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Parlatini V, Bellato A, Murphy D, Cortese S. From neurons to brain networks, pharmacodynamics of stimulant medication for ADHD. Neurosci Biobehav Rev 2024; 164:105841. [PMID: 39098738 DOI: 10.1016/j.neubiorev.2024.105841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/25/2024] [Accepted: 08/01/2024] [Indexed: 08/06/2024]
Abstract
Stimulants represent the first line pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) and are among the most prescribed psychopharmacological treatments. Their mechanism of action at synaptic level has been extensively studied. However, it is less clear how their mechanism of action determines clinically observed benefits. To help bridge this gap, we provide a comprehensive review of stimulant effects, with an emphasis on nuclear medicine and magnetic resonance imaging (MRI) findings. There is evidence that stimulant-induced modulation of dopamine and norepinephrine neurotransmission optimizes engagement of task-related brain networks, increases perceived saliency, and reduces interference from the default mode network. An acute administration of stimulants may reduce brain alterations observed in untreated individuals in fronto-striato-parieto-cerebellar networks during tasks or at rest. Potential effects of prolonged treatment remain controversial. Overall, neuroimaging has fostered understanding on stimulant mechanism of action. However, studies are often limited by small samples, short or no follow-up, and methodological heterogeneity. Future studies should address age-related and longer-term effects, potential differences among stimulants, and predictors of treatment response.
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Affiliation(s)
- Valeria Parlatini
- School of Psychology, University of Southampton, Southampton, United Kingdom; Centre for Innovation in Mental Health, University of Southampton, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom; Solent NHS Trust, Southampton, United Kingdom.
| | - Alessio Bellato
- School of Psychology, University of Southampton, Southampton, United Kingdom; Centre for Innovation in Mental Health, University of Southampton, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Solent NHS Trust, Southampton, United Kingdom; School of Psychology, University of Nottingham, Semenyih, Malaysia
| | - Declan Murphy
- Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Samuele Cortese
- School of Psychology, University of Southampton, Southampton, United Kingdom; Centre for Innovation in Mental Health, University of Southampton, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Solent NHS Trust, Southampton, United Kingdom; Mind and Neurodevelopment (MiND) Research Group, University of Nottingham, Semenyih, Malaysia; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
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Bakhshi S, Tehrani-Doost M, Batouli SAH. Evaluation of fronto-cerebellar neurometabolites in youth with ADHD compared to the healthy group and their associations with cognitive and behavioral characteristics: A proton magnetic spectroscopy study. Int J Psychophysiol 2022; 182:190-199. [DOI: 10.1016/j.ijpsycho.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
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Emerging findings of glutamate-glutamine imbalance in the medial prefrontal cortex in attention deficit/hyperactivity disorder: systematic review and meta-analysis of spectroscopy studies. Eur Arch Psychiatry Clin Neurosci 2022; 272:1395-1411. [PMID: 35322293 DOI: 10.1007/s00406-022-01397-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/01/2022] [Indexed: 12/11/2022]
Abstract
One of the main challenges in investigating the neurobiology of ADHD is our limited capacity to study its neurochemistry in vivo. Magnetic resonance spectroscopy (MRS) estimates metabolite concentrations within the brain, but approaches and findings have been heterogeneous. To assess differences in brain metabolites between patients with ADHD and healthy controls, we searched 12 databases screening for MRS studies. Studies were divided into 'children and adolescents' and 'adults' and meta-analyses were performed for each brain region with more than five studies. The quality of studies was assessed by the Newcastle-Ottawa Scale. Thirty-three studies met our eligibility criteria, including 874 patients with ADHD. Primary analyses revealed that the right medial frontal area of children with ADHD presented higher concentrations of a composite of glutamate and glutamine (p = 0.02, SMD = 0.53). Glutamate might be implicated in pruning and neurodegenerative processes as an excitotoxin, while glutamine excess might signal a glutamate depletion that could hinder neurotrophic activity. Both neuro metabolites could be implicated in the differential cortical thinning observed in patients with ADHD across all ages. Notably, more homogeneous designs and reporting guidelines are the key factors to determine how suitable MRS is for research and, perhaps, for clinical psychiatry. Results of this meta-analysis provided an overall map of the brain regions evaluated so far, addressed the role of glutamatergic metabolites in the pathophysiology of ADHD, and pointed to new perspectives for consistent use of the tool in the field.
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Pujol-Gualdo N, Sánchez-Mora C, Ramos-Quiroga JA, Ribasés M, Soler Artigas M. Integrating genomics and transcriptomics: Towards deciphering ADHD. Eur Neuropsychopharmacol 2021; 44:1-13. [PMID: 33495110 DOI: 10.1016/j.euroneuro.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/04/2021] [Indexed: 12/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable condition that represents the most common neurodevelopmental disorder in childhood, persisting into adulthood in around 40-65% of the cases. ADHD is characterised by age-inappropriate symptoms of inattention, impulsivity, and hyperactivity. Mounting evidence points towards ADHD having a strong genetic component and the first genome-wide significant findings have recently been reported. However, the functional characterization of variants unravelled by genome-wide association studies (GWAS) is challenging. Likewise, gene expression profiling studies have also been undertaken and novel integrative approaches combining genomic and transcriptomic data are starting to be conducted, which offers an exciting way that might provide a more informative insight towards the genetic architecture of ADHD. In this review, we summarised current knowledge on genomics, transcriptomics and integrative approaches in ADHD, focusing on GWAS and GWAS meta-analyses (GWAS-MA)- as genomics analyses- microarray and RNA-seq- as transcriptomics analyses-, and studies integrating genomics and transcriptomics data. In addition, current strengths and limitations of such approaches are discussed and further research avenues are proposed in order to face unsolved issues. Although important progress has been made, there is still a long way ahead to elucidate the biological mechanisms of ADHD, which eventually may lead to more personalized approaches in the future. Large- scale research efforts and new technological and statistical approaches are envisaged as important means towards deciphering ADHD in the upcoming years.
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Affiliation(s)
- Natàlia Pujol-Gualdo
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain.
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain.
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Sánchez-Mora C, Soler Artigas M, Garcia-Martínez I, Pagerols M, Rovira P, Richarte V, Corrales M, Fadeuilhe C, Padilla N, de la Cruz X, Franke B, Arias-Vásquez A, Casas M, Ramos-Quiroga JA, Ribasés M. Epigenetic signature for attention-deficit/hyperactivity disorder: identification of miR-26b-5p, miR-185-5p, and miR-191-5p as potential biomarkers in peripheral blood mononuclear cells. Neuropsychopharmacology 2019; 44:890-897. [PMID: 30568281 PMCID: PMC6461896 DOI: 10.1038/s41386-018-0297-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/21/2018] [Accepted: 12/07/2018] [Indexed: 01/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood and persists into adulthood in 40-65% of cases. Given the polygenic and heterogeneous architecture of the disorder and the limited overlap between genetic studies, there is a growing interest in epigenetic mechanisms, such as microRNAs, that modulate gene expression and may contribute to the phenotype. We attempted to clarify the role of microRNAs in ADHD at a molecular level through the first genome-wide integrative study of microRNA and mRNA profiles in peripheral blood mononuclear cells of medication-naive individuals with ADHD and healthy controls. We identified 79 microRNAs showing aberrant expression levels in 56 ADHD cases and 69 controls, with three of them, miR-26b-5p, miR-185-5p, and miR-191-5p, being highly predictive for diagnostic status in an independent dataset of 44 ADHD cases and 46 controls. Investigation of downstream microRNA-mediated mechanisms underlying the disorder, which was focused on differentially expressed, experimentally validated target genes of the three highly predictive microRNAs, provided evidence for aberrant myo-inositol signaling in ADHD and indicated an enrichment of genes involved in neurological disease and psychological disorders. Our comprehensive study design reveals novel microRNA-mRNA expression profiles aberrant in ADHD, provides novel insights into microRNA-mediated mechanisms contributing to the disorder, and highlights promising candidate peripheral biomarkers.
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Affiliation(s)
- Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Iris Garcia-Martínez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Mireia Pagerols
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Paula Rovira
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Montse Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Natàlia Padilla
- Research Unit in Clinical and Translational Bioinformatics, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier de la Cruz
- Research Unit in Clinical and Translational Bioinformatics, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alejandro Arias-Vásquez
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Miguel Casas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Josep-Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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Faraone SV. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev 2018; 87:255-270. [PMID: 29428394 DOI: 10.1016/j.neubiorev.2018.02.001] [Citation(s) in RCA: 305] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 12/20/2022]
Abstract
Psychostimulants, including amphetamines and methylphenidate, are first-line pharmacotherapies for individuals with attention-deficit/hyperactivity disorder (ADHD). This review aims to educate physicians regarding differences in pharmacology and mechanisms of action between amphetamine and methylphenidate, thus enhancing physician understanding of psychostimulants and their use in managing individuals with ADHD who may have comorbid psychiatric conditions. A systematic literature review of PubMed was conducted in April 2017, focusing on cellular- and brain system-level effects of amphetamine and methylphenidate. The primary pharmacologic effect of both amphetamine and methylphenidate is to increase central dopamine and norepinephrine activity, which impacts executive and attentional function. Amphetamine actions include dopamine and norepinephrine transporter inhibition, vesicular monoamine transporter 2 (VMAT-2) inhibition, and monoamine oxidase activity inhibition. Methylphenidate actions include dopamine and norepinephrine transporter inhibition, agonist activity at the serotonin type 1A receptor, and redistribution of the VMAT-2. There is also evidence for interactions with glutamate and opioid systems. Clinical implications of these actions in individuals with ADHD with comorbid depression, anxiety, substance use disorder, and sleep disturbances are discussed.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.
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Jiménez-Figueroa G, Ardila-Duarte C, Pineda DA, Acosta-López JE, Cervantes-Henríquez ML, Pineda-Alhucema W, Cervantes-Gutiérrez J, Quintero-Ibarra M, Sánchez-Rojas M, Vélez JI, Puentes-Rozo PJ. Prepotent response inhibition and reaction times in children with attention deficit/hyperactivity disorder from a Caribbean community. ACTA ACUST UNITED AC 2017; 9:199-211. [PMID: 28238028 DOI: 10.1007/s12402-017-0223-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 02/16/2017] [Indexed: 01/19/2023]
Abstract
Impairment in inhibitory control has been postulated as an underlying hallmark of attention deficit/hyperactivity disorder (ADHD), which can be utilized as a quantitative trait for genetic studies. Here, we evaluate whether inhibitory control, measured by simple automatized prepotent response (PR) inhibition variables, is a robust discriminant function for the diagnosis of ADHD in children and can be used as an endophenotype for future genetic studies. One hundred fifty-two school children (30.9% female, 67.8% with ADHD) were recruited. The ADHD checklist was used as the screening tool, whilst the DSM-IV Mini International Neuropsychiatry Interview, neurologic interview and neurologic examination, and the WISC III FSIQ test were administered as the gold standard procedure to assert ADHD diagnosis. A Go/No-Go task using a naturalistic and automatized visual signal was administered. A linear multifactor model (MANOVA) was fitted to compare groups including ADHD status, age, and gender as multiple independent factors. Linear discriminant analysis and the receiver operating characteristic curve were used to assess the predictive performance of PR inhibition variables for ADHD diagnosis. We found that four variables of prepotent response reaction time- and prepotent response inhibition established statistically significant differences between children with and without ADHD. Furthermore, these variables generated a strong discriminant function with a total classification capability of 73, 84% specificity, 68% sensitivity, and 90% positive predictive value for ADHD diagnosis, which support reaction times as a candidate endophenotype that could potentially be used in future ADHD genetic research.
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Affiliation(s)
- Giomar Jiménez-Figueroa
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Carlos Ardila-Duarte
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - David A Pineda
- Neuroscience Research Group, University of Antioquia, Medellín, Colombia
- Neuropsychology and Conduct Research Group, University of Antioquia, Medellín, Colombia
| | - Johan E Acosta-López
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Martha L Cervantes-Henríquez
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Wilmar Pineda-Alhucema
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Jeimys Cervantes-Gutiérrez
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Marisol Quintero-Ibarra
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Manuel Sánchez-Rojas
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia
| | - Jorge I Vélez
- Neuroscience Research Group, University of Antioquia, Medellín, Colombia
- Universidad del Norte, Barranquilla, Colombia
- Genomics and Predictive Medicine Group, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Pedro J Puentes-Rozo
- Grupo de Neurociencias del Caribe, Laboratorio de Neurociencias Cognitivas, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Calle 54 # 59 -189, Sede 1, Bloque C, Barranquilla, Colombia.
- Grupo de Neurociencias del Caribe, Universidad Simón Bolívar-Universidad del Atlántico, Barranquilla, Colombia.
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Bae S, Han DH, Kim SM, Shi X, Renshaw PF. Neurochemical correlates of internet game play in adolescents with attention deficit hyperactivity disorder: A proton magnetic resonance spectroscopy (MRS) study. Psychiatry Res Neuroimaging 2016; 254:10-17. [PMID: 27295400 DOI: 10.1016/j.pscychresns.2016.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/17/2016] [Accepted: 05/26/2016] [Indexed: 01/14/2023]
Abstract
Previous studies have examined the relationship of brain metabolic changes in patients with attention deficit hyperactivity disorder (ADHD) and internet gaming disorder (IGD). However, these studies have been limited by a small number of subjects, a large variance in subject age, and different brain regions of interest. The present study assessed the effects of chronic internet game play in ADHD children. Twenty eight ADHD adolescents with IGD (IGD+ADHD), 27 ADHD adolescents without problematic internet game playing (ADHD only) and 42 healthy comparison adolescents (HC) were included in the study. Magnetic resonance spectroscopy (MRS) was performed on a 3T MRI scanner. Our results indicate that the levels of NAA in both ADHD groups were lower than those observed in the HC group. The levels of Glu+Gln in the ADHD only group were increased, compared to those observed in the control group. However, Glu+Gln was not increased in the IGD+ADHD group. In addition, the levels of Glu+Gln in the IGD+ADHD group were positively correlated with K-ARS total and inattention scores. ADHD and IGD subjects were both characterized by decreased NAA levels within the frontal lobe, consistent with hypofrontality.
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Affiliation(s)
- Sujin Bae
- Industry Academic Cooperation Foundation, Chung Ang University, Seoul, South Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea.
| | - Sun Mi Kim
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea
| | - Xianfeng Shi
- Brain Institute, University of Utah, Salt Lake City, UT, USA
| | - Perry F Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, USA
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Orsini CA, Setlow B, DeJesus M, Galaviz S, Loesch K, Ioerger T, Wallis D. Behavioral and transcriptomic profiling of mice null for Lphn3, a gene implicated in ADHD and addiction. Mol Genet Genomic Med 2016; 4:322-43. [PMID: 27247960 PMCID: PMC4867566 DOI: 10.1002/mgg3.207] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 01/08/2023] Open
Abstract
Background The Latrophilin 3 (LPHN3) gene (recently renamed Adhesion G protein‐coupled receptor L3 (ADGRL3)) has been linked to susceptibility to attention deficit/hyperactivity disorder (ADHD) and vulnerability to addiction. However, its role and function are not well understood as there are no known functional variants. Methods To characterize the function of this little known gene, we phenotyped Lphn3 null mice. We assessed motivation for food reward and working memory via instrumental responding tasks, motor coordination via rotarod, and depressive‐like behavior via forced swim. We also measured neurite outgrowth of primary hippocampal and cortical neuron cultures. Standard blood chemistries and blood counts were performed. Finally, we also evaluated the transcriptome in several brain regions. Results Behaviorally, loss of Lphn3 increases both reward motivation and activity levels. Lphn3 null mice display significantly greater instrumental responding for food than wild‐type mice, particularly under high response ratios, and swim incessantly during a forced swim assay. However, loss of Lphn3 does not interfere with working memory or motor coordination. Primary hippocampal and cortical neuron cultures demonstrate that null neurons display comparatively enhanced neurite outgrowth after 2 and 3 days in vitro. Standard blood chemistry panels reveal that nulls have low serum calcium levels. Finally, analysis of the transcriptome from prefrontal cortical, striatal, and hippocampal tissue at different developmental time points shows that loss of Lphn3 results in genotype‐dependent differential gene expression (DGE), particularly for cell adhesion molecules and calcium signaling proteins. Much of the DGE is attenuated with age, and is consistent with the idea that ADHD is associated with delayed cortical maturation. Conclusions Transcriptome changes likely affect neuron structure and function, leading to behavioral anomalies consistent with both ADHD and addiction phenotypes. The data should further motivate analyses of Lphn3 function in the developmental timing of altered gene expression and calcium signaling, and their effects on neuronal structure/function during development.
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Affiliation(s)
- Caitlin A Orsini
- Department of Psychiatry McKnight Brain Institute University of Florida College of Medicine Gainesville Florida 32610
| | - Barry Setlow
- Department of Psychiatry McKnight Brain Institute University of Florida College of Medicine Gainesville Florida 32610
| | - Michael DeJesus
- Department of Computer Science and Engineering Texas A&M University College Station Texas 77843
| | - Stacy Galaviz
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
| | - Kimberly Loesch
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
| | - Thomas Ioerger
- Department of Computer Science and Engineering Texas A&M University College Station Texas 77843
| | - Deeann Wallis
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
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Ende G, Cackowski S, Van Eijk J, Sack M, Demirakca T, Kleindienst N, Bohus M, Sobanski E, Krause-Utz A, Schmahl C. Impulsivity and Aggression in Female BPD and ADHD Patients: Association with ACC Glutamate and GABA Concentrations. Neuropsychopharmacology 2016; 41:410-8. [PMID: 26040503 PMCID: PMC5130117 DOI: 10.1038/npp.2015.153] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 04/29/2015] [Accepted: 05/15/2015] [Indexed: 11/09/2022]
Abstract
Borderline personality disorder (BPD) and attention-deficit-hyperactivity disorder (ADHD) are both characterized by high impulsivity and difficulties in controlling anger and aggression. In BPD, comorbid ADHD may further increase impulsivity. For both disorders, altered MR spectroscopy levels of the neurotransmitters glutamate and GABA as well as some correlations with impulsivity were previously reported. The objective of this study was to investigate the neurotransmitters glutamate and GABA in relation to impulsivity and aggression as expressed in the anterior cingulate cortex (ACC) in groups of female patients with BPD and ADHD, respectively. Associations of glutamate and GABA levels with further BPD (symptom severity) and ADHD aspects (hyperactivity and inattention) were exploratively evaluated. 1H MR spectra were acquired at 3T to determine glutamate to total creatine ratios (Glu/tCr) and GABA levels from the ACC in a BPD group (n=26), an ADHD group (n=22), and a healthy control (HC) group (n=30); all participants were females. Both patient groups showed higher scores on self-reported impulsivity, anger, and aggression compared with HCs. ACC GABA levels were significantly lower in ADHD than HC. Although measures of impulsivity were positively related to glutamate and negatively to GABA, for aggression only a negative correlation with GABA could be demonstrated. These data provide human in vivo evidence for the role of ACC Glu/tCr and GABA in impulsivity and aggression. If distinct associations of Glu/tCr and GABA for BPD and ADHD can be confirmed in future studies, this might yield implications for more specific pharmacological treatments.
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Affiliation(s)
- Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany,Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, Mannheim D-68159, Germany. Tel: +49 621 1703 2971; Fax: +49 621 1703 702971; E-mail:
| | - Sylvia Cackowski
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Julia Van Eijk
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Markus Sack
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Traute Demirakca
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Nikolaus Kleindienst
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Martin Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Esther Sobanski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Annegret Krause-Utz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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11
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Endres D, Perlov E, Maier S, Feige B, Nickel K, Goll P, Bubl E, Lange T, Glauche V, Graf E, Ebert D, Sobanski E, Philipsen A, Tebartz van Elst L. Normal Neurochemistry in the Prefrontal and Cerebellar Brain of Adults with Attention-Deficit Hyperactivity Disorder. Front Behav Neurosci 2015; 9:242. [PMID: 26441572 PMCID: PMC4585345 DOI: 10.3389/fnbeh.2015.00242] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/24/2015] [Indexed: 01/07/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In an attempt to extend earlier neurochemical findings, we organized a magnetic resonance spectroscopy (MRS) study as part of a large, government-funded, prospective, randomized, multicenter clinical trial comparing the effectiveness of specific psychotherapy with counseling and stimulant treatment with placebo treatment (Comparison of Methylphenidate and Psychotherapy Study). We report the baseline neurochemical data for the anterior cingulate cortex (ACC) and the cerebellum in a case–control setting. For the trial, 1,480 adult patients were contacted for participation, 518 were assessed for eligibility, 433 were randomized, and 187 were potentially eligible for neuroimaging. The control group included 119 healthy volunteers. Single-voxel proton MRS was performed. In the patient group, 113 ACC and 104 cerebellar spectra fulfilled all quality criteria for inclusion in statistical calculations, as did 82 ACC and 78 cerebellar spectra in the control group. We did not find any significant neurometabolic differences between the ADHD and control group in the ACC (Wilks’ lambda test: p = 0.97) or in the cerebellum (p = 0.62). Thus, we were unable to replicate earlier findings in this methodologically sophisticated study. We discuss our findings in the context of a comprehensive review of other MRS studies on ADHD and a somewhat skeptical neuropsychiatric research perspective. As in other neuropsychiatric disorders, the unclear nosological status of ADHD might be an explanation for false-negative findings.
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Affiliation(s)
- Dominique Endres
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Simon Maier
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Bernd Feige
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Peter Goll
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Emanuel Bubl
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Thomas Lange
- Department of Radiology, Medical Physics, University Medical Center Freiburg , Freiburg , Germany ; Freiburg Institute for Advanced Studies, Albert-Ludwigs-University , Freiburg , Germany
| | - Volkmar Glauche
- Department of Neurology, University Medical Center Freiburg , Freiburg , Germany
| | - Erika Graf
- Clinical Trials Unit, University Medical Center Freiburg , Freiburg , Germany
| | - Dieter Ebert
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Esther Sobanski
- Clinic for Psychiatry and Psychotherapy, Central Institute for Mental Health Mannheim , Mannheim , Germany
| | - Alexandra Philipsen
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany
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12
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Malak R, Kostiukow A, Krawczyk-Wasielewska A, Mojs E, Samborski W. Delays in Motor Development in Children with Down Syndrome. Med Sci Monit 2015; 21:1904-10. [PMID: 26132100 PMCID: PMC4500597 DOI: 10.12659/msm.893377] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Children with Down syndrome (DS) present with delays in motor development. The reduced size of the cerebrum, brain maturation disorders, and pathophysiological processes lead to motor development delay. The aim of this study was to examine the gross motor function and estimate what motor abilities are significantly delayed in children with Down syndrome even if they attend physical therapy sessions. Another purpose of the study was to assess the functional balance. Material/Methods The study group consisted of 79 children with DS (42 boys, 37 girls), average age 6 years and 3 months ±4 years and 6 months. Participants were divided into 3 groups according to (i) age: <3 years old, 3–6 years old, and >6 years old; and (ii) motor impairment scale: mild (SNR 1), moderate (SNR 2), and severe (SNR 3). Children were assessed using the Gross Motor Function Measure-88 (GMFM-88) and Pediatric Balance Scale (PBS). Results None of the assessed children developed all the functions included in GMFM-88. The standing position was achieved at the specified age by 10% of children in the first age group (<3 years old) and 95% of children aged 3–6 years. Similarly, the walking ability was performed by 10% of children under 3 years old and by 95% of children aged 3–6 years. The median score of PBS was 50 points (min. 34 p. – max. 56 p.). There was a statistically significant correlation between PBS scores and GMFM-88 scores, r=0.7; p<0.0001, and between balance scores and GMFM – 88 E (walking, running, jumping) (r=0.64; p<0.0001). Conclusions Motor development, especially standing position and walking ability, is delayed in children with Down syndrome. Balance and motor functions are correlated with each other, so both aspects of development should be consider together in physical therapy of children with Down syndrome.
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Affiliation(s)
- Roksana Malak
- Department of Rheumatology and Rehabilitation, Poznań University of Medical Sciences, Poznań, Poland
| | - Anna Kostiukow
- Department of Rheumatology and Rehabilitation, Poznań University of Medical Science, Poznań, Poland
| | | | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, Poznań, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznań University of Medical Science, Poznań, Poland
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Naaijen J, Lythgoe DJ, Amiri H, Buitelaar JK, Glennon JC. Fronto-striatal glutamatergic compounds in compulsive and impulsive syndromes: A review of magnetic resonance spectroscopy studies. Neurosci Biobehav Rev 2015; 52:74-88. [DOI: 10.1016/j.neubiorev.2015.02.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 12/20/2014] [Accepted: 02/13/2015] [Indexed: 11/29/2022]
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Han DH, Lee YS, Shi X, Renshaw PF. Proton magnetic resonance spectroscopy (MRS) in on-line game addiction. J Psychiatr Res 2014; 58:63-8. [PMID: 25088284 PMCID: PMC4681457 DOI: 10.1016/j.jpsychires.2014.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 06/30/2014] [Accepted: 07/03/2014] [Indexed: 12/27/2022]
Abstract
Recent brain imaging studies suggested that both the frontal and temporal cortices are important candidate areas for mediating the symptoms of internet addiction. We hypothesized that deficits of prefrontal and temporal cortical function in patients with on-line game addiction (PGA) would be reflected in decreased levels of N-acetyl aspartate (NAA) and cytosolic, choline containing compound (Cho). Seventy three young PGA and 38 age and sex matched healthy control subjects were recruited in the study. Structural MR and (1)H MRS data were acquired using a 3.0 T MRI scanner. Voxels were sequentially placed in right frontal cortex and right medial temporal cortices. In the right frontal cortex, the levels of NAA in PGA were lower than those in healthy controls. In the medial temporal cortex, the levels of Cho in PGA participants were lower than those observed in healthy controls. The Young Internet Addiction Scale (YIAS) scores and perseverative responses in PGA were negatively correlated with the level of NAA in right frontal cortex. The Beck Depressive Inventory (BDI) scores in the PGA cohort were negatively correlated with Cho levels in the right temporal lobe. To the best of our knowledge, this is the first MRS study of individuals with on-line game addiction. Although, the subjects with on-line game addiction in the current study were free from psychiatric co-morbidity, patients with on-line game addiction appear to share characteristics with ADHD and MDD in terms of neurochemical changes in frontal and temporal cortices.
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Affiliation(s)
- Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Republic of Korea
| | - Young Sik Lee
- Department of Psychiatry, Chung Ang University Hospital, Seoul, Republic of Korea
| | - Xianfeng Shi
- Brain Institute, University of Utah, Salt Lake City, UT, U.S.A
| | - Perry F. Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, U.S.A,Corresponding author. Brain Institute, University of Utah, 383 Colorow Drive, Room 334, Salt Lake City, UT 84108, United States. Tel.: +1 801 587 1216; fax: +1 801 585 5375. (P.F. Renshaw)
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15
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Wiguna T, Guerrero APS, Wibisono S, Sastroasmoro S. The Amygdala's Neurochemical Ratios after 12 Weeks Administration of 20 mg Long-acting Methylphenidate in Children with Attention Deficit and Hyperactivity Disorder: A Pilot Study Using (1)H Magnetic Resonance Spectroscopy. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:137-41. [PMID: 25191504 PMCID: PMC4153860 DOI: 10.9758/cpn.2014.12.2.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 02/05/2014] [Accepted: 03/10/2014] [Indexed: 12/15/2022]
Abstract
Objective Recent pediatric studies have suggested a correlation between decreased amygdala volume and attention deficit and hyperactivity disorder (ADHD) symptoms, including the emotional dysregulation. To investigate the hypothesis that medication treatment of ADHD specifically improves amygdala function, we used 1H magnetic resonance spectroscopy (MRS) to study the effect of 12 weeks of treatment with daily 20 mg long-acting methylphenidate on the Glu/Cr, NAA/Cr, Cho/Cr, and mI/Cr ratios in the amygdala of medication-naïve children with ADHD. Methods This was a prospective study, using a pre- and post-test design, on a single group of 21 children (average age 8.52 years, 17 males and 4 females) diagnosed with ADHD. Low Time Echo MRS scans sampled voxels of interest (1.5×1.5×2.0) from both the right and left amygdala. Results There was significant clinical improvement after 12 weeks of treatment with 20 mg long-acting methylphenidate. On 1H MRS, there were no statistical significant differences of NAA/Cr ratio, Cho/Cr ratio, mI/Cr ratio before and after 12 weeks administration of 20 mg long-acting methylphenidate both in the right and left amygdala. In addition, Glu/Cr ratio decreased 14.1% in the right amygdala (p=0.029) and 11.4% in the left amygdala (p=0.008). Standardized mean effect sizes ranged from 0.14-0.32. Conclusion The findings are consistent with the possibility that hyperglutamatergic processes in the amygdale are related to the hyperactive-impulsive symptoms of ADHD.
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Affiliation(s)
- Tjhin Wiguna
- Child and Adolescent Psychiatry Division, Department of Psychiatry, University of Indonesia, Jakarta, Indonesia. ; Consultation-Lialison Psychiatry Division, Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
| | - Anthony Paul Sison Guerrero
- Departments of Psychiatry and Pediatrics, University of Hawai'i John A. Burns School of Medicine, Honolulu, USA
| | - Sasanto Wibisono
- Consultation-Lialison Psychiatry Division, Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
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Altabella L, Zoratto F, Adriani W, Canese R. MR imaging-detectable metabolic alterations in attention deficit/hyperactivity disorder: from preclinical to clinical studies. AJNR Am J Neuroradiol 2014; 35:S55-63. [PMID: 24481327 DOI: 10.3174/ajnr.a3843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
MR spectroscopy represents one of the most suitable in vivo tool to assess neurochemical dysfunction in several brain disorders, including attention deficit/hyperactivity disorder. This is the most common neuropsychiatric disorder in childhood and adolescence, which persists into adulthood (in approximately 30%-50% of cases). In past years, many studies have applied different MR spectroscopy techniques to investigate the pathogenesis and effect of conventional treatments. In this article, we review the most recent clinical and preclinical MR spectroscopy results on subjects with attention deficit/hyperactivity disorder and animal models, from childhood to adulthood. We found that the most investigated brain regions were the (pre)frontal lobes and striatum, both involved in the frontostriatal circuits and networks that are known to be impaired in this pathology. Neurometabolite alterations were detected in several regions: the NAA, choline, and glutamatergic compounds. The creatine pool was also altered when an absolute quantitative protocol was adopted. In particular, glutamate was increased in children with attention deficit/hyperactivity disorder, and this can apparently be reversed by methylphenidate treatment. The main difficulties in reviewing MR spectroscopy studies were in the nonhomogeneity of the analyzed subjects, the variety of the investigated brain regions, and also the use of different MR spectroscopy techniques. As for possible improvements in future studies, we recommend the use of standardized protocols and the analysis of other brain regions of particular interest for attention deficit hyperactivity disorder, like the hippocampus, limbic structures, thalamus, and cerebellum.
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Affiliation(s)
- L Altabella
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
| | - F Zoratto
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, ItalyBambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy
| | - W Adriani
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
| | - R Canese
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
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Krause B, Márquez-Ruiz J, Cohen Kadosh R. The effect of transcranial direct current stimulation: a role for cortical excitation/inhibition balance? Front Hum Neurosci 2013; 7:602. [PMID: 24068995 PMCID: PMC3781319 DOI: 10.3389/fnhum.2013.00602] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/04/2013] [Indexed: 01/04/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a promising tool for cognitive enhancement and neurorehabilitation in clinical disorders in both cognitive and clinical domains (e.g., chronic pain, tinnitus). Here we suggest the potential role of tDCS in modulating cortical excitation/inhibition (E/I) balance and thereby inducing improvements. We suggest that part of the mechanism of action of tDCS can be explained by non-invasive modulations of the E/I balance.
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Affiliation(s)
- Beatrix Krause
- 1Department of Experimental Psychology, University of Oxford Oxford, Oxfordshire, UK
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Age-related change of neurochemical abnormality in attention-deficit hyperactivity disorder: a meta-analysis. Neurosci Biobehav Rev 2013; 37:1692-701. [PMID: 23735885 DOI: 10.1016/j.neubiorev.2013.04.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/19/2013] [Accepted: 04/30/2013] [Indexed: 12/18/2022]
Abstract
Prevalence and symptoms of attention-deficit hyperactivity disorder (ADHD) change with advancing age. However, neurochemical background of such age-related change is yet to be elucidated. We therefore conducted a meta-analysis of 16 proton magnetic resonance spectroscopy studies comprising 270 individuals with ADHD and 235 controls. Standardized mean differences were calculated and used as an effect size. Sensitivity analyses and meta-regression to explore the effect of age on neurochemical abnormality were performed. A random effects model identified a significantly higher-than-normal N-acetylaspartate (NAA) in the medial prefrontal cortex (mPFC), but no significant differences of other metabolites in that area. No significant difference in metabolite levels was demonstrated in any other region. Sensitivity analysis of children with ADHD revealed significantly higher-than-normal NAA, whereas no significant difference was found in adults with ADHD. Meta-regression revealed significant correlation between advanced age and normal levels of NAA in the mPFC, suggesting that age-dependent abnormality of NAA level in the mPFC is a potential neural basis of age-related change of symptoms of ADHD.
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