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ORIGINAL RESEARCH article

Front. Hum. Neurosci.

Sec. Brain Health and Clinical Neuroscience

Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1612997

This article is part of the Research TopicPsychiatric Comorbidities of Neurogenetic and Neurodegenerative DiseasesView all articles

Impaired Glymphatic System Function and Its Association with Speech and Language Delay in Children with ADHD: A Prospective Study

Provisionally accepted
Yangchen LiYangchen Li1,2Jianhong WangJianhong Wang3,4Xinyu YuanXinyu Yuan2Lili ZhangLili Zhang4Yuchun YanYuchun Yan2Lin WangLin Wang4*Yang YangYang Yang5*
  • 1China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
  • 2Radiology, CAPITAL CENTER FOR CHILDREN'S HEALTH，CAPITAL MEDICAL UNIVERSITY, Beijing, China
  • 3Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing Municipality, China
  • 4Center of Children’s Healthcare, CAPITAL CENTER FOR CHILDREN'S HEALTH，CAPITAL MEDICAL UNIVERSITY, Beijing, China
  • 5Department of Medical Engineering, CAPITAL CENTER FOR CHILDREN'S HEALTH，CAPITAL MEDICAL UNIVERSITY, Beijing, China

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Objective: The glymphatic system, a glial cell-dependent waste clearance pathway in the brain, is essential for the maintenance of brain homeostasis. This study aimed to explore the relationship between attention-deficit/hyperactivity disorder (ADHD) and its co-occurring clinical phenomena, including gross motor and language development, and the glymphatic system. Methods: A total of 56 children with ADHD and 33 age-and gender-matched typically developing (TD) children were included in this prospective study. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) was used to calculate the ALPS index, which evaluates glymphatic system function. The ALPS index of ADHD patients was compared with that of TD, and the correlation between the gross motor retardation and speech and language delay in ADHD patients and ALPS index was further analyzed.Results: The ALPS index in ADHD patients was significantly lower than that in TD children (1.503±0.153 vs 1.591±0.152, p < 0.05). After adjusting for age and sex, the ALPS index was negatively correlated with speech and language delay in ADHD patients (r=-0.329, p=0.015). However, no significant correlation was found between the ALPS index and gross motor retardation in ADHD patients. Conclusion: Glymphatic system function may be impaired in ADHD patients. This study is the first to demonstrate that speech and language delay in ADHD patients may be associated with impaired glymphatic system function. Early intervention may be linked to better language trajectories in ADHD, providing a rationale for longitudinal trials to test causality.

Keywords: ADHD, Glymphatic System Function, Speech and language delay, DTI-ALPS, Comorbidity

Received: 16 Apr 2025; Accepted: 29 Jul 2025.

Copyright: © 2025 Li, Wang, Yuan, Zhang, Yan, Wang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Lin Wang, Center of Children’s Healthcare, CAPITAL CENTER FOR CHILDREN'S HEALTH，CAPITAL MEDICAL UNIVERSITY, Beijing, China
Yang Yang, Department of Medical Engineering, CAPITAL CENTER FOR CHILDREN'S HEALTH，CAPITAL MEDICAL UNIVERSITY, Beijing, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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