ADHD symptoms are associated with the modular structure of intrinsic brain networks in a representative sample of healthy adults

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant and often lifelong effects on social, emotional, and cognitive functioning. Influential neurocognitive models of ADHD link behavioral symptoms to altered connections between and within functional brain networks. Here, we investigate whether network-based theories of ADHD can be generalized to understanding variations in ADHD-related behaviors within the normal (i.e., clinically unaffected) adult population. In a large and representative sample, self-rated presence of ADHD symptoms varied widely; only 8 out of 291 participants scored in the clinical range. Subject-specific brain network graphs were modeled from functional MRI resting-state data and revealed significant associations between (nonclinical) ADHD symptoms and region-specific profiles of between-module and within-module connectivity. Effects were located in brain regions associated with multiple neuronal systems including the default-mode network, the salience network, and the central executive system. Our results are consistent with network perspectives of ADHD and provide further evidence for the relevance of an appropriate information transfer between task-negative (default-mode) and task-positive brain regions. More generally, our findings support a dimensional conceptualization of ADHD and contribute to a growing understanding of cognition as an emerging property of functional brain networks. Author Summary Neurocognitive models of ADHD link behavioral symptoms to altered connections between and within functional brain networks. We investigate whether these network-based theories of ADHD can be generalized to ADHD-related behaviors within the normal adult population. Subject-specific brain graphs were modeled from functional MRI resting-state data of a large and representative sample (N = 291). Significant associations between ADHD-related behaviors and region-specific profiles of between-module and within-module connectivity were observed in brain regions associated with multiple functional systems including the default-mode network, the salience network, and the central executive system. Our results support a dimensional conceptualization of ADHD and enforce network-based models of ADHD by providing further evidence for the relevance of an appropriate information transfer between task-negative (default-mode) and task-positive brain regions.