Enhanced ADHD classification through deep learning and dynamic resting state fMRI analysis

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by deficits in attention, hyperactivity, and/or impulsivity. Resting-state functional connectivity analysis has emerged as a promising approach for ADHD classification using resting-state functional magnetic resonance imaging (rs-fMRI), although with limited accuracy. Recent studies have highlighted dynamic changes in functional connectivity patterns among ADHD children. In this study, we introduce Skip-Vote-Net, a novel deep learning-based network designed for classifying ADHD from typically developing children (TDC) by leveraging dynamic connectivity analysis on rs-fMRI data collected from 222 participants included in the NYU dataset within the ADHD-200 database. Initially, for each subject, functional connectivity matrices were constructed from overlapping segments using Pearson's correlation between mean time series of 116 regions of interest defined by the Automated Anatomical Labeling (AAL) 116 atlas. Skip-Vote-Net was then developed, employing a majority voting mechanism to classify ADHD/TDC children, as well as distinguishing between the two main subtypes: the inattentive subtype (ADHD_I) and the predominantly combined subtype (ADHD_C). The proposed method was evaluated across four classification scenarios: (1) two-class classification of ADHD from TD children using balanced data, (2) two-class classification between ADHD and TD children using unbalanced data, (3) two-class classification between ADHD_I and ADHD_C, and (4) three-class classification among ADHD_I, ADHD_C, and TD children. Using Skip-Vote-Net, we achieved mean classification accuracies of 97% ± 1.87 and 97.7% ± 2.2 for the balanced and unbalanced classification cases, respectively. Furthermore, the mean classification accuracy for discriminating between ADHD_I and ADHD_C reached 99.4% ± 1.21. Finally, the proposed method demonstrated an average accuracy of 98.86% ± 1.03 in classifying ADHD_I, ADHD_C, and TD children collectively. Our findings highlight the superior performance of Skip-Vote-Net over existing methods in the classification of ADHD, showcasing its potential as an effective diagnostic tool for identifying ADHD subtypes and distinguishing ADHD from typically developing children.