Latent class analysis of attention and white matter correlation in children with attention-deficit/hyperactivity disorder

This study aimed to explore attentional patterns among children with inattentive attention-deficit/hyperactivity disorder (ADHD-I) and children with typical development (TD), using a latent class analysis (LCA). Patterns of brain connectivity were also explored. The sample comprised 29 ADHD-I and 29 TD matched children. An LCA was conducted to reclassify subjects according to their attentional performance, considering cognitive measures of attention and behavioral symptoms, regardless of group of origin. The new clusters were then compared in respect to brain white matter measurements (extracted from diffusion tensor imaging). Participants were rearranged in 2 new latent classes, according to their performance in an attention task and the results of behavioral scales, resulting in groups with more homogeneous attentional profiles. A comparison of the 2 new classes using the white matter measurements revealed increased fractional anisotropy in the left inferior fronto-occipital fasciculus and left inferior longitudinal fasciculus for the class composed by participants with a higher risk of attentional problems. The findings indicated that it was possible to observe variability regarding neuropsychological profile, accompanied by underpinning neurobiological differences, even among individuals with the same disorder subtype - inattentive ADHD. This specific data-driven clustering analysis may help to enhance understanding of the pathophysiology of the disorder's phenotypes.

本研究借助潜类别分析（latent class analysis, LCA），旨在探究注意缺陷型注意缺陷多动障碍（inattentive attention-deficit/hyperactivity disorder, ADHD-I）儿童与典型发育（typical development, TD）儿童的注意模式，并同步分析脑连接特征。本研究共纳入29名ADHD-I儿童与29名人口学匹配的TD儿童作为研究样本。研究人员以注意力认知测评指标与行为症状为依据，不考虑被试的原始分组类别，对其注意表现开展潜类别分析以完成重新分类。基于注意力任务表现与行为量表结果，被试被重新划分为2个新的潜类别，形成注意特征更为均一的组别。研究者对这2个新类别进行脑白质测量指标（提取自弥散张量成像（diffusion tensor imaging）数据）的比较后发现，由注意问题风险更高的被试组成的类别，其左侧额下枕束（inferior fronto-occipital fasciculus）与左侧下纵束（inferior longitudinal fasciculus）的各向异性分数（fractional anisotropy, FA）显著升高。研究结果表明，即便同为注意缺陷型ADHD患者，其神经心理学特征仍存在异质性，且伴随相应的神经生物学差异。此种基于数据驱动的聚类分析方法，有助于加深人们对该障碍表型（phenotypes）病理生理学（pathophysiology）机制的理解。