The exposome and attention-related brain networks jointly predict attention problems in early adolescence

Background: Attention problems are common transdiagnostic symptoms of psychiatric illness. Although environmental exposures and experiences influence attention during adolescent development, the underlying neural pathways by which they do so is unclear. Methods: We measured attention problems, attention-related brain networks, and multidimensional environmental experiences (the exposome) using data from the ABCD Study (N = 11,878). We tested whether the exposome is associated with 9-10-year-olds attention-related brain network strength and current and future attention problems. We further examined cross-sectional indirect pathways linking the exposome, brain network strength, and attention problems. Results: The exposome predicted youths current and future self-, caregiver-, and teacher-reported attention problems as well as their current attention-related brain network strength. This brain network signature of sustained attention also predicted attention problems from all three reporters. Indirect effects models revealed that the exposome was associated with current reported attention problems both directly and indirectly though this brain signature. Conversely, predictive brain network strength was related to attention problems both directly and indirectly through the exposome. Conclusion: Interactions between environmental exposures, experiences, and brain network organization are associated with attention problems in early adolescence. These findings support a bidirectional framework linking the environment and functional brain networks in the development of attention problems.