Functional reorganization of brain activity in children with attention-deficit/hyperactivity disorder: Evidence from the modulatory effect of cognitive demand during visuospatial attention task

Previous studies reported that the inferior parietal lobule (IPL) had lower activation during visuospatial attention in children with attention-deficit/hyperactivity disorder (ADHD), while the functional connectivity (FC) between the IPL and other brain regions and how cognitive demand might modulate IPL's FC remain unclear. We performed a functional magnetic resonance imaging experiment recruiting two task conditions with relatively low and high cognitive demand of visuospatial attention. Forty-four children with ADHD and 36 age- and sexmatched healthy controls were included. IPL's regional activation and FC intensities were compared between groups and correlated with clinical measurements. We found that the IPL had significantly reduced activation in children with ADHD compared to healthy controls and this abnormal activation was not modulated by the cognitive demand of visuospatial attention. Importantly, further analysis revealed that the functional connectivity between IPL and inferior frontal gyrus was modulated by the cognitive demand of visuospatial attention in children with ADHD. These results revealed a modulatory effect of cognitive demand of visuospatial attention on IPL's functional connectivity but not IPL's activation in children with ADHD. More generally, these results highlight the functional reorganization of the brain activity as a possible compensatory strategy in response to the symptoms of ADHD.