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Growth charting of brain connectivity may identify ADHD risk factors

Recent findings suggest growth charting of brain connectivity may identify clinically relevant conditions such as attention impairment in youth.

“With the advent of resting-state functional neuroimaging, the potential now exists to extend growth charting methods to maturing functional relationships in the brain,” Daniel Kessler, BS, of University of Michigan, Ann Arbor, and colleagues wrote. “The human brain is organized into several large-scale intrinsic connectivity networks, each associated with distinct neurocognitive functions. Moreover, relationships within and between [intrinsic connectivity networks] exhibit clear trajectories of change from childhood to young adulthood. It is plausible, then, that deviations from normative trajectories of network maturation might be predictive of a range of clinically important psychological characteristics and conditions.”

Researchers used a network growth charting approach to assess the association between changes in intrinsic connectivity network maturation and attention performance among a population-based sample of youth from the Philadelphia Neurodevelopment Cohort. Study participants included 519 youth with a mean age of 15.7 years. Of these, 4.8% met criteria for attention-deficit/hyperactivity disorder.

Researchers found that participants’ patterns of deviation from normative maturational trajectories indicated sustained attention functioning and were a reliable biomarker of severe attention impairment.

Specifically, a down-shifted pattern of intrinsic connectivity network maturation rather than a right-shifted pattern was associated with reduced attention performance.

Further, researchers found parallel associations between intrinsic connectivity network dysmaturation and diagnosis of ADHD.

“What might future brain-based growth charts look like in psychiatry? This partly depends on intended use. If universal screening is the goal, we need measures that are cost-effective, easy to acquire, and reliable (analogous to head circumference). Given this, do we even have to include direct measures of brain function? Could we instead use metrics such as cognitive tests?” Philip Shaw, BM, BCh, PhD, of the NIMH, Bethesda, Maryland, wrote in an accompanying editorial. “We may need more direct measures from neuroimaging. Given the expense and complexity of neuroimaging, its possible future role may be in the assessment of children presenting to mental health care settings rather than in screening.” – by Amanda Oldt

Disclosure: Kessler and colleagues report no relevant financial disclosures. Shaw reports no relevant financial disclosures.