# Stanford Medicine-led study of 3,508 children identifies three brain biotypes in ADHD and anxiety

- Published: 2026-11-13 04:48 UTC
- Section: Life & Health › Neurotechnology
- Tags: ADHD brain biotypes, anxiety in children, Stanford Medicine study, functional connectivity fMRI, Adolescent Brain Cognitive Development, DeCoDE framework, transdiagnostic dimensions, Healthy Brain Network, Nature Mental Health
- URL: https://realtech.media/news/rt-6c7a1534ca05b25f7c1c731d_stanford_medicine_led/

**An observational analysis of fMRI connectivity and behavioral data in children aged 9–11 outlined three biotypes spanning ADHD and anxiety, detectable before symptom onset.**

![Stanford Medicine-led study of 3,508 children identifies three brain biotypes in ADHD and anxiety](https://realtech.media/media/2026/11/71dcf85c3d43c1bf.png)
*nature.com*

A study led by Stanford Medicine, with the University of Iowa, identified three brain biotypes in children with attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders. The work, reported on nature.com in Nature Mental Health, analyzed 3,508 children aged 9–11 from the Adolescent Brain Cognitive Development (ABCD) study [1]. It is an observational cohort analysis, not a clinical trial.

ADHD and anxiety disorders are common in youth and often co-occur. The authors note that heterogeneity within and across these disorders limits neurobiological specificity and complicates treatment selection [1]. Diagnoses rely on symptom checklists, and children with one condition often show symptoms of the other, according to co-senior author Yu Zhang.

## Method and brain–behavior dimensions

The authors developed a computational framework, DeCoDE, that combines clinically salient functional connectivity from fMRI with cognitive and behavioral measures [1]. Its code is publicly available on GitHub, while the ABCD participant-level data are controlled-access.

The model revealed two reproducible brain–behavior dimensions. One reflects cognitive control, the other emotion–attention regulation [1].

## Three biotypes and their generalization

These dimensions yielded three biotypes: externalizing–disinhibited, internalizing–distressed and mixed dysregulation. According to the authors, they differ in symptom profiles, network organization and brain development [1].

The biotypes generalized to 224 age-matched participants of the Healthy Brain Network. They were also detectable before symptom onset, which the authors interpret as preclinical expression [1].

The biotypes do not map one-to-one onto diagnoses. Children with ADHD, anxiety or a mix of both can have any of the three, although certain biotypes are more common in each diagnosis, Zhang said.

The authors say the findings support using brain–behavior dimensions to parse transdiagnostic heterogeneity and to motivate early risk stratification and mechanism-informed intervention in youth mental health [1]. The research team also said the biotypes could aid early diagnosis and help match patients to treatments. These are stated prospects; the study did not test any intervention.

## Sources

1. [nature.com](https://www.nature.com/articles/s44220-026-00740-3)
2. [EurekAlert](https://www.eurekalert.org/news-releases/1151369)

---

Source: RealTech, realtech.media — https://realtech.media/news/rt-6c7a1534ca05b25f7c1c731d_stanford_medicine_led/