A Comprehensive Analysis Comparing Isotropic ADC to BOLD-fMRI: Sensitivity to Resting State Networks and Grey to White Matter Functional Connectivity

Abstract

While Blood Oxygenation Level-Dependent (BOLD) fMRI remains the gold standard for mapping functional brain networks with MRI, its vascular origins inherently conflate haemodynamic effects with neural activity, limiting its sensitivity in white matter (WM) or its interpretation in neurovascular diseases. Apparent Diffusion Coefficient (ADC) fMRI offers an alternative, diffusion-based contrast that is theoretically more sensitive to neuromorphological coupling and therefore more specific to neuronal activation, though investigated primarily during task-based conditions. This study aimed to comprehensively evaluate the efficacy of isotropic ADC-fMRI in detecting established resting-state networks (RSNs) and to extend this methodology to the investigation of grey-to-white matter (GM-WM) functional connectivity. Our analyses revealed a gradient of ADC detectability shaped by the degree of static functional cohesion and structural tethering of each network. The visual and somatomotor networks, being both highly segregated and strongly anchored to underlying structural pathways, yielded the most robust detection. The default mode network (DMN) and dorsal attention network (DAN) reached group-level significance but with lower effect sizes, and their detection proved fragile across analytical approaches. The frontoparietal network (FPN) and salience network (SAN), whose functional identity is defined by dynamic cross-network reconfiguration, did not reach significance. This gradient partially mirrors the established hierarchy of network segregation observed in BOLD, while further suggesting that ADC sensitivity depends on the structural grounding of each network. Furthermore, ADC demonstrated superior sensitivity to GM-WM functional coupling compared to BOLD. GM-WM functional connectivity profiles derived from ADC were significantly more aligned with underlying structural WM architecture across subjects. Taken together, these findings position isotropic ADC-fMRI as a viable complementary modality to BOLD, offering a more direct window into the neural and structural foundations of brain connectivity.