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Functional magnetic resonance imaging of methylphenidate and placebo in attention-deficit/hyperactivity disorder during the multi-source interference task.
- Source :
-
Archives of general psychiatry [Arch Gen Psychiatry] 2008 Jan; Vol. 65 (1), pp. 102-14. - Publication Year :
- 2008
-
Abstract
- Context: Previous studies have reported hypofunction, structural abnormalities, and biochemical abnormalities of the dorsal anterior midcingulate cortex (daMCC) in attention-deficit/hyperactivity disorder (ADHD). Stimulant medications are effective treatments for ADHD, but their neural effects have not been fully characterized.<br />Objective: To determine whether the methylphenidate hydrochloride osmotic-release oral system (OROS) would increase functional magnetic resonance imaging (fMRI) activation, compared with placebo, in the daMCC and other frontoparietal regions subserving attention during the Multi-Source Interference Task (MSIT).<br />Design: Randomized, placebo-controlled, 6-week, before-after fMRI study.<br />Setting: Academic medical center ambulatory clinic.<br />Patients: Twenty-one adults with ADHD randomized to 6 weeks of treatment with methylphenidate OROS (n = 11) or placebo (n = 10).<br />Interventions: Patients underwent fMRI twice while performing the MSIT (scan 1 at baseline and scan 2 at 6 weeks).<br />Main Outcome Measures: Group-averaged, random-effects, repeated-measures, general linear model analyses were used to compare daMCC (and whole-brain) fMRI activation during the MSIT. Individual-based daMCC volume-of-interest confirmatory analyses and behavioral data are also presented.<br />Results: Performance and baseline fMRI measures in the daMCC and other a priori brain regions did not differ between groups. Group comparisons showed a group x scan interaction and t test confirmation of higher activation in the daMCC at 6 weeks in the methylphenidate OROS group than in the placebo group (P < 1 x 10(-4), cluster corrected for multiple comparisons). Individual daMCC volume-of-interest analyses confirmed group-averaged findings and suggested that daMCC activity might be related to clinical response. Methylphenidate OROS also produced higher activation in the dorsolateral prefrontal cortex and the parietal cortex at 6 weeks.<br />Conclusion: Methylphenidate OROS increased daMCC activation during the MSIT and may act, in part, by normalizing daMCC hypofunction in ADHD.
- Subjects :
- Administration, Oral
Adult
Attention Deficit Disorder with Hyperactivity pathology
Central Nervous System Stimulants administration & dosage
Double-Blind Method
Female
Frontal Lobe physiopathology
Humans
Magnetic Resonance Imaging
Male
Methylphenidate administration & dosage
Parietal Lobe physiopathology
Reaction Time
Task Performance and Analysis
Attention Deficit Disorder with Hyperactivity drug therapy
Attention Deficit Disorder with Hyperactivity physiopathology
Central Nervous System Stimulants pharmacology
Frontal Lobe drug effects
Methylphenidate pharmacology
Parietal Lobe drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1538-3636
- Volume :
- 65
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Archives of general psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 18180434
- Full Text :
- https://doi.org/10.1001/archgenpsychiatry.2007.16