OBJECTIVES To explore the alterations in the white matter (WM) structural connectome in children with drug-naïve attention-deficit/hyperactivity disorder (ADHD). METHODS Forty-nine pediatric ADHD and 51 age- and gender-matched typically developing (TD) children aged 6-14 years old were enrolled. This cross-sectional study applied graph theoretical analysis to assess the white matter organization based on deterministic diffusion tensor imaging (DTI). WM structural connectivity was constructed in 90 cortical and subcor-tical regions, and topological parameters of the resulting graphs were calculated. Networks were compared between two groups. The digit cancellation test (DCT) was taken to evaluate clinical symptom severity in pediatric ADHD, using the concentration index and the total cancellation test scores. Then, a partial correlation analysis was performed to explore the re-lationship between significant topologic metrics and clinical symptom severity. RESULTS Compared to TDs, ADHD showed an increase in the characteristic path length (Lp), normalized clustering coefficient (γ), small-worldness (σ), and a decrease in the global effi-ciency (Eglob) (all P <0.05). Furthermore, ADHD showed reduced nodal centralities mainly in the regions of default mode (DMN), central executive network (CEN), basal ganglia, and bilateral thalamus (all P <0.05). After performing Benjamini-Hochberg's procedure, only left orbital part of superior frontal gyrus (ORBsup.L) and left caudate (CAU) were statistically significant (P < 0.05, FDR-corrected). In addition, the concentration index of ADHD was negatively correlated with the nodal betweenness of the left orbital part of the middle frontal gyrus (ORBmid.L) (r = -0.302, P = 0.042). CONCLUSIONS Our findings revealed an ADHD-related shift of WM network topology toward "regularization" pattern, characterized by decreased global network integration, which is also reflected by changed nodal centralities involving DMN, CEN, basal ganglia, and bilateral thalamus. ADHD could be understood by examining the dysfunction of large-scale spatially distributed neural networks.

中文翻译：

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患有未曾用药的注意力缺陷/多动症儿童的小世界网络被破坏：基于 DTI 的网络分析。

目的 探讨初治注意力缺陷/多动障碍 (ADHD) 儿童白质 (WM) 结构连接组的变化。方法 纳入 49 名 ADHD 儿童和 51 名年龄和性别匹配的 6-14 岁典型发育 (TD) 儿童。这项横断面研究应用图论分析来评估基于确定性扩散张量成像 (DTI) 的白质组织。在 90 个皮质和皮质下区域构建了 WM 结构连接，并计算了所得图的拓扑参数。比较两组之间的网络。数字取消测试（DCT）用于使用集中指数和总取消测试分数来评估儿童 ADHD 的临床症状严重程度。然后，进行部分相关分析以探讨显着拓扑指标与临床症状严重程度之间的关系。结果与TD相比，ADHD表现出特征路径长度（Lp）、归一化聚类系数（γ）、小世界性（σ）的增加和全局效率（Eglob）的下降（均P <0.05） 。此外，ADHD 的节点中心性降低主要集中在默认模式（DMN）、中央执行网络（CEN）、基底神经节和双侧丘脑区域（均 P <0.05）。执行 Benjamini-Hochberg 手术后，只有额上回的左眼眶部分 (ORBsup.L) 和左尾状核 (CAU) 具有统计学意义（P < 0.05，FDR 校正）。此外，ADHD浓度指数与额中回左眼眶部分（ORBmid.L）的节点介数呈负相关（r=-0.302，P=0.042）。结论 我们的研究结果揭示了与 ADHD 相关的 WM 网络拓扑向“正规化”模式的转变，其特征是全局网络整合减少，这也反映在涉及 DMN、CEN、基底神经节和双侧丘脑的节点中心性的变化。多动症可以通过检查大规模空间分布神经网络的功能障碍来理解。