{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:14:32Z","timestamp":1789578872941,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82101613"],"award-info":[{"award-number":["82101613"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071537"],"award-info":[{"award-number":["82071537"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is an ongoing debate about the restrictive inattentive (RI) presentation of attention deficit hyperactivity disorder (ADHD). The current study aimed to systematically investigate the clinical, neuropsychological, and brain functional characteristics of children with ADHD restrictive inattentive presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A clinical sample of 789 children with or without ADHD participated in the current study and finished clinical interviews, questionnaires, and neuropsychological tests. Those individuals with a diagnosis of ADHD were further divided into three subgroups according to the presentation of inattentive and\/or hyperactive\/impulsive symptoms, the ADHD-RI, the ADHD-I (inattentive), and the ADHD-C (combined) groups. Between-group comparisons were carried out on each clinical and neuropsychological measure using ANCOVA, with age and sex as covariates. Bonferroni corrections were applied to correct for multiple comparisons. Two hundred twenty-seven of the subjects also went through resting-state functional magnetic resonance imaging scans. Five ADHD-related brain functional networks, including the default mode network (DMN), the dorsal attention network (DAN), the ventral attention network, the executive control network, and the salience network, were built using predefined regions of interest (ROIs). Voxel-based group-wise comparisons were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with healthy controls, all ADHD groups presented more clinical problems and weaker cognitive function. Among the ADHD groups, the ADHD-C group had the most clinical problems, especially delinquent and aggressive behaviors. Regarding cognitive function, the ADHD-RI group displayed the most impaired sustained attention, and the ADHD-C group had the worst response inhibition function. In terms of brain functional connectivity (FC), reduced FC in the DMN was identified in the ADHD-C and the ADHD-I groups but not the ADHD-RI group, compared to the healthy controls. Subjects with ADHD-I also presented decreased FC in the DAN in contrast to the control group. The ADHD-RI displayed marginally significantly lower FC in the salience network compared to the ADHD-I and the control groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ADHD-RI group is distinguishable from the ADHD-I and the ADHD-C groups. It is characterized by fewer externalizing behaviors, worse sustained attention, and better response inhibition function. The absence of abnormally high hyperactive\/impulsive symptoms in ADHD-RI might be related to less impaired brain function in DMN, but potentially more impairment in the salience network.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1099882","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T05:40:12Z","timestamp":1677649212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["The clinical, neuropsychological, and brain functional characteristics of the ADHD restrictive inattentive presentation"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhao-Min","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Lan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Jiu","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin-Rang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S2215-0366(17)30167-0","article-title":"ADHD in children and young people: prevalence, care pathways, and service provision","volume":"5","author":"Sayal","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref2","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1007\/s10802-013-9834-9","article-title":"Changes in ADHD symptom endorsement: preschool to school age","volume":"42","author":"Curchack-Lichtin","year":"2014","journal-title":"J Abnorm Child Psychol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0165120","DOI":"10.1371\/journal.pone.0165120","article-title":"Statistical evidence suggests that inattention drives hyperactivity\/impulsivity in attention deficit-hyperactivity disorder","volume":"11","author":"Sokolova","year":"2016","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10802-013-9771-7","article-title":"The separation of ADHD inattention and hyperactivity-impulsivity symptoms: pathways from genetic effects to cognitive impairments and symptoms","volume":"42","author":"Kuntsi","year":"2014","journal-title":"J Abnorm Child Psychol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"893239","DOI":"10.3389\/fnins.2022.893239","article-title":"Dissociation in neural correlates of hyperactive\/impulsive vs. inattentive symptoms in attention-deficit\/hyperactivity disorder","volume":"16","author":"Luo","year":"2022","journal-title":"Front Neurosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1038\/npp.2016.223","article-title":"White matter microstructural alterations in children with ADHD: categorical and dimensional perspectives","volume":"42","author":"Wu","year":"2017","journal-title":"Neuropsychopharmacology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1017\/S0033291718001599","article-title":"Developmental changes of neuropsychological functioning in individuals with and without childhood ADHD from early adolescence to young adulthood: a 7-year follow-up study","volume":"49","author":"Lin","year":"2019","journal-title":"Psychol Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1093\/cercor\/bhab276","article-title":"Structural brain changes and associated symptoms of ADHD subtypes in children","volume":"32","author":"Mu","year":"2022","journal-title":"Cereb Cortex"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jpsychires.2022.02.012","article-title":"ADHD-inattentive versus ADHD-combined subtypes: a severity continuum or two distinct entities? A comprehensive analysis of clinical, cognitive and neuroimaging data","volume":"149","author":"Wu","year":"2022","journal-title":"J Psychiatr Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1097\/CHI.0b013e31819996ba","article-title":"Simple identification of complex ADHD subtypes using current symptom counts","volume":"48","author":"Volk","year":"2009","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"295","DOI":"10.14744\/hnhj.2019.81557","article-title":"Clinical correlates of restrictive type attention deficit hyperactivity disorder in adolescents","volume":"61","author":"\u00d6zalp Ekinci","year":"2021","journal-title":"Haydarpa\u015fa Numune Med J"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1080\/15374416.2010.517168","article-title":"Cognitive control and attentional selection in adolescents with ADHD versus ADD","volume":"39","author":"Carr","year":"2010","journal-title":"J Clin Child Adolesc Psychol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s00787-015-0731-3","article-title":"Decreasing ADHD phenotypic heterogeneity: searching for neurobiological underpinnings of the restrictive inattentive phenotype","volume":"25","author":"Ercan","year":"2016","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1097\/00004583-199707000-00021","article-title":"Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data","volume":"36","author":"Kaufman","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"ref16","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2000"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1542\/pir.21.8.265","article-title":"The child behavior checklist and related forms for assessing behavioral\/emotional problems and competencies","volume":"21","author":"Achenbach","year":"2000","journal-title":"Pediatr Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1111\/j.1469-7610.2005.01570.x","article-title":"Test-retest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR","volume":"47","author":"Leung","year":"2006","journal-title":"J Child Psychol Psychiatry"},{"key":"ref19","first-page":"1177","article-title":"The revision of WISC-IV Chinese version","volume":"5","author":"Zhang","year":"2009","journal-title":"J Psychol Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1177\/10870547221090662","article-title":"Neuropsychological characteristics of children with attention-deficit\/hyperactivity disorder and sluggish cognitive tempo","volume":"26","author":"Wu","year":"2022","journal-title":"J Atten Disord"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2657","DOI":"10.1007\/s11682-022-00722-w","article-title":"Behavioral and brain functional characteristics of children with attention-deficit\/hyperactivity disorder and anxiety trait","author":"Wu","year":"2022","journal-title":"Brain Imaging Behav"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.neuroimage.2015.02.064","article-title":"ICA-AROMA: a robust ICA-based strategy for removing motion artifacts from fMRI data","volume":"112","author":"Pruim","year":"2015","journal-title":"NeuroImage"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1089\/cap.2018.0169","article-title":"Frontostriatal resting state functional connectivity in resilient and non-resilient adolescents with a family history of alcohol use disorder","volume":"29","author":"Martz","year":"2019","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"636730","DOI":"10.3389\/fpsyt.2021.636730","article-title":"Altered functional connectivity of the salience network in problematic smartphone users","volume":"12","author":"Ahn","year":"2021","journal-title":"Front Psychol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/desc.12359","article-title":"Atypical developmental of dorsal and ventral attention networks in autism","volume":"19","author":"Farrant","year":"2016","journal-title":"Dev Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.neuroimage.2014.01.060","article-title":"Permutation inference for the general linear model","volume":"92","author":"Winkler","year":"2014","journal-title":"NeuroImage"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1111\/jcpp.13556","article-title":"A symptom level perspective on reactive and proactive aggressive behaviours and ADHD symptoms in childhood","volume":"63","author":"Speyer","year":"2022","journal-title":"J Child Psychol Psychiatry"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1177\/1087054715617533","article-title":"Clinical effects of ADHD subtypes in patients with social anxiety disorder","volume":"23","author":"Koyuncu","year":"2019","journal-title":"J Atten Disord"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/07448481.2017.1382499","article-title":"Anxiety and depression among college students with attention-deficit\/hyperactivity disorder (ADHD): cross-informant, sex, and subtype differences","volume":"66","author":"Nelson","year":"2018","journal-title":"J Am Coll Heal"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1080\/15374416.2014.895940","article-title":"ADHD subtype differences in reinforcement sensitivity and Visuospatial working memory","volume":"44","author":"Dovis","year":"2015","journal-title":"J Clin Child Adolesc Psychol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1080\/08039488.2017.1402951","article-title":"The effects of ADHD on cognitive performance","volume":"72","author":"Claesdotter","year":"2018","journal-title":"Nord J Psychiatry"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1177\/1087054712457038","article-title":"How informative is the CANTAB to assess executive functioning in children with ADHD? A controlled study","volume":"19","author":"Fried","year":"2015","journal-title":"J Atten Disord"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1111\/j.1469-7610.2010.02215.x","article-title":"Executive functions as endophenotypes in ADHD: evidence from the Cambridge neuropsychological test battery (CANTAB)","volume":"51","author":"Gau","year":"2010","journal-title":"J Child Psychol Psychiatry"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/j.bpsgos.2021.10.006","article-title":"Task-based functional connectivity in attention-deficit\/hyperactivity disorder: a systematic review","volume":"2","author":"Kowalczyk","year":"2022","journal-title":"Biol Psychiatry Glob Open Sci"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1038\/s41386-022-01408-z","article-title":"Evidence from \"big data\" for the default-mode hypothesis of ADHD: a mega-analysis of multiple large samples","author":"Norman","year":"2022","journal-title":"Neuropsychopharmacology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s00406-015-0630-0","article-title":"Altered intrinsic organisation of brain networks implicated in attentional processes in adult attention-deficit\/hyperactivity disorder: a resting-state study of attention, default mode and salience network connectivity","volume":"266","author":"Sidlauskaite","year":"2016","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1080\/15622975.2020.1775889","article-title":"Resting-state network dysconnectivity in ADHD: a system-neuroscience-based meta-analysis","volume":"21","author":"Sutcubasi","year":"2020","journal-title":"World J Biol Psychiatry"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"859538","DOI":"10.3389\/fnhum.2022.859538","article-title":"Intrinsic functional connectivity in the default mode network differentiates the combined and inattentive attention deficit hyperactivity disorder types","volume":"16","author":"Saad","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12868-020-00589-x","article-title":"Aberrant functional connectivity in resting state networks of ADHD patients revealed by independent component analysis","volume":"21","author":"Zhang","year":"2020","journal-title":"BMC Neurosci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.drugalcdep.2017.11.005","article-title":"Salience network coupling is linked to both tobacco smoking and symptoms of attention deficit hyperactivity disorder (ADHD)","volume":"182","author":"Janes","year":"2018","journal-title":"Drug Alcohol Depend"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2023.1099882\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T05:40:17Z","timestamp":1677649217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2023.1099882\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,1]]},"references-count":40,"alternative-id":["10.3389\/fpsyt.2023.1099882"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2023.1099882","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,1]]},"article-number":"1099882"}}