Functional Brain Connectivity Differences Between Different ADHD Presentations: Impaired Functional Segregation in ADHD-Combined Presentation but not in ADHD-Inattentive Presentation

Introduction Contrary to Diagnostic and Statistical Manual of Mental Disorders (DSM-5), fifth edition, some studies indicate that ADHD-inattentive presentation (ADHD-I) is a distinct diagnostic disorder and not an ADHD presentation. Methods In this study, 12 ADHD-combined presentation (ADHD-C), 10 ADHD-I, and 13 controls were enrolled and their resting state EEG recorded. Following this, a graph theoretical analysis was performed and functional integration and segregation of brain network was calculated. Results The results show that clustering coefficient of theta band was significantly different among three groups and significant differences were observed in theta global efficiency between controls and ADHD-C. Regarding the alpha band, a lower clustering coefficient was observed in control subjects. In the beta band, clustering coefficient was significantly different between the control and children with ADHD-C and also between ADHD-I and ADHD-C. The clustering coefficient, in the subjects with ADHD-C, demonstrated a rapid decline and was significantly lower than the subjects with ADHD-I and control. Conclusion Decreased clustering, in high thresholds, may be associated with hyperactivity while increased segregation in low thresholds with inattentiveness. A different functional network occurs in the ADHD-C brain that is consistent with several studies that have reported ADHD-I as a distinct disorder.