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Daood M, Magal N, Peled-Avron L, Nevat M, Ben-Hayun R, Aharon-Peretz J, Tomer R, Admon R. Graph analysis uncovers an opposing impact of methylphenidate on connectivity patterns within default mode network sub-divisions. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2024; 20:15. [PMID: 38902791 PMCID: PMC11191242 DOI: 10.1186/s12993-024-00242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The Default Mode Network (DMN) is a central neural network, with recent evidence indicating that it is composed of functionally distinct sub-networks. Methylphenidate (MPH) administration has been shown before to modulate impulsive behavior, though it is not yet clear whether these effects relate to MPH-induced changes in DMN connectivity. To address this gap, we assessed the impact of MPH administration on functional connectivity patterns within and between distinct DMN sub-networks and tested putative relations to variability in sub-scales of impulsivity. METHODS Fifty-five right-handed healthy adults underwent two resting-state functional MRI (rs-fMRI) scans, following acute administration of either MPH (20 mg) or placebo, via a randomized double-blind placebo-controlled design. Graph modularity analysis was implemented to fractionate the DMN into distinct sub-networks based on the impact of MPH (vs. placebo) on DMN connectivity patterns with other neural networks. RESULTS MPH administration led to an overall decreased DMN connectivity, particularly with the auditory, cinguloopercular, and somatomotor networks, and increased connectivity with the parietomedial network. Graph analysis revealed that the DMN could be fractionated into two distinct sub-networks, with one exhibiting MPH-induced increased connectivity and the other decreased connectivity. Decreased connectivity of the DMN sub-network with the cinguloopercular network following MPH administration was associated with elevated impulsivity and non-planning impulsiveness. CONCLUSION Current findings highlight the intricate effects of MPH administration on DMN rs-fMRI connectivity, uncovering its opposing impact on distinct DMN sub-divisions. MPH-induced dynamics in DMN connectivity patterns with other neural networks may account for some of the effects of MPH administration on impulsive behavior.
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Affiliation(s)
- Maryana Daood
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
- Sakhnin College of Education, Sakhnin, Israel
| | - Noa Magal
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
| | - Leehe Peled-Avron
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Michael Nevat
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
| | - Rachel Ben-Hayun
- Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Judith Aharon-Peretz
- Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Rachel Tomer
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, 31905, Israel.
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
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Harkness K, Bray S, Murias K. The role of stimulant washout status in functional connectivity of default mode and fronto-parietal networks in children with neurodevelopmental conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 146:104691. [PMID: 38340416 DOI: 10.1016/j.ridd.2024.104691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Stimulant medication is the primary pharmacological treatment for attention dysregulation and is commonly prescribed for children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism. Neuroimaging studies of these groups commonly use a 24-48-hour washout period to mediate the effects of stimulant medication on functional connectivity (FC) metrics. However, the impact of washout on functional connectivity has received limited study. METHODS We used fMRI data from participants with diagnosis of Autism and ADHD (and an off stimulant control) from the Adolescent Brain and Cognitive Development (ABCD) and Autism Brain Imaging Data Exchange (ABIDE) databases to explore the effect of simulant washout on FC. Connectivity within and between the default mode (DMN) and fronto-parietal networks (FPN) was examined, as these networks have previously been implicated in attention dysregulation and associated with stimulant medication usage. For each diagnostic group, we assessed effects in interconnectivity between DMN and FPN, intraconnectivity within DMN, and intraconnectivity within FPN. RESULTS We found no significant effect of medication status in intra- and inter-connectivity of the DMN and the FPN in either diagnostic group. IMPLICATIONS Our findings suggest that more information is needed about the effect of stimulant medication, and washout, on the FC of attention networks in clinical populations.
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Affiliation(s)
- Kelsey Harkness
- Department of Graduate Studies, University of Calgary, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Canada; Alberta Children's Hospital Research Institute, Canada.
| | - Signe Bray
- Hotchkiss Brain Institute, Cumming School of Medicine, Canada; Alberta Children's Hospital Research Institute, Canada; Cumming School of Medicine, University of Calgary, Canada
| | - Kara Murias
- Hotchkiss Brain Institute, Cumming School of Medicine, Canada; Alberta Children's Hospital Research Institute, Canada; Cumming School of Medicine, University of Calgary, Canada
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Burns C, Michelogiannakis D, Ahmed ZU, Rossouw PE, Javed F. Influence of psychostimulants on bone mineral density and content among children with attention deficit hyperactivity disorder. A systematic review. Bone 2024; 179:116982. [PMID: 38006907 DOI: 10.1016/j.bone.2023.116982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 11/27/2023]
Abstract
There is a controversy over the influence of psychostimulant medications on bone mineral density (BMD) and bone mineral content (BMC) among children with attention-deficit-hyperactivity-disorder (ADHD). The aim of the present systematic review was to assess the influence of psychostimulant medications on BMD and BMC among children with ADHD. A comprehensive search of electronic databases, including PubMed, Scopus, Embase, and Cochrane Library, was conducted to identify relevant studies published up until July 2023. Clinical studies that addressed the focused question "Do psychostimulant medications affect bone mineral density and content in children with ADHD?" were included. Letters to the Editor, studies on animal-models, ex-vivo and in-vitro studies, commentaries and reviews were excluded. The primary outcome measures were changes in BMD and BMC. Study quality was assessed using the risk of bias for non-randomized studies-exposure tool. Five non-randomized clinical studies were included. The number of participants ranged from 18 to 6489 with mean ages ranging from 7.3 to 13.75 years. The study durations ranged between five and seven years. In all studies osseous evaluation was done using dual-energy X-ray absorptiometry. The bone locations examined included total body, lumbar-spine, femur, femoral-neck, femoral body, and pelvis. Two studies reported that psychostimulant medications reduce BMC and BMD. In one study, bone turnover, serum leptin and fat levels were reduced in children using psychostimulant medications but no unusual reduction recorded among controls. In general, 80 % of the studies concluded that psychostimulant medications compromise BMC and BMD. Power analysis was done in one study. One study had a low RoB and the remaining demonstrated some concerns. Given the methodological concerns observed in the included studies, arriving at a definitive conclusion regarding the effects of psychostimulant medications on BMC, BMD, and bone turnover in children with ADHD is challenging. However, it is important to acknowledge that an association between psychostimulant medications and these bone-related parameters cannot be disregarded.
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Affiliation(s)
- Christopher Burns
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Zain Uddin Ahmed
- Department of Community Dentistry & Oral Disease Prevention, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States.
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Tomasi D, Manza P, Yan W, Shokri-Kojori E, Demiral ŞB, Yonga MV, McPherson K, Biesecker C, Dennis E, Johnson A, Zhang R, Wang GJ, Volkow ND. Examining the role of dopamine in methylphenidate's effects on resting brain function. Proc Natl Acad Sci U S A 2023; 120:e2314596120. [PMID: 38109535 PMCID: PMC10756194 DOI: 10.1073/pnas.2314596120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023] Open
Abstract
The amplitude of low-frequency fluctuations (ALFF) and global functional connectivity density (gFCD) are fMRI (Functional MRI) metrics widely used to assess resting brain function. However, their differential sensitivity to stimulant-induced dopamine (DA) increases, including the rate of DA rise and the relationship between them, have not been investigated. Here we used, simultaneous PET-fMRI to examine the association between dynamic changes in striatal DA and brain activity as assessed by ALFF and gFCD, following placebo, intravenous (IV), or oral methylphenidate (MP) administration, using a within-subject double-blind placebo-controlled design. In putamen, MP significantly reduced D2/3 receptor availability and strongly reduced ALFF and increased gFCD in the brain for IV-MP (Cohen's d > 1.6) but less so for oral-MP (Cohen's d < 0.6). Enhanced gFCD was associated with both the level and the rate of striatal DA increases, whereas decreased ALFF was only associated with the level of DA increases. These findings suggest distinct representations of neurovascular activation with ALFF and gFCD by stimulant-induced DA increases with differential sensitivity to the rate and the level of DA increases. We also observed an inverse association between gFCD and ALFF that was markedly enhanced during IV-MP, which could reflect an increased contribution from MP's vasoactive properties.
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Affiliation(s)
- Dardo Tomasi
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Peter Manza
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Weizheng Yan
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Ehsan Shokri-Kojori
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Şükrü Barış Demiral
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Michele-Vera Yonga
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Katherine McPherson
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Catherine Biesecker
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Evan Dennis
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Allison Johnson
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Rui Zhang
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Gene-Jack Wang
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Nora D. Volkow
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
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Karavallil Achuthan S, Stavrinos D, Argueta P, Vanderburgh C, Holm HB, Kana RK. Thalamic functional connectivity and sensorimotor processing in neurodevelopmental disorders. Front Neurosci 2023; 17:1279909. [PMID: 38161799 PMCID: PMC10755010 DOI: 10.3389/fnins.2023.1279909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/08/2023] [Indexed: 01/03/2024] Open
Abstract
One of the earliest neurobiological findings in autism has been the differences in the thalamocortical pathway connectivity, suggesting the vital role thalamus plays in human experience. The present functional MRI study investigated resting-state functional connectivity of the thalamus in 49 (autistic, ADHD, and neurotypical) young adults. All participants underwent structural MRI and eyes-open resting state functional MRI scans. After preprocessing the imaging data using Conn's connectivity toolbox, a seed-based functional connectivity analysis was conducted using bilateral thalamus as primary seeds. Autistic participants showed stronger thalamic connectivity, relative to ADHD and neurotypical participants, between the right thalamus and right precentral gyrus, right pars opercularis-BA44, right postcentral gyrus, and the right superior parietal lobule (RSPL). Autistic participants also showed significantly increased connectivity between the left thalamus and the right precentral gyrus. Furthermore, regression analyses revealed a significant relationship between autistic traits and left thalamic-precentral connectivity (R2 = 0.1113), as well as between autistic traits and right postcentral gyrus and RSPL connectivity (R2 = 0.1204) in autistic participants compared to ADHD. These findings provide significant insights into the role of thalamus in coordinating neural information processing and its alterations in neurodevelopmental disorders.
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Affiliation(s)
- Smitha Karavallil Achuthan
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Despina Stavrinos
- Department of Psychology and the Institute of Social Science Research, The University of Alabama, Tuscaloosa, AL, United States
| | - Paula Argueta
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Caroline Vanderburgh
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Haley B. Holm
- Children’s Hospital of Atlanta, Atlanta, GA, United States
| | - Rajesh K. Kana
- Department of Psychology and the Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
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Husain SF, Chiang SK, Vasu AA, Goh CP, McIntyre RS, Tang TB, Tran BX, Dang THT, Nguyen TT, Ho RC, Ho CS. Functional Near-Infrared Spectroscopy of English-Speaking Adults With Attention-Deficit/Hyperactivity Disorder During a Verbal Fluency Task. J Atten Disord 2023; 27:1448-1459. [PMID: 37341192 DOI: 10.1177/10870547231180111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE Functional near-infrared spectroscopy (fNIRS) provides direct and quantitative assessment of cortical hemodynamic response. It has been used to identify neurophysiological alterations in medication-naïve adults with attention-deficit/hyperactivity disorder (ADHD). Hence, this study aimed to distinguish both medication-naïve and medicated adults with ADHD from healthy controls (HC). METHOD 75 HCs, 75 medication-naïve, and 45 medicated patients took part in this study. fNIRS signals during a verbal fluency task (VFT) were acquired using a 52-channel system and relative oxy-hemoglobin changes in the prefrontal cortex were quantified. RESULTS Prefrontal cortex hemodynamic response was lower in patients than HCs (p ≤ ≤.001). Medication-naïve and medicated patients did not differ in hemodynamic response or symptom severity (p > .05). fNIRS measurements were not associated with any clinical variables (p > .05). 75.8% patients and 76% HCs were correctly classified using hemodynamic response. CONCLUSION fNIRS may be a potential diagnostic tool for adult ADHD. These findings need to be replicated in larger validation studies.
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Affiliation(s)
| | | | | | | | - Roger S McIntyre
- University Health Network, Toronto, ON, Canada
- University of Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Tong Boon Tang
- University Teknologi PETRONAS, Seri Iskandar, Perak Darul Ridzuan, Malaysia
| | - Bach X Tran
- Hanoi Medical University, Dong Da, Vietnam
- Johns Hopkins University, Baltimore, MD, USA
| | - Trang H T Dang
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Tham T Nguyen
- Duy Tan University, Da Nang, Vietnam
- Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Roger C Ho
- National University of Singapore, Singapore
| | - Cyrus S Ho
- National University of Singapore, Singapore
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Spildrejorde M, Samara A, Sharma A, Leithaug M, Falck M, Modafferi S, Sundaram AY, Acharya G, Nordeng H, Eskeland R, Gervin K, Lyle R. Multi-omics approach reveals dysregulated genes during hESCs neuronal differentiation exposure to paracetamol. iScience 2023; 26:107755. [PMID: 37731623 PMCID: PMC10507163 DOI: 10.1016/j.isci.2023.107755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/30/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
Prenatal paracetamol exposure has been associated with neurodevelopmental outcomes in childhood. Pharmacoepigenetic studies show differences in cord blood DNA methylation between unexposed and paracetamol-exposed neonates, however, causality and impact of long-term prenatal paracetamol exposure on brain development remain unclear. Using a multi-omics approach, we investigated the effects of paracetamol on an in vitro model of early human neurodevelopment. We exposed human embryonic stem cells undergoing neuronal differentiation with paracetamol concentrations corresponding to maternal therapeutic doses. Single-cell RNA-seq and ATAC-seq integration identified paracetamol-induced chromatin opening changes linked to gene expression. Differentially methylated and/or expressed genes were involved in neurotransmission and cell fate determination trajectories. Some genes involved in neuronal injury and development-specific pathways, such as KCNE3, overlapped with differentially methylated genes previously identified in cord blood associated with prenatal paracetamol exposure. Our data suggest that paracetamol may play a causal role in impaired neurodevelopment.
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Affiliation(s)
- Mari Spildrejorde
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Athina Samara
- Division of Clinical Paediatrics, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children′s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ankush Sharma
- Department of Informatics, University of Oslo, Oslo, Norway
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Magnus Leithaug
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Martin Falck
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Stefania Modafferi
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Arvind Y.M. Sundaram
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ganesh Acharya
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Alfred Nobels Allé 8, SE-14152 Stockholm, Sweden
- Center for Fetal Medicine, Karolinska University Hospital, SE-14186 Stockholm, Sweden
| | - Hedvig Nordeng
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Ragnhild Eskeland
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristina Gervin
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
| | - Robert Lyle
- PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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D’Aiello B, Lazzaro G, Battisti A, Pani P, Di Vara S, De Rossi P, Pretelli I, Costanzo F, Vicari S, Menghini D. Methylphenidate is more effective to improve inhibitory control and working memory compared to tDCS in children and adolescents with attention deficit/hyperactivity disorder: a proof-of-concept study. Front Neurosci 2023; 17:1170090. [PMID: 37483344 PMCID: PMC10360130 DOI: 10.3389/fnins.2023.1170090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Attention-deficit/hyperactivity disorder (ADHD) is characterized by an inappropriate, pervasive and persistent pattern of inattention, hyperactivity, and/or impulsivity and associated with substantial functional impairment. Despite considerable advances in the understanding and management of ADHD, some patients do not respond well to methylphenidate (MPH), the first-choice pharmacological treatment. Over the past decades, among non-invasive brain stimulation techniques, transcranial direct current stimulation (tDCS) has proven to be an effective and safe technique to improve behavior and cognition in children with neurodevelopmental disorders, including ADHD, by modifying cortical excitability. However, the effect of tDCS has never been directly compared with that of the MPH. The present randomized sham-controlled trial evaluated the effect of a single session of anodal tDCS compared with the administration of a single dose of MPH in children and adolescents with ADHD. Methods After completing baseline assessment (T0), 26 children and adolescents with ADHD were exposed to 3 conditions with a 24-h interval-sessions: (A) a single session of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC); (B) a single session of sham tDCS over the left DLPFC; (C) a single dose of MPH. Results Our results showed that after administering a single dose of MPH, children and adolescents with ADHD improved inhibitory control and visual-spatial WM compared with baseline, anodal, and sham tDCS. However, a single session of active tDCS over the left DLPFC was not effective compared with either baseline or sham tDCS. Discussion In conclusion, our protocol in ADHD involving a single tDCS session did not demonstrate consistent improvements in neurocognitive features compared with baseline, sham tDCS, or single MPH administration. Different protocols need to be developed to further test the effectiveness of tDCS in improving ADHD symptoms.
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Affiliation(s)
- Barbara D’Aiello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Andrea Battisti
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Pierpaolo Pani
- Department of Physiology and Pharmacology, Sapienza University, Rome, Italy
| | - Silvia Di Vara
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Pietro De Rossi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Italo Pretelli
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Rode J, Runnamo R, Thunberg P, Msghina M. Salience and hedonic experience as predictors of central stimulant treatment response in ADHD - A resting state fMRI study. J Psychiatr Res 2023; 163:378-385. [PMID: 37269772 DOI: 10.1016/j.jpsychires.2023.05.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Roughly 20-30% of patients with Attention-deficit/hyperactivity disorder (ADHD) fail to respond to central stimulant (CS) medication. Genetic, neuroimaging, biochemical and behavioral biomarkers for CS response have been investigated, but currently there are no biomarkers available for clinical use that help identify CS responders and non-responders. METHODS In the present paper, we studied if incentive salience and hedonic experience evaluated after a single-dose CS medication could predict response and non-response to CS medication. We used a bipolar visual analogue 'wanting' and 'liking' scale to gauge incentive salience and hedonic experience in 25 healthy controls (HC) and 29 ADHD patients. HC received 30 mg methylphenidate (MPH) and ADHD patients received either MPH or lisdexamphetamine (LDX) as selected by their clinician, with dosage individually determined for optimal effect. Clinician-evaluated global impression - severity (CGI-S) and improvement (CGI-I) and patient-evaluated improvement (PGI-I) were used to assess response to CS medication. Resting state functional magnetic resonance imaging (fMRI) was conducted before and after single-dose CS to correlate wanting and liking scores to changes in functional connectivity. RESULTS Roughly 20% of the ADHD patients were CS non-responders (5 of 29). CS responders had significantly higher incentive salience and hedonic experience scores compared to healthy controls and CS non-responders. Resting state fMRI showed that wanting scores were significantly associated to changes in functional connectivity in ventral striatum including nucleus accumbens. CONCLUSION Incentive salience and hedonic experience evaluated after a single-dose CS medication segregate CS responders and non-responders, with corresponding neuroimaging biomarkers in the brain reward system.
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Affiliation(s)
- Julia Rode
- Center for Experimental and Biomedical Imaging in Örebro (CEBIO), Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden; Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Rebecka Runnamo
- Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Per Thunberg
- Center for Experimental and Biomedical Imaging in Örebro (CEBIO), Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden; Department for Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Mussie Msghina
- Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institute, 17177, Stockholm, Sweden.
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Henry TR, Fogleman ND, Nugiel T, Cohen JR. Effect of methylphenidate on functional controllability: a preliminary study in medication-naïve children with ADHD. Transl Psychiatry 2022; 12:518. [PMID: 36528602 PMCID: PMC9759578 DOI: 10.1038/s41398-022-02283-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/18/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Methylphenidate (MPH) is the recommended first-line treatment for attention-deficit/hyperactivity disorder (ADHD). While MPH's mechanism of action as a dopamine and noradrenaline transporter blocker is well known, how this translates to ADHD-related symptom mitigation is still unclear. As functional connectivity is reliably altered in ADHD, with recent literature indicating dysfunctional connectivity dynamics as well, one possible mechanism is through altering brain network dynamics. In a double-blind, placebo-controlled MPH crossover trial, 19 medication-naïve children with ADHD underwent two functional MRI scanning sessions (one on MPH and one on placebo) that included a resting state scan and two inhibitory control tasks; 27 typically developing (TD) children completed the same protocol without medication. Network control theory, which quantifies how brain activity reacts to system inputs based on underlying connectivity, was used to assess differences in average and modal functional controllability during rest and both tasks between TD children and children with ADHD (on and off MPH) and between children with ADHD on and off MPH. Children with ADHD on placebo exhibited higher average controllability and lower modal controllability of attention, reward, and somatomotor networks than TD children. Children with ADHD on MPH were statistically indistinguishable from TD children on almost all controllability metrics. These findings suggest that MPH may stabilize functional network dynamics in children with ADHD, both reducing reactivity of brain organization and making it easier to achieve brain states necessary for cognitively demanding tasks.
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Affiliation(s)
- Teague R Henry
- Department of Psychology and School of Data Science, University of Virginia, Charlottesville, VA, USA.
| | - Nicholas D Fogleman
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tehila Nugiel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica R Cohen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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