Background: This study assessed adolescent brain-behavior relationships between large-scale dynamic functional network connectivity (FNC) and an integrated attention-deficit/hyperactivity disorder (ADHD) phenotype, including measures of inattention, impulsivity/hyperactivity and emotional dysregulation. Despite emotion dysregulation being a core clinical feature of ADHD, studies rarely assess its impact on large-scale FNC.

Methods: We conducted resting-state functional magnetic resonance imaging in 78 adolescents (34 with ADHD) and obtained experimental and self-reported measures of inattention, impulsivity/hyperactivity, and emotional reactivity. We used multivariate analyses to evaluate group differences in dynamic FNC between the default mode, salience and central executive networks, meta-state functional connectivity and ADHD symptomology.

Results: We present two significant group*behavior effects. Compared to controls, adolescents with ADHD had 1) diminished salience network-centered dynamic FNC that was driven by an integrated ADHD phenotype (p < .004, r = 0.57) and 2) more variable patterns of global connectivity, as measured through meta-state analysis, which were driven by heightened emotional reactivity (p < .002, r = 0.63).

Conclusions: Atypical patterns of dynamic FNC in adolescents with ADHD are associated with the affective and cognitive components of ADHD symptomology. Limitations include sample size and self-reported measures of emotional reactivity.