Connectomic disturbances in ADHD: A meta-analysis of global and nodal topology

Emerging evidence indicates that the neuropathology of attention-deficit/hyperactivity disorder (ADHD) extends beyond localized anomalies, and graph theoretical approaches provide interpretable indices for characterizing network-level organization. However, reported alterations of topological measures in ADHD remain inconsistent across studies, underscoring the need for a quantitative synthesis. We conducted a systematic search and identified 31 eligible datasets, including 14 structural network studies (459 ADHD individuals; 460 controls) and 17 functional network studies (975 ADHD individuals; 1287 controls). A random-effects meta-analysis was performed to examine global topological patterns, and nodal signatures were explored using coordinate-based neuroimaging meta-analysis. Individuals with ADHD demonstrated significantly reduced global efficiency (Hedge’s g = -0.31; p = .010) in structural networks, whereas functional networks did not display significant global alterations. No nodal findings survived multiple-comparison correction; however, exploratory analyses at an uncorrected threshold suggested centrality alterations in key regions, including the caudate (Z = -3.60) and putamen (Z = -3.11) in structural networks, and the caudate (Z = 3.50), orbitofrontal cortex (Z = -3.41), and precuneus (Z = -3.58) in functional networks. Together, reduced structural global efficiency suggests compromised capacity for brain-wide information integration in ADHD, while these spatially convergent nodal patterns may reflect altered network centrality. This configuration aligns with atypical network development in ADHD, and points to the involvement of regions linked to cognitive control and internally oriented processing.