Resting-state network dysconnectivity in ADHD: a system-neuroscience-based meta-analysis

Objectives: Neuroimaging studies report altered resting-state functional connectivity in attention deficit/hyperactivity disorder (ADHD) across multiple brain systems. However, there is inconsistency among individual studies. Methods: We meta-analyzed seed-based resting state studies of ADHD connectivity within and between four established resting state brain networks (default mode, cognitive control, salience, affective/motivational) using Multilevel Kernel Density Analysis method. Results: Twenty studies with 944 ADHD patients and 1121 controls were included in the analysis. Compared to controls, ADHD was associated with disrupted within-default mode network (DMN) connectivity – reduced in the core (i.e. posterior cingulate cortex seed) but elevated in the dorsal medial prefrontal cortex sub-system (i.e. temporal pole-inferior frontal gyrus). Connectivity was elevated between nodes in the cognitive control system. When the analysis was restricted to children and adolescents, additional reduced connectivity was detected between DMN and cognitive control and affective/motivational and salience networks. Conclusions: Our data are consistent with the hypothesis that paediatric ADHD is a DMN-dysconnectivity disorder with reduced connectivity both within the core DMN sub-system and between that system and a broad set of nodes in systems involved in cognition and motivation.