A Systematic Review of Imaging Studies in the Combined and Inattentive Subtypes of Attention Deficit Hyperactivity Disorder
Jacqueline F. Saad, Kristi R. Griffiths, Mayuresh S. Korgaonkar
Abstract
Objective: Insights to underlying neural mechanisms in ADHD have emerged from neuroimaging research; however, the neural mechanisms that distinguish ADHD subtypes remain inconclusive. Method: We reviewed nineteen studies integrating magnetic resonance imaging (structural, diffusion, fMRI) findings into a framework exploring pathophysiological mechanisms underlying the combined (ADHD-C) and predominantly inattentive (ADHD-I) ADHD subtypes. Results: Despite equivocal structural MRI results, findings from fMRI and DTI imaging modalities consistently implicate disrupted connectivity in regions and tracts involving frontal striatal thalamic in ADHD-C and frontoparietal neural networks in ADHD-I. Alterations of the default mode, cerebellum and motor networks in ADHD-C and cingulo-frontoparietal attention and visual networks in ADHD-I highlight network organization differences between subtypes. Conclusion: Growing evidence from neuroimaging studies highlight neurobiological differences between ADHD clinical subtypes, particularly from a network perspective. Understanding brain network organization and connectivity may help us to better conceptualize the ADHD types and their symptom variability.