White matter integrity predicts executive dysfunction in later‐life attention deficit/hyperactivity disorder
Bibliographic record
Abstract
BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is a risk factor for cognitive decline and dementia, in particular vascular and Lewy Body subtypes. The reasons for this are unclear. White matter integrity (WMI) in ADHD is characterized by delayed and deficient tract development compared to healthy controls and predicts reduced cognitive performance. Impaired WMI in ADHD may be a marker of neurobiological vulnerability to subsequent injury from both healthy and degenerative brain aging processes, resulting in increased dementia risk. We investigated the relationship between WMI and cognition in adults with ADHD while accounting for age. METHOD: Adults aged >40 with ADHD were recruited from the community for this cross-sectional observational study. ADHD diagnosis was confirmed through structured clinical interview. All participants completed life history interviews, clinical questionnaires, cognitive testing, and structural neuroimaging that included diffusion-weighted imaging sequences. Whole-brain fractional anisotropy (FA) was calculated as a metric of WMI using tract-based spatial statistics. Cognitive outcomes were mean z-score composites for executive function, processing speed, immediate recall, and delayed recall. The relationships between FA and cognitive performance, covarying for age, were examined using general linear models corrected for multiple comparisons. RESULT: Analyses included 45 participants with ADHD aged 58.5 ± 10.3 years (range: 40-80), 64.4% female, education = 15.2 ± 2.5 years, and 82.2% White. FA was significantly and positively associated with executive function while accounting for age in several white matter tracts throughout the brain. These included the cingulum, anterior thalamic radiations, uncinate fasciculi, corpus callosum, forceps minor, anterior and superior corona radiata, inferior and superior longitudinal fasciculi, and inferior fronto-occipital fasciculi (Figure 1). There were no significant relationships between FA and composites of processing speed, immediate recall, or delayed recall. CONCLUSION: Impaired WMI in diffuse tracts that support executive function in ADHD may contribute to increased risk for cognitive decline and dementias that present with primary executive dysfunction. Future research should examine neurobiological and lifestyle factors that may interact with decreased WMI in ADHD to augment dementia vulnerability. Identification of deficient WMI as a unique contributor to poor cognitive aging in ADHD may lead to targeted preventative interventions for this neurodiverse, high-risk group.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".