Abstract
BACKGROUND AND AIMS: Previous studies have identified both auditory attention deficits and functional connectivity abnormalities in auditory brain regions in children with ADHD. However, auditory attention deficits are prevalent in children with Attention Deficit/Hyperactivity Disorder (ADHD), but the underlying neurophysiological mechanisms remain unclear, particularly the direct relationship between auditory attention performance and auditory cortical connectivity, which our study uniquely addresses. This study aimed to investigate the relationship between auditory attention deficits and functional connectivity (FC) in the auditory cortex and other auditory-related regions in children with ADHD. METHODS: We assessed auditory attention in 42 unmedicated children with ADHD and 36 healthy controls (HC) using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), along with clinical symptom ratings and neuropsychological assessments. We then conducted a seed-based functional connectivity analysis, focusing on the auditory cortex and related regions. We analyzed the FC of these regions for correlations with auditory attention levels and clinical symptom scores in ADHD. RESULTS: Compared to HC, children with ADHD performed more poorly on the IVA-CPT, showing decreased FC between the insula, right planum polare, and bilateral cerebellum; between the left Heschl’s gyrus, right insula, and left superior temporal gyrus; and between the planum temporale and the right insula. In contrast, increased FC was observed between the right Heschl’s gyrus and the superior frontal gyrus, and between the bilateral middle frontal gyrus, right supramarginal gyrus, and right planum temporale. CONCLUSIONS: Our results indicate that children with ADHD exhibit significant auditory attention deficits, along with numerous abnormalities in functional connectivity within the auditory cortex and related regions, which are correlated with auditory attention performance. Abnormalities in auditory cortical FC in children with ADHD may underlie auditory attention deficits. These regions could serve as potential therapeutic targets for clinical interventions aimed at ADHD children with auditory attention deficits. CLINICAL TRIAL NUMBER: Not applicable.