Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, and is often characterized by altered executive functioning. Executive function has been found to be supported by flexibility in dynamic brain reconfiguration. Thus, we applied multilayer community detection to resting-state fMRI data in 180 children with ADHD and 180 typically developing children (TDC) to identify alterations in dynamic brain reconfiguration in children with ADHD. We specifically evaluated MR derived neural flexibility, which is thought to underlie cognitive flexibility, or the ability to selectively switch between mental processes. Significantly decreased neural flexibility was observed in the ADHD group at both the whole brain (raw p = 0.0005) and sub-network levels (p < 0.05, FDR corrected), particularly for the default mode network, attention-related networks, executive function-related networks, and primary networks. Furthermore, the subjects with ADHD who received medication exhibited significantly increased neural flexibility (p = 0.025, FDR corrected) when compared to subjects with ADHD who were medication naïve, and their neural flexibility was not statistically different from the TDC group (p = 0.74, FDR corrected). Finally, regional neural flexibility was capable of differentiating ADHD from TDC (Accuracy: 77% for tenfold cross-validation, 74.46% for independent test) and of predicting ADHD severity using clinical measures of symptom severity (R²: 0.2794 for tenfold cross-validation, 0.156 for independent test). In conclusion, the present study found that neural flexibility is altered in children with ADHD and demonstrated the potential clinical utility of neural flexibility to identify children with ADHD, as well as to monitor treatment responses and disease severity.

注意力缺陷/多动障碍 (ADHD) 是儿童期最常见的神经发育障碍之一，通常以执行功能改变为特征。人们发现执行功能是由动态大脑重新配置的灵活性来支持的。因此，我们将多层社区检测应用于 180 名 ADHD 儿童和 180 名典型发育儿童 (TDC) 的静息态 fMRI 数据，以识别 ADHD 儿童动态大脑重构的变化。我们专门评估了 MR 衍生的神经灵活性，这被认为是认知灵活性或有选择地在心理过程之间切换的能力的基础。在 ADHD 组中，整个大脑（原始p = 0.0005）和子网络水平（ p < 0.05，FDR 校正）的神经灵活性均显着下降，特别是默认模式网络、注意力相关网络、执行功能 -相关网络和主要网络。此外，与未接受药物治疗的 ADHD 受试者相比，接受药物治疗的 ADHD 受试者表现出显着增加的神经灵活性（ p = 0.025，FDR 校正），并且他们的神经灵活性与 TDC 组没有统计学差异（ p = 0.74，罗斯福修正）。最后，区域神经灵活性能够区分 ADHD 和 TDC（准确度：十倍交叉验证为 77%，独立测试为 74.46%），并能够使用症状严重程度的临床测量来预测 ADHD 严重程度（十倍交叉验证的R ² ：0.2794） ，独立测试为 0.156）。 总之，本研究发现 ADHD 儿童的神经灵活性发生了改变，并证明了神经灵活性在识别 ADHD 儿童以及监测治疗反应和疾病严重程度方面的潜在临床效用。