324. doi: 10.1503/jpn.220209. Print 2023 Jul-Aug.

Authors

Affiliations

¹ From the Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, China (Zhu, Qin, X. Li, Gong); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH (Zhu, Qin, Tallman, Patino, Fleck, Aghera, Sweeney, McNamara, DelBello); the College of Medical Informatics, Chongqing Medical University, Chongqing, China (Lei); the Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China (X. Li); the Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (W. Li); the Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China (Gong); the Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China (Gong).
² From the Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, China (Zhu, Qin, X. Li, Gong); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH (Zhu, Qin, Tallman, Patino, Fleck, Aghera, Sweeney, McNamara, DelBello); the College of Medical Informatics, Chongqing Medical University, Chongqing, China (Lei); the Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China (X. Li); the Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China (W. Li); the Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China (Gong); the Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China (Gong) alien18@163.com qiyonggong@hmrrc.org.cn.

^# Contributed equally.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is highly prevalent among youth with or at familial risk for bipolar-I disorder (BD-I), and ADHD symptoms commonly precede and may increase the risk for BD-I; however, associated neuropathophysiological mechanisms are not known. In this cross-sectional study, we sought to investigate brain structural network topology among youth with ADHD, with and without familial risk of BD-I.

Methods: We recruited 3 groups of psychostimulant-free youth (aged 10-18 yr), namely youth with ADHD and at least 1 biological parent or sibling with BD-I (high-risk group), youth with ADHD who did not have a first- or second-degree relative with a mood or psychotic disorder (low-risk group) and healthy controls. We used graph-based network analysis of structural magnetic resonance imaging data to investigate topological properties of brain networks. We also evaluated relationships between topological metrics and mood and ADHD symptom ratings.

Results: A total of 149 youth were included in the analysis (49 healthy controls, 50 low-risk youth, 50 high-risk youth). Low-risk and high-risk ADHD groups exhibited similar differences from healthy controls, mainly in the default mode network and central executive network. We found topological alterations in the salience network of the high-risk group, relative to both low-risk and control groups. We found significant abnormalities in global network properties in the high-risk group only, compared with healthy controls. Among both low-risk and high-risk ADHD groups, nodal metrics in the right triangular inferior frontal gyrus correlated positively with ADHD total and hyperactivity/impulsivity subscale scores.

Limitations: The cross-sectional design of this study could not determine the relevance of these findings to BD-I risk progression.

Conclusion: Youth with ADHD, with and without familial risk for BD-I, exhibit common regional abnormalities in the brain connectome compared with healthy youth, whereas alterations in the salience network distinguish these groups and may represent a prodromal feature relevant to BD-I risk.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity* / diagnostic imaging
Bipolar Disorder* / diagnostic imaging
Brain / diagnostic imaging
Brain Diseases*
Connectome*
Cross-Sectional Studies
Genetic Predisposition to Disease
Humans
Magnetic Resonance Imaging

Grants and funding

R01 MH097818/MH/NIMH NIH HHS/United States