CoChat
Sign Up
Cited by 130Attention Deficit Hyperactivity DisorderFunctional Brain Connectivity StudiesNeural and Behavioral Psychology Studies

Characterizing heterogeneity in children with and without ADHD based on reward system connectivity

Open access
Costa Dias, Taciana G., Iyer, Swathi P., Carpenter, Samuel D., Cary, Robert P., Wilson, Vanessa B., Mitchell, Suzanne H., Nigg, Joel T., Fair, Damien A.·2015·Developmental Cognitive Neuroscience
DOI 10.1016/j.dcn.2014.12.005PMC PMC4373624
Open this paper in CoChat — free account

Abstract

One potential obstacle limiting our ability to clarify ADHD etiology is the heterogeneity within the disorder, as well as in typical samples. In this study, we utilized a community detection approach on 106 children with and without ADHD (aged 7-12 years), in order to identify potential subgroups of participants based on the connectivity of the reward system. Children with ADHD were compared to typically developing children within each identified community, aiming to find the community-specific ADHD characteristics. Furthermore, to assess how the organization in subgroups relates to behavior, we evaluated delay-discounting gradient and impulsivity-related temperament traits within each community. We found that discrete subgroups were identified that characterized distinct connectivity profiles in the reward system. Importantly, which connections were atypical in ADHD relative to the control children were specific to the community membership. Our findings showed that children with ADHD and typically developing children could be classified into distinct subgroups according to brain functional connectivity. Results also suggested that the differentiation in "functional" subgroups is related to specific behavioral characteristics, in this case impulsivity. Thus, combining neuroimaging data and community detection might be a valuable approach to elucidate heterogeneity in ADHD etiology and examine ADHD neurobiology.

AI snapshot

Written from the paper’s full text.

TL;DR

Using resting-state functional connectivity of the left nucleus accumbens and community detection, this study identified three subgroups among 106 children with and without ADHD. Atypical reward-system connectivity in ADHD was subgroup-specific, and only one subgroup showed atypical delay discounting and activity level.

Key findings

  • Community detection on reward-region connectivity organized the sample into three subgroups: A (n = 33), B (n = 47), and C (n = 26); each subgroup contained both children with ADHD and controls. Whole-sample ADHD vs. control comparisons showed weaker positive NAcc connectivity to anterior PFC, middle temporal gyrus, and PCC, weaker negative connectivity to dorsolateral PFC, inferior parietal lobule, and occipital lobe, stronger positive connectivity to left OFC, and stronger negative connectivity to thalamus.
  • ADHD-related atypical connections differed by subgroup: subgroup A primarily involved the default network; subgroup B involved cingulo-opercular, default, and fronto-parietal networks; subgroup C most prominently involved the cingulo-opercular network.
  • Only subgroup A showed atypical delay discounting: ln(k) differed between ADHD and controls (p = 0.005; p = 0.008 after controlling for age), with ADHD-A more impulsive. ADHD subgroups differed by ANOVA (F(2,33) = 4.091, p = 0.026), and ADHD-A had greater ln(k) than ADHD-B (p = 0.028); subgroups B and C did not differ on ln(k) (p = 0.386 and p = 0.546).
  • Activity level was significantly higher in ADHD than controls only in subgroup A (p = 0.002); ADHD subgroups showed a trend for activity level (F(3,38) = 3.152, p = 0.054). Impulsivity, inhibitory control, and activation control differed between ADHD and controls in every subgroup.

Methods

  • The study included 106 children aged 7–12 years (63 controls, 42 with ADHD, 1 with subthreshold ADHD). Diagnosis used a best-estimate procedure with K-SADS-E and parent/teacher rating scales. Delay discounting was analyzed in 90 participants (54 controls, 36 ADHD); TMCQ subscales measured impulsivity-related temperament.
  • Resting-state fMRI was acquired on a 3.0 T scanner. The reward ROI was the left nucleus accumbens (Talairach coordinates −9 +7 −6), defined via a NeuroSynth reverse inference map for “reward.” Voxelwise functional connectivity maps were used to build a 106 × 106 subject correlation matrix; community detection was applied at a reachability threshold of r = 0.52, with variation of information used to assess robustness.
  • Within each subgroup, ADHD and control connectivity maps were compared using two-sample t-tests with Monte Carlo correction (Z > 2.25, p < 0.05, 53 contiguous voxels). Findings were mapped onto brain networks defined by community detection in a separate sample of 32 adults.

Limitations

  • The paper states that functional connectivity cannot reveal whether connections are excitatory or inhibitory; negative correlations are controversial because they become evident after global signal regression and may partly reflect statistical artifact. It also notes that subgroup sample sizes were small after community detection, and that only one objective impulsivity task (delay discounting) was used, so additional delay or impulsivity tasks are needed.
  • Evident from the text: the design is cross-sectional, so it cannot test whether community organization is stable over time or relates to long-term outcomes. Subgroup analyses also have limited power, as the authors note for matched subgroup B, where some differences weakened after matching.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.dcn.2014.12.005

Cites

Statistics

5 tests recomputed · 1 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 91 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    We identified three subgroups of children with and without ADHD.

    “We identified three subgroups of children with and without ADHD.”
    Quote in the paperSubstantial claim
  • Findingown data

    The brain communities identified in the adult sample corresponded to known brain networks.

    “The brain communities identified corresponded to known brain networks (brain communities found in this analysis will be referred to as “brain networks” henceforth).”
    Quote in the paperSubstantial claim
  • Findingnone given

    Atypical connections in ADHD were specific to subgroup membership.

    “Atypical connections in ADHD were specific to subgroup membership.”
    Quote in the paperSubstantial claim
  • Findingown data

    In both groups the reward region (left NAcc) was strongly functionally connected to the medial prefrontal cortex (PFC; medial frontal gyrus) and temporal lobe bilaterally (middle temporal gyrus).

    “We found that in both groups the reward region (left NAcc) was strongly functionally connected to the medial prefrontal cortex (PFC; medial frontal gyrus) and temporal lobe bilaterally (middle temporal gyrus).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In subgroup B, children with ADHD displayed atypical reward connectivity to inferior parietal lobule bilaterally, caudate, ACC, right middle temporal gyrus, and superior frontal gyrus.

    “Within subgroup B, ADHD children displayed atypical connectivity to the inferior parietal lobule bilaterally, caudate, ACC, right middle temporal gyrus, and superior frontal gyrus (Fig. 5).”
    Quote in the paperSubstantial claim
  • May combine two claims. 47
  • Classified as probably not a substantial claim. 49

  • May combine two claims.

    Findingown data

    In the ADHD group, four communities were found (Q=0.34; A1 n=4, A2 n=5, B n=18, C n=16); original subgroup A split into A1 and A2, and only eight subjects switched subgroups.

    “In the ADHD group, the results yielded four communities (Q = 0.34; A1: n = 4/A2: n = 5/B: n = 18/C: n = 16). Participants from the original subgroup A split up into two communities (A1 and A2). Only eight subjects switched subgroups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the typically developing group, three communities were found (Q=0.39; A n=24, B n=28, C n=11), with only nine participants switching communities relative to whole-sample organization.

    “In the typically developing group, we found three communities (Q = 0.39; A: n = 24/B: n = 28/C: n = 11); only nine participants switched communities, comparing to the whole-sample community organization.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In children with ADHD compared to controls, reward region connectivity was stronger positive to left OFC and stronger negative to thalamus.

    “On the other hand, the ADHD group displayed stronger positive connectivity to left orbito-frontal cortex (OFC; inferior frontal gyrus) and stronger negative connectivity to the thalamus (Fig. 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In children with ADHD compared to controls, reward region connectivity was weaker for positive connections to anterior PFC, middle temporal gyrus, and PCC, and for negative connections to dorso-lateral PFC, inferior parietal lobule bilaterally, and occipital lobe bilaterally.

    “When comparing controls vs. children with ADHD, we found the following connections from the reward region were weaker in ADHD: positive connections to anterior PFC (medial frontal gyrus and superior frontal gyrus), middle temporal gyrus, posterior cingulate cortex (PCC); and negative connections to dorso-lateral PFC (middle frontal gyrus), inferior parietal lobule bilaterally and occipital lobe (L”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    ln(k) was correlated with age (R = −0.258, p = 0.014), but in this sample it was not correlated with IQ (R = −0.113, p = 0.29) or movement (mean FD of remaining frames [R = 0.028, p = 0.79]).

    “We tested whether ln(k) was correlated with other variables and found that it was correlated with age (R = −0.258, p = 0.014), but in this sample it was not correlated with IQ (R = −0.113, p = 0.29) or movement (mean FD of remaining frames [R = 0.028, p = 0.79]).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Within each subgroup, ADHD children differed significantly from controls in impulsivity, inhibitory control, and activation control; only in subgroup A did ADHD children differ from controls in activity level (p=0.002), with ADHD-A higher than controls-A.

    “When comparing children with ADHD to controls within each subgroup, ADHD children were significantly different from controls in impulsivity, inhibitory control, and activation control scores in every subgroups, but only ADHD children from subgroup A were significantly different from controls in activity level scores (two-tailed, unequal variances, p = 0.002), with ADHD-A displaying significantly”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Ln(k) differed significantly between ADHD subgroups (F(2,33)=4.091, p=0.026), but not between control subgroups (F(2,51)=3.161, p=0.051).

    “There were also significant differences between subgroups of ADHD children as determined by one-way ANOVA (F(2,33) = 4.091, p = 0.026), but differences between subgroups of controls were not significant (F(2,51) = 3.161, p = 0.051).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    ADHD children from each subgroup had atypical connections in different networks: subgroup A primarily in default network; subgroup B in cingulo-opercular, default, and fronto-parietal networks; subgroup C in several networks, most prominently cingulo-opercular.

    “The ADHD children from each subgroup had atypical connections in different networks. ADHD children in subgroup A showed atypical connections primarily in the default network. In subgroup B atypical connections were identified in the cingulo-opercular, default and fronto-parietal networks. Finally, in subgroup C, ADHD children showed atypical connections to several networks, but most prominently, t”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The pattern and strength of NAcc connectivity to the default system and/or task control systems varied according to community assignment in both children with and without ADHD, being distinct for each neurotype.

    “Importantly, the distinct relationships of connectivity to the default system and/or the task control systems varied according to the community assignment in both children with and without ADHD. In other words the pattern and strength of NAcc connectivity to each of these systems were distinct for each neurotype.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    After controlling for age, a trend-level difference in ln(k) was identified (F(1,87)=3.812, p=0.054), with ADHD more impulsive than controls.

    “After controlling for age a trend level difference was identified (F(1,87) = 3.812, p = 0.054), and was consistent with prior reports (Sagvolden et al., 1998, Wilson et al., 2011), with ADHD more impulsive than controls.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Sagvolden et al., 1998 source

      Not checked in the free run.

    • cites Wilson et al., 2011 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    TMCQ measures of impulsivity, inhibitory control, and activation control differed significantly between controls and ADHD (p<0.001 for all three), as did activity level (p=0.001).

    “The temperament measures of impulsivity, inhibitory control, and activation control were significantly different between controls and ADHD (Table 1; two-tailed, unequal variances, p < 0.001 for the three subscales), and so was activity level (two-tailed, equal variances, p = 0.001).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The networks connected to NAcc included control systems (fronto-parietal, cingulo-opercular), attention systems (dorsal attention, temporal-occipital/ventral attention), the default network, and motor network.

    “These networks included control systems (fronto-parietal, cingulo-opercular networks), attention systems (dorsal attention, temporal-occipital/ventral attention networks), the default network, and motor network.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Discrete subgroups were identified in the ADHD population that characterized distinct reward connectivity profiles, as with the typically developing population.

    “Here, we found that, as with the typically developing population, discrete subgroups were identified that characterized distinct reward connectivity profiles.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Nineteen communities corresponding to known brain systems were identified in a sample of typical adults.

    “Nineteen communities (or networks), which corresponded to known brain systems, were identified in a sample of typical adults (Supplementary Material, Figure S.1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After matching, differences in middle temporal gyrus and caudate became weaker and did not survive Monte Carlo correction.

    “The differences in the middle temporal gyrus and in the caudate became weaker after matching the groups, and did not remain after Monte Carlo correction.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Atypical connections between NAcc and control/attention networks were evident in the three subgroups, but involved networks and regions were specific to each subgroup.

    “Atypical connections between NAcc and control/attention networks were also evident in the three subgroups, but involved networks and regions were, again, specific to each subgroup.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • May combine two claims.

    Findingown data

    Behaviorally, only one of the neurotypes (subgroup A) showed atypical delay discounting and atypical activity level scores.

    “Just as importantly, behaviorally, only one of these neurotypes showed atypical delay discounting and atypical activity level scores.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Nine of the nineteen networks had voxels overlapping with the comparison maps: cingulo-opercular, default, temporal-occipital/ventral attention, dorsal attention, motor, fronto-parietal, temporal pole/posterior OFC, ventral attention, and lateral occipital and fusiform/visual 2.

    “Of these networks, nine had voxels overlapping with the comparison maps, which included the cingulo-opercular, default, temporal-occipital/ventral attention, dorsal attention, motor, fronto-parietal, temporal pole/posterior OFC, ventral attention, and lateral occipital and fusiform/visual 2.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Comparing ADHD subgroups, there was a trend for activity level (F(3,38)=3.152, p=0.054), with ADHD-A displaying higher activity levels than other ADHD subgroups.

    “There was also a trend toward significance when comparing ADHD subgroups only for activity level scores (F(3,38) = 3.152, p = 0.054); the ADHD-A subgroup displayed higher activity levels compared to the other ADHD subgroups (Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Within subgroups B and C, ln(k) did not differ significantly between control and ADHD children (p=0.386 and p=0.546, respectively).

    “Within the other subgroups (B and C), ln(k) was not significantly different between control and ADHD children (p = 0.386, p = 0.546, respectively; two-tailed, equal variances/B: n[ADHD] = 14, n[controls] = 25; C: n[ADHD] = 14, n[controls] = 10) (Table 1 and Fig. 8).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Findingnone given

    The same systems involved in decision-making highlighted in this prior work are identified here.

    “Indeed the same systems involved in decision-making highlighted in this prior work are identified here.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • May combine two claims.

    Findingown data

    In subgroup A, the NAcc was also connected to regions of the attention networks (dorsal attention and temporal-occipital/ventral attention), to the motor region and to a visual network (lateral occipital and fusiform).

    “In subgroup A, the NAcc was also connected to regions of the attention networks (dorsal attention and temporal-occipital/ventral attention, to the motor region and to a visual network (lateral occipital and fusiform).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • May combine two claims.

    Findingown data

    Children with ADHD within subgroup A displayed specifically atypical connections between the NAcc and regions of the attention networks: stronger negative connectivity with ventral attention network and weaker negative connectivity with dorsal attention network.

    “Children with ADHD within subgroup A displayed specifically atypical connections between the NAcc and regions of the attention networks: stronger negative connectivity with ventral attention network and weaker negative connectivity with dorsal attention network.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • May combine two claims.

    Findingown data

    ANOVA between the three ADHD groups confirmed the differences in delay discounting, with ADHD-A significantly more impulsive than ADHD-B.

    “ANOVA between the three ADHD groups confirmed the differences in delay discounting, with ADHD-A significantly more impulsive than ADHD-B (Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Even within the same DSM ADHD subtype, variations in clinical presentation are remarkable, and variations in etiology and pathophysiology are expected.

    “however, even within the same subtype, variations in clinical presentation are remarkable, and variations in etiology and pathophysiology are expected (Fair et al., 2012, Karalunas et al., 2015, Nigg et al., 2005).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Karalunas et al., 2015

      Not checked in the free run.

    • cites Nigg et al., 2005

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Impairment in reward processing is hypothesized as one core dysfunction in ADHD.

    “Impairment in reward processing is hypothesized as one core dysfunction in ADHD (Nigg, 2005, Sonuga-Barke, 2005).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Nigg, 2005

      Not checked in the free run.

    • cites Sonuga-Barke, 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    In order to verify robustness of the community structure, we examined variation of information (VOI).

    “In order to verify robustness of the community structure, we examined variation of information (VOI).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In summary, 90 participants (54 controls, 36 children with ADHD) were included in the analysis of delay discounting.

    “In summary, 90 participants (54 controls, 36 children with ADHD) were included in the analysis of delay discounting.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Those regions have been described as part of a network responsible for cognitive and attention processes.

    “Those regions have been described as part of a network responsible for cognitive and attention processes (Dosenbach et al., 2007, Fox et al., 2005) (Fig. 2).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Dosenbach et al., 2007 source

      Not checked in the free run.

    • cites Fox et al., 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The failure to find communities in whole-brain data may be because including too much information introduced noise and decreased the chance of identifying communities.

    “This finding may be due to the inclusion of too much information, which introduced noise to the data, and thus decreased the chance of identifying communities.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Data from 11 participants had to be excluded because of negative k values or unsystematic data.

    “Data from 11 participants had to be excluded because of two exclusion criteria: (a) negative k values, which makes it impossible to perform the log-transformations and (b) data deemed unsystematic (i.e. the data pattern indicated the action of processes other than reward/delay evaluation), which was identified as described by Johnson and Bickel (2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Johnson and Bickel, 2008

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The process was repeated 20 times and was also applied on a random network with equivalent degree.

    “The process was repeated 20 times and was also applied on a random network with equivalent degree.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Most networks have well defined internal structures and can be described or demarcated with graph theoretical analyses.

    “Importantly, most networks have well defined internal structures and can be described or demarcated with graph theoretical analyses (Boccaletti et al., 2006).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Boccaletti et al., 2006 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The ADHD and control groups differed significantly in gender distribution and age; a matched analysis by age and gender (n=42 each) yielded very similar results.

    “Because the ADHD and the control groups differed significantly in gender distribution and age, we performed the same analysis on ADHD and control groups matched by age and gender (ADHD: n = 42; controls: n = 42). The results were very similar and are displayed in the Supplementary Material, Figure S.2.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Gates et al. (2014) utilized simulated imaging data and empirical resting-state functional connectivity of the fronto-parietal network to validate the use of community detection in identifying subgroups.

    “Gates et al. (2014) utilized simulated imaging data, along with empirical resting-state functional connectivity of the fronto-parietal network to validate the use of community detection in identifying subgroups.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gates et al., 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Those regions are part of the default network, a network implicated with self-referential processes, such as daydreaming, past recollection and future planning.

    “Those regions are part of the default network, a network implicated with self-referential processes, such as daydreaming, past recollection and future planning (Buckner et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Buckner et al., 2008 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    ADHD and controls within subgroup B differed in age; matched analysis (n=17 each) yielded very similar results.

    “Because ADHD and controls within subgroup B significantly differed in age, we performed the same analysis on ADHD and control groups matched by age (ADHD: n = 17; controls: n = 17). The results were very similar and are displayed in the Supplementary Material, Figure S.4.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Three recent reports from the authors' team have highlighted the use of community detection as a way to characterize heterogeneity in ADHD.

    “Three recent reports from our team have highlighted the use of community detection as a way to characterize heterogeneity in ADHD (Fair et al., 2012, Gates et al., 2014, Karalunas et al., 2015).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Gates et al., 2014 source

      Not checked in the free run.

    • cites Karalunas et al., 2015

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Findings from these studies suggest that identifying mechanistic subpopulations across ADHD and typically developing children may inform heterogeneity and the clinical course of a given child.

    “Findings from these studies suggest that identifying mechanistic subpopulations across ADHD and typically developing children may inform heterogeneity and the clinical course of a given child.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Gates et al., 2014 source

      Not checked in the free run.

    • cites Karalunas et al., 2015

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    An imbalance of these interactions results in impaired inhibitory control and, subsequently, a "Go" (instead of a normative "Stop") response.

    “An imbalance of these interactions results in impaired inhibitory control and, subsequently, a “Go” (instead of a normative “Stop”) response.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    There are multiple pathways (atypical connections) that can lead to the same atypical phenotype (GO response).

    “The first principle suggests that there are multiple pathways (i.e. atypical connections) that can lead to the same atypical phenotype (i.e. GO response).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The identified communities had a quality index Q=0.38 and robust assignment stability, making them highly unlikely to be random.

    “The quality index (Q = 0.38) and a secondary analysis utilizing variation of information (Supplementary Material, Figure S.3) showed that the communities identified were highly unlikely to be random, by demonstrating robust community assignment stability.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Normative behavior can be equally heterogeneous; as long as balance is maintained in the system, multiple normative profiles may exist within a typically developing group or atypically developing group.

    “The second principle the model highlights is that normative behavior can be equally heterogeneous. In other words, as long as balance is maintained in the system, multiple normative profiles may exist within a typically developing group or atypically developing group.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The delay-discounting task measures impulsive choice by evaluating intolerance to delay-of-gratification, or delay discounting, proposed to be a core dysfunction of ADHD.

    “The task measures impulsive choice by evaluating the intolerance to delay-of-gratification, or delay discounting, proposed to be a core dysfunction of ADHD (Sagvolden et al., 1998, Sonuga-Barke, 2005).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Sagvolden et al., 1998 source

      Not checked in the free run.

    • cites Sonuga-Barke, 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The best-estimate diagnostic team's agreement on ADHD/non-ADHD status was acceptable (k > 0.85 for all diagnoses occurring at base rate > 5% in the sample, including ADHD and ADHD subtype).

    “Their agreement on ADHD/non-ADHD status was acceptable (k > 0.85 for all diagnoses occurring at base rate > 5% in the sample, including ADHD and ADHD subtype).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Both addiction and ADHD have been strongly associated with dysfunction in ascending dopaminergic systems that relate to reward response.

    “It readily applies to ADHD because children with ADHD are at elevated risk of addiction, and both addiction and ADHD have been strongly associated with dysfunction in ascending dopaminergic systems that relate to reward response (Volkow et al., 2009, Volkow et al., 2011a, Volkow et al., 2011b).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Volkow et al., 2009 source

      Not checked in the free run.

    • cites Volkow et al., 2011a

      Not checked in the free run.

    • cites Volkow et al., 2011b

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Fair and colleagues found that both children with ADHD and typically developing children could be classified into unique, but similar neuropsychological profiles, and children with ADHD from each profile showed atypical scores in very specific neuropsychological measures.

    “The study found that both groups (children with ADHD and typically developing children) could be classified into unique, but similar neuropsychological profiles. Furthermore, children with ADHD from each profile showed atypical scores in very specific neuropsychological measures.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    These preprocessing steps aim to reduce spurious variance unlikely to reflect neuronal activity.

    “These preprocessing steps aim to reduce spurious variance unlikely to reflect neuronal activity (Fox and Raichle, 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fox and Raichle, 2007 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Karalunas et al. (2015) found that the sample was organized into communities, which were associated with specific patterns of physiological response, brain connectivity of the amygdala, and long-term outcomes.

    “The study found that the sample was organized into communities, which were associated with specific patterns of physiological response, brain connectivity of the amygdala, and, most importantly, long-term outcomes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Karalunas et al., 2015

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    ADHD subgroups and control subgroups did not differ in ADHD-RS scores, age, IQ, mean FD, or comorbid diagnosis; ADHD subgroups also did not differ in stimulant use or ADHD subtype.

    “ADHD subgroups and control subgroups did not differ in ADHD-RS scores, age, IQ, movement (mean FD), and presence of comorbid diagnosis. ADHD subgroups also did not differ in stimulant use and ADHD subtype (or presentation).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The positive connection between default network and reward system is consistent with the default system's role in assigning value to future rewards, future planning, and goal setting.

    “This relationship is consistent with work highlighting the default system's role in assigning value to future rewards, future planning and goal setting (Buckner et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Buckner et al., 2008 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Variation across several neuropsychological measures does not always shape across a continuous dimension (unimodal distribution), but rather some behavioral features form multiple discrete subgroups (multimodal distribution).

    “For example, in a recent work, we showed that variation across several neuropsychological measures does not always shape across a continuous dimension (i.e. unimodal distribution), but rather some behavioral features form multiple discrete subgroups (i.e. multimodal distribution) (Fair et al., 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The finding that NAcc connectivity patterns vary by neurotype is similar in theme to previous reports.

    “This particular finding is similar in theme to that of previous reports (Fair et al., 2012, Gates et al., 2014).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Gates et al., 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    In typically developing and disorder populations, reward system connections may diverge between individuals, but if the system remains balanced, behavior would be typical.

    “Relating this model to the current cohort would suggest that in typically developing populations, as well as in disorder populations, the connections of the reward system may diverge from one individual to another; however, if the system remained in balance, the result would be typical (as opposed to atypical) behavior.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    The NAcc is functionally connected to several networks.

    “The NAcc is functionally connected to several networks.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Several possible connection combinations may unbalance the system and result in atypical behavior.

    “Several possible connection combinations may unbalance the system and result in atypical behavior.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The model asserts that balanced interaction between all systems is necessary for adequate inhibitory control and decision-making.

    “The model asserts that a balanced interaction between all of the systems is necessary for adequate inhibitory control and decision-making (see Fig. 1).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Task-control and attention networks are important for providing task-level control and inhibiting inappropriate behaviors.

    “These systems are important for providing task level control and inhibiting inappropriate behaviors (Corbetta and Shulman, 2002, Dosenbach et al., 2008).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Corbetta and Shulman, 2002 source

      Not checked in the free run.

    • cites Dosenbach et al., 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Volkow and colleagues proposed a model of how interaction of cortical and sub-cortical systems with NAcc might inform addictive behaviors.

    “Volkow and colleagues have recently proposed a model of how the interaction of cortical and sub-cortical systems with the NAcc might inform addictive behaviors (Volkow et al., 2011a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Some connections may be atypical but still result in adapted behavior if balance is maintained.

    “Some connections may be atypical, but still result in adapted behavior, as long as the balance is maintained.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The data highlight variation not only in ADHD but also in typically developing children.

    “These data highlight not only variation in ADHD, but in typically developing children as well (Fair et al., 2012, Gates et al., 2014).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Gates et al., 2014 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The model suggests that balanced interaction of reward system with other networks is essential for adaptive decision-making, and impulsivity results from imbalance.

    “This model suggests that a balanced interaction of the reward system with other brain networks is essential for adaptive (i.e. not impulsive) decision-making. On the other hand, impulsivity (and other associated behaviors) would be a result of an unbalance of those connections (Volkow et al., 2011a).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Volkow et al., 2011a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    The negative and positive connections have to be balanced to provide adapted behavior.

    “The negative and positive connections have to be balanced in order to provide adapted behavior (i.e. not impulsive).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The findings highlight the importance of characterizing heterogeneity when attributing dysfunction to children with ADHD.

    “These findings further highlight the importance of characterizing heterogeneity when attributing dysfunction to children with ADHD.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The absence of these regions after correction may be due to reduced power from matching.

    “However, these findings are visible in the uncorrected comparison maps, suggesting the absence of these regions may be due to power, since sample size reduced after matching.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Unique behavioral phenotypes may exist between these ADHD groups.

    “Importantly, as each of these systems is likely to underlie unique control processes, it is possible that unique behavioral phenotypes may exist between these ADHD groups.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prior reports show NAcc connectivity to several brain networks either positively or negatively.

    “The current report builds on prior reports showing NAcc connectivity to several brain networks either positively or negatively (see Fig. 2 and Costa Dias et al., 2012, Cservenka et al., 2014, Tomasi and Volkow, 2012).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Costa Dias et al., 2012

      Not checked in the free run.

    • cites Cservenka et al., 2014 source

      Not checked in the free run.

    • cites Tomasi and Volkow, 2012

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The data support and add to multifactorial models of ADHD heterogeneity.

    “Our data support and add to these theories in several ways.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Different tasks that evaluate impulsivity and delay processing may be related to unique brain processing mechanisms.

    “Different tasks that evaluate impulsivity and delay processing may be related to unique brain processing mechanisms.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Systems that are positively correlated may be interpreted as integrated systems, while the ones negatively correlated may be highly segregated.

    “Previous studies suggest systems that are positively correlated may be interpreted as integrated systems, while the ones negatively correlated may be highly segregated (Castellanos et al., 2008, Fox et al., 2005, Fox et al., 2009).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Castellanos et al., 2008 source

      Not checked in the free run.

    • cites Fox et al., 2005 source

      Not checked in the free run.

    • cites Fox et al., 2009 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Negative connections provide biologically plausible and relevant information.

    “Studies have shown that they provide biologically plausible and relevant information (Fox et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fox et al., 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    We do not interpret the functional connectivity data as revealing information about excitatory or inhibitory synapses.

    “While we use the addiction model here as a heuristic for our data, we do not interpret the functional connectivity data as revealing information about excitatory or inhibitory synapses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Improved correspondence of functional connectivity to secondary measures occurs after the use of global regression.

    “Other work in animal models highlights the improved correspondence of functional connectivity to secondary measures (e.g. viral tracings of axonal tracts) after the use of global regression (Miranda-Dominguez et al., 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miranda-Dominguez et al., 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    Negative connections in functional data may be purely a statistical artifact.

    “The interpretation of negative correlations is especially controversial because they only become strongly evident after regressing out the global signal; therefore some argue that negative connections in functional data may be purely a statistical artifact (Murphy et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Murphy et al., 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There are several other measures of impulsive decision-making, including delay aversion tasks or other methods of evaluating discounting of delayed rewards.

    “There are several other measures of impulsive decision-making, including delay aversion tasks or other methods of evaluating discounting of delayed rewards (Bitsakou et al., 2006, Knutson et al., 2001, Muller et al., 2006, Rachlin et al., 1991).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Bitsakou et al., 2006 source

      Not checked in the free run.

    • cites Knutson et al., 2001 source

      Not checked in the free run.

    • cites Muller et al., 2006 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Atypical discounting of delayed rewards and atypical activity level may be a result of an unbalanced connectivity of the reward system, which in this case was specific to a subset of individuals (subgroup A).

    “On the other hand our findings suggest that atypical discounting of delayed rewards and atypical activity level may be a result of an unbalanced connectivity of the reward system, which in this case was specific to a subset of individuals (subgroup A).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The unbalance of the system potentially relates to impulsive behavior - as measured by delay discounting - and higher activity level.

    “The unbalance of the system potentially relates to impulsive behavior – as measured by delay discounting – and higher activity level.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The findings are presented as an illustrative framework and do not exclude the potential for the ADHD subjects in subgroups B and C to be impulsive in unique ways, measured via different instruments.

    “While we were able to complement this task with temperament traits related to impulsivity and hyperactivity, our findings are presented as an illustrative framework and do not exclude the potential for the ADHD subjects in subgroups B and C to be impulsive in unique ways, measured via different instruments.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    In subgroup A, impulsive decision-making - as measured by the delay-discounting task - and activity level traits share similar neurobiological underpinnings.

    “It is possible that, in subgroup A, impulsive decision-making – as measured by the delay- discounting task – and activity level traits share similar neurobiological underpinnings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Attention networks likely support the involvement of moment-to-moment control and shifts of attention related to reward processing and decision-making.

    “These attention networks likely support the involvement of moment-to-moment control and shifts of attention related to reward processing and decision-making (Dosenbach et al., 2008), findings consistent with the extant literature on ADHD (Tomasi and Volkow, 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Dosenbach et al., 2008 source

      Not checked in the free run.

    • cites Tomasi and Volkow, 2012

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Control networks are important for moment-to-moment task level control, maintenance of task sets, as well as inhibitory control - processes likely important for the regulation of reward processing.

    “These control networks are important for moment-to-moment task level control, maintenance of task sets (Dosenbach et al., 2008), as well as inhibitory control (Dosenbach et al., 2007, Dosenbach et al., 2008) – processes likely important for the regulation of reward processing.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Dosenbach et al., 2008 source

      Not checked in the free run.

    • cites Dosenbach et al., 2007 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Our findings support that combining graph theory with neuroimaging data may represent a valuable approach for classifying children with ADHD and typical development; for informing ADHD heterogeneity; and for investigating ADHD neurobiology.

    “Our findings support that combining graph theory with neuroimaging data may represent a valuable approach for classifying children with ADHD and typical development; for informing ADHD heterogeneity; and for investigating ADHD neurobiology.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.
    • Rests on an assumption: A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    In our model one cannot know whether a connection is excitatory or inhibitory.

    “In our model one cannot know whether a connection is excitatory or inhibitory.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Similar methods have been used to assess behavioral and temperamental variation in ADHD and typically developing populations.

    “Similar methods have been used to assess behavioral and temperamental variation in ADHD and typically developing populations (Fair et al., 2012, Gates et al., 2014, Karalunas et al., 2015).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Fair et al., 2012 source

      Not checked in the free run.

    • cites Gates et al., 2014 source

      Not checked in the free run.

    • cites Karalunas et al., 2015

      Not checked in the free run.

84 of 84

  • The paper relies on this without support.

    Heterogeneity within ADHD must be properly characterized to understand its neurobiological underpinnings and etiology.

    “Our understanding of the neurobiological underpinnings and etiology of ADHD will likely be limited without the proper characterization of the heterogeneity within the disorder.”

  • The paper relies on this without support.

    The TMCQ subscales of impulsivity, inhibitory control, and activity level overlap with DSM-IV and DSM-5 symptom criteria.

    “Items on the impulsivity, inhibitory control, and activity level TMCQ subscales overlap with DSM-IV and DSM-5 symptom criteria; therefore differences between controls and ADHD are expected for these temperament traits.”

  • The paper relies on this without support.

    The sample of typical adults used to define the nineteen networks is representative of typical brain network organization.

    “Nineteen communities (or networks), which corresponded to known brain systems, were identified in a sample of typical adults (Supplementary Material, Figure S.1).”

  • The paper relies on this without support.

    The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.

    “The brain is organized into systems (or networks), whose patterns of interaction (within and between systems) underlie behavioral traits.”

  • The paper relies on this without support.

    A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.

    “A core system involved in ADHD is the reward system, which interacts with other brain networks to promote decision-making.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • ADHD is a heterogeneous disorder, with heterogeneity in multifactorial etiological risk factors, symptom expressions, comorbid disorders, neuropsychological impairments, and long-term trajectories.

    “Previous studies have repeatedly emphasized that ADHD is a heterogeneous disorder, in terms of the multifactorial etiological risk factors, diverse expressions of the symptom domains, comorbid disorders, neuropsychological impairments, and long-term trajectories (Castellanos et al., 2006; Costa Dias et al., 2015).”

    From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Costa Dias et al., 2015

    The Introduction describes variation in ADHD presentation and expected variation in etiology; the Discussion describes multifactorial models and differences in neuropsychological deficits. The Introduction also mentions comorbid disorders and poor long-term outcomes, but the paper does not establish heterogeneity in comorbid disorders or long-term trajectories. Its Conclusions call for future research on long-term outcomes. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Schizophrenia, ADHD, Autism, and potentially other DSM-defined disorders each constitute a highly heterogeneous set of etiologies.

    “The first challenge is the ever-expanding evidence that Schizophrenia (Meda et al., 2014; Satterthwaite and Baker, 2015), ADHD (Costa Dias et al., 2015; Fair et al., 2012a; Gates et al., 2014; Karalunas et al., 2014), Autism (Jeste and Geschwind, 2014; Rudie et al., 2012), and potentially other DSM defined disorders, each constitutes a highly heterogeneous set of etiologies.”

    From Development of large-scale functional networks from birth to adulthood: A guide to the neuroimaging literature (2017) · cites this paper as Costa Dias et al., 2015

  • Recent evidence has emerged for neurobiological subgroups of ADHD based on network connectivity of the reward system and other large-scale brain networks.

    “Recent evidence has also emerged for neurobiological subgroups of ADHD based on network connectivity of the reward system (Costa Dias et al., 2015) and other large-scale brain networks (Gates et al., 2014).”

    From Investigating functional brain network integrity using a traditional and novel categorical scheme for neurodevelopmental disorders (2019) · cites this paper as Costa Dias et al., 2015

  • ADHD subtyping using resting-state functional connectivity MRI and ADHD symptoms revealed similar subtypes within ADHD and typical samples, associated with impulsive characteristics, independent of diagnosis.

    “Specifically, the in- vestigators found that similar subtypes existed within ADHD and typical samples and were associated with impulsive characteristics, independent of diagnosis.”

    From Methods and challenges for assessing heterogeneity (2020) · cites this paper as [31]

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value across alpha = .05: F(3,38) = 3.152, p = .054

    Major

    The paper reports p = .054 here; recomputing from the test statistic and its degrees of freedom gives p = .036. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .054 · recomputed p = .036

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(3, 38) = 3.152reported p = .054 · recomputed p = .036The two fall on opposite sides of .05

    “F(3,38) = 3.152, p = .054”

  • Consistentz > 2.25reported p < .05 · recomputed p = .024

    “(Z > 2.25, p < .05”

  • ConsistentF(1, 87) = 3.812reported p = .054 · recomputed p = .054

    “F(1,87) = 3.812, p = .054”

  • ConsistentF(2, 33) = 4.091reported p = .026 · recomputed p = .026

    “F(2,33) = 4.091, p = .026”

  • ConsistentF(2, 51) = 3.161reported p = .051 · recomputed p = .051

    “F(2,51) = 3.161, p = .051”

5 of 5

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • ADHD subgroups are said not to differ in age despite a significant table result

    Minor

    Table 2 reports an age difference among the ADHD subgroups (p < 0.001), contradicting the statement that they did not differ in age.

  • Activity-level ANOVA degrees of freedom imply four ADHD subgroups

    Minor

    The activity-level comparison is described as comparing the three ADHD subgroups, but its reported numerator degrees of freedom are 3. A one-way ANOVA across three groups has 2 numerator degrees of freedom.

2 of 2

The citation lists haven’t been fetched yet

References 71 · Cited by 130

Research works printed but not linked: 4

  1. Buckner, 2008, The brain's default network: anatomy, function, and relevance to disease, Ann. N.Y. Acad. Sci., 1124, 1, 10.1196/annals.1440.011 · DOI · Paper page
  2. Karalunas, 2015, Toward biologically-based nosology: ADHD subtyping using temperament dimensions, Arch. Gen. Psychiatry
  3. Newman, 2003, 45, 167
  4. Walhovd, 2012, Pediatric imaging, neurocognition, and genetics study, long-term influence of normal variation in neonatal characteristics on human brain development, Proc. Natl. Acad. Sci. U. S. A., 109, 20089, 10.1073/pnas.1208180109 · DOI · Paper page

Authors
Costa Dias, T. G., Iyer, S. P., Carpenter, S. D., Cary, R. P., Wilson, V. B., Mitchell, S. H., Nigg, J. T., & Fair, D. A.
Affiliations
  • Brigham and Women's Hospital (US)
  • Oregon Health & Science University (US)
Corresponding author
Fair, Damien A.
ORCID
Venue
Developmental Cognitive Neuroscience
Publisher
Elsevier BV
Published
2015-02
Volume
11
Pages
155-174
ISSN
1878-9293 (ISSN-L)
DOI
10.1016/j.dcn.2014.12.005
PMC
PMC4373624
OpenAlex
W2093918468
Semantic Scholar
54a5c7c0110c68a457d0780d8cb6b620f1bc76d7
Cited by
130
References
71
Citations by year
2026: 3 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 11 · 2021: 9 · 2020: 22 · 2019: 20 · 2018: 14 · 2017: 15 · 2016: 9 · 2015: 5
FWCI
11.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Developmental Cognitive Neuroscience (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Oregon Health and Science University
  • National Institutes of Health (5r01mh099064-05)
  • National Institute of Mental Health (R01-MH099064, K99/R00 MH091238, K99MH091238, R00MH091238, R01MH096773, R01MH086654)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
attention deficit hyperactivity disorder, heterogeneity, reward systems, functional connectivity, community detection, children, delay discounting, impulsivity, temperament, subgroup classification, ADHD etiology, neurobiology of ADHD
MeSH terms
Attention Deficit Disorder with Hyperactivity, Brain, Child, Female, Humans, Impulsive Behavior, Male, Nerve Net, Reward, Temperament, Neuroimaging

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review