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Hilz EN, Schnurer C, Bhamidipati S, Deka J, Thompson LM, Gore AC. Cognitive effects of early life exposure to PCBs: Sex-specific behavioral, hormonal and neuromolecular mechanisms involving the brain dopamine system. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.13.612971. [PMID: 39314290 PMCID: PMC11419158 DOI: 10.1101/2024.09.13.612971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Endocrine-disrupting chemicals (EDCs) are environmental toxicants that disrupt hormonal and neurodevelopmental processes. Among these chemicals, polychlorinated biphenyls (PCBs) are particularly concerning due to their resistance to biodegradation and tendency to bioaccumulate. PCBs affect neurodevelopmental function and disrupt the brain's dopamine (DA) system, which is crucial for attentional, affective, and reward processing. These disruptions may contribute to the rising prevalence of DA-mediated neuropsychiatric disorders such as ADHD, depression, and substance use disorders. Notably, these behaviors are sexually dimorphic, in part due to differences in sex hormones and their receptors, which are targets of estrogenic PCBs. Therefore, this study determined effects of early life PCB exposure on behaviors and neurochemistry related to potential disruption of dopaminergic signaling. Male and female Sprague Dawley rats were exposed to PCBs or vehicle perinatally and then underwent a series of behavioral tests, including the sucrose preference test to measure affect, conditioned orienting to assess incentive-motivational phenotype, and attentional set-shifting to evaluate cognitive flexibility and response latency. Following these tests, rats were euthanized, and we measured serum estradiol (E2), midbrain DA cells, and gene expression in the midbrain. Female rats exposed perinatally to A1221 exhibited decreased sucrose preference, and both male and female A1221 rats had reduced response latency in the attentional set-shifting task compared to vehicle counterparts. Conditioned orienting, serum estradiol (E2), and midbrain DA cell numbers were not affected in either sex; however, A1221-exposed male rats displayed higher expression of estrogen receptor alpha ( Esr1 ) in the midbrain and non-significant effects on other DA-signaling genes. Additionally, E2 uniquely predicted behavioral outcomes and DAergic cell numbers in A1221-exposed female rats, whereas DA signaling genes were predictive of behavioral outcomes in males. These data highlight sex-specific effects of A1221 on neuromolecular and behavioral phenotypes.
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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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3
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Palmini A. Attention-deficit/hyperactivity disorder (ADHD) in adults: a multilayered approach to a serious disorder of inattention to the future. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-12. [PMID: 39357854 DOI: 10.1055/s-0044-1791513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) affects people of all ages, yet its presentation varies as the person matures and social demands increase from childhood into adulthood. Interestingly, when analyzing the disorder in adults, it is not immediately clear what the 'attention deficit' in the ADHD denomination exactly means. Adults with ADHD have a broad range of difficulties, far beyond an attentional deficit, that impact negatively their social functioning and often lead to failures in all walks of life. Therefore, in this review, I attempt to reconcile the notion of attention deficit with the protean manifestations of ADHD in adults through a proposal that ADHD symptoms have as a common denominator an inattention to the future. I build this construct through a multilayered approach, progressing from the epidemiological and clinical considerations for Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis, to a deeper understanding of the disorder, discussing how these patients fail to anchor the present into the future (i.e., to be attentive to future consequences), thus failing to approximate future goals from present action. Integrating cognitive observations with imaging abnormalities, it is possible to propose that ADHD in adults is perhaps the most prevalent frontal lobe disorder in humans, ultimately impacting upon psychosocial management and treatment strategies.
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Affiliation(s)
- André Palmini
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Núcleo de Neurociências, Porto Alegre RS, Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Serviço de Neurologia, Porto Alegre RS, Brazil
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Wu F, Zhang W, Ji W, Zhang Y, Jiang F, Li G, Hu Y, Wei X, Wang H, Wang SYA, Manza P, Tomasi D, Volkow ND, Gao X, Wang GJ, Zhang Y. Stimulant medications in children with ADHD normalize the structure of brain regions associated with attention and reward. Neuropsychopharmacology 2024; 49:1330-1340. [PMID: 38409281 PMCID: PMC11224385 DOI: 10.1038/s41386-024-01831-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
Children with ADHD show abnormal brain function and structure. Neuroimaging studies found that stimulant medications may improve brain structural abnormalities in children with ADHD. However, prior studies on this topic were conducted with relatively small sample sizes and wide age ranges and showed inconsistent results. In this cross-sectional study, we employed latent class analysis and linear mixed-effects models to estimate the impact of stimulant medications using demographic, clinical measures, and brain structure in a large and diverse sample of children aged 9-11 from the Adolescent Brain and Cognitive Development Study. We studied 273 children with low ADHD symptoms and received stimulant medication (Stim Low-ADHD), 1002 children with high ADHD symptoms and received no medications (No-Med ADHD), and 5378 typically developing controls (TDC). After controlling for the covariates, compared to Stim Low-ADHD and TDC, No-Med ADHD showed lower cortical thickness in the right insula (INS, d = 0.340, PFDR = 0.003) and subcortical volume in the left nucleus accumbens (NAc, d = 0.371, PFDR = 0.003), indicating that high ADHD symptoms were associated with structural abnormalities in these brain regions. In addition, there was no difference in brain structural measures between Stim Low-ADHD and TDC children, suggesting that the stimulant effects improved both ADHD symptoms and ADHD-associated brain structural abnormalities. These findings together suggested that children with ADHD appear to have structural abnormalities in brain regions associated with saliency and reward processing, and treatment with stimulant medications not only improve the ADHD symptoms but also normalized these brain structural abnormalities.
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Affiliation(s)
- Feifei Wu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Wenchao Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Weibin Ji
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Yaqi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Fukun Jiang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Guanya Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Yang Hu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Xiaorong Wei
- Kindergarten affiliated to Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Haoyi Wang
- College of Westa, Southwest University, Chongqing, 400715, China
| | - Szu-Yung Ariel Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Dardo Tomasi
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Xinbo Gao
- Chongqing Key Laboratory of Image Cognition, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China
- Chongqing Institute for Brain and Intelligence, Guangyang Bay Laboratory, Chongqing, 400064, China
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA.
| | - Yi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University & Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, Shaanxi, 710126, China.
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China.
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Stasiłowicz-Krzemień A, Nogalska W, Maszewska Z, Maleszka M, Dobroń M, Szary A, Kępa A, Żarowski M, Hojan K, Lukowicz M, Cielecka-Piontek J. The Use of Compounds Derived from Cannabis sativa in the Treatment of Epilepsy, Painful Conditions, and Neuropsychiatric and Neurodegenerative Disorders. Int J Mol Sci 2024; 25:5749. [PMID: 38891938 PMCID: PMC11171823 DOI: 10.3390/ijms25115749] [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: 03/12/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Neurological disorders present a wide range of symptoms and challenges in diagnosis and treatment. Cannabis sativa, with its diverse chemical composition, offers potential therapeutic benefits due to its anticonvulsive, analgesic, anti-inflammatory, and neuroprotective properties. Beyond cannabinoids, cannabis contains terpenes and polyphenols, which synergistically enhance its pharmacological effects. Various administration routes, including vaporization, oral ingestion, sublingual, and rectal, provide flexibility in treatment delivery. This review shows the therapeutic efficacy of cannabis in managing neurological disorders such as epilepsy, neurodegenerative diseases, neurodevelopmental disorders, psychiatric disorders, and painful pathologies. Drawing from surveys, patient studies, and clinical trials, it highlights the potential of cannabis in alleviating symptoms, slowing disease progression, and improving overall quality of life for patients. Understanding the diverse therapeutic mechanisms of cannabis can open up possibilities for using this plant for individual patient needs.
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Affiliation(s)
- Anna Stasiłowicz-Krzemień
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Wiktoria Nogalska
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Zofia Maszewska
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Mateusz Maleszka
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Maria Dobroń
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Agnieszka Szary
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Aleksandra Kępa
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
| | - Marcin Żarowski
- Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewski 49, 60-355 Poznan, Poland;
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, Swięcickiego 6, 61-847 Poznan, Poland;
- Department of Rehabilitation, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznan, Poland
| | - Malgorzata Lukowicz
- Department of Rehabilitation, Centre of Postgraduate Medical Education, Konarskiego 13, 05-400 Otwock, Poland;
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy and Biomaterials, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (A.S.-K.)
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, Wojska Polskiego 71b, 60-630 Poznan, Poland
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6
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Johansson J, Ericsson M, Axelsson J, Bjerkén SA, Virel A, Karalija N. Amphetamine-induced dopamine release in rat: Whole-brain spatiotemporal analysis with [ 11C]raclopride and positron emission tomography. J Cereb Blood Flow Metab 2024; 44:434-445. [PMID: 37882727 PMCID: PMC10870964 DOI: 10.1177/0271678x231210128] [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: 05/25/2023] [Revised: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023]
Abstract
Whole-brain mapping of drug effects are needed to understand the neural underpinnings of drug-related behaviors. Amphetamine administration is associated with robust increases in striatal dopamine (DA) release. Dopaminergic terminals are, however, present across several associative brain regions, which may contribute to behavioral effects of amphetamine. Yet the assessment of DA release has been restricted to a few brain regions of interest. The present work employed positron emission tomography (PET) with [11C]raclopride to investigate regional and temporal characteristics of amphetamine-induced DA release across twenty sessions in adult female Sprague Dawley rats. Amphetamine was injected intravenously (2 mg/kg) to cause displacement of [11C]raclopride binding from DA D2-like receptors, assessed using temporally sensitive pharmacokinetic PET model (lp-ntPET). We show amphetamine-induced [11C]raclopride displacement in the basal ganglia, and no changes following saline injections. Peak occupancy was highest in nucleus accumbens, followed by caudate-putamen and globus pallidus. Importantly, significant amphetamine-induced displacement was also observed in several extrastriatal regions, and specifically in thalamus, insula, orbitofrontal cortex, and secondary somatosensory area. For these, peak occupancy occurred later and was lower as compared to the striatum. Collectively, these findings demonstrate distinct amphetamine-induced DA responses across the brain, and that [11C]raclopride-PET can be employed to detect such spatiotemporal differences.
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Affiliation(s)
- Jarkko Johansson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | | | - Jan Axelsson
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Sara af Bjerkén
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Ana Virel
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Nina Karalija
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
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7
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Newcorn JH, Ivanov I, Krone B, Li X, Duhoux S, White S, Schulz KP, Bédard ACV, Pedraza J, Adler L, Blair RJ. Neurobiological basis of reinforcement-based decision making in adults with ADHD treated with lisdexamfetamine dimesylate: Preliminary findings and implications for mechanisms influencing clinical improvement. J Psychiatr Res 2024; 170:19-26. [PMID: 38101205 DOI: 10.1016/j.jpsychires.2023.11.037] [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: 05/02/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND ADHD is often described as a disorder of altered reward sensitivity, yet few studies have examined the extent to which: (i) treatments for ADHD impact reward-related mechanisms; and (ii) changes in the reward system are associated with clinical improvement. This study addresses these issues - examining the extent to which clinical improvement following lisdexamfetamine (LDX) treatment is associated with changes in brain reward system activation. METHODS Twenty adults (M = 11, 55%, F = 9, 45%), ages 19-52 (M = 33.9, SD = 10.0) with ADHD participated in a randomized cross-over study with lisdexamfetamine (LDX) and placebo (PB). Changes in brain activation were assessed during functional magnetic resonance (fMRI) scans: after receiving 3-5 weeks of treatment with LDX and 3-5 weeks of no drug/PB. fMRI contrasts were derived from the passive-avoidance (PA) learning task, which assessed reward-related learning using computational variables. We analyzed the following conditions: the Choice-Phase, modulated by the expected value (EV; i.e., object-choose and object-reject), and the Feedback-Phase, modulated by the prediction error (PE; i.e., reward and punish). Clinical symptom severity was assessed via interview with the ADHD-Rating Scale (ADHD-RS-IV). To address the primary objective, we performed group-level mass-univariate regression analyses between LDX and PB of percent change of the ADHD-RS total scores and the four contrast images under the Choice- and Feedback-conditions. Significance was set at a whole-brain voxel-wise threshold of p < 0.05 with family-wise error (FWE) correction and an extent (cluster) threshold of 50 contiguous voxels. RESULTS Improvement in ADHD symptoms with LDX was accompanied by significantly increased activation in a series of brain regions previously implicated in reinforcement processing in the choice and feedback conditions (e.g., left caudate and putamen, right orbitofrontal cortex, left middle frontal, superior frontal, and precentral gyri). CONCLUSIONS These findings, while preliminary, are the first to show that ADHD symptom improvement with stimulant treatment is associated with increased responsiveness of brain systems engaged in reward processing. Results support the hypothesis that LDX treatment may restore balance to dysfunction (e.g., hypoactivation) within the brain reward circuitry in adults with ADHD. Trial RegistrationClinicaltrials.gov Identifier: NCT01924429.
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Affiliation(s)
- Jeffrey H Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
| | - Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Beth Krone
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | | | | | - Kurt P Schulz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anne-Claude V Bédard
- Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S 1V6, USA
| | - Juan Pedraza
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Lenard Adler
- New York University Crossman School of Medicine, New York, NY, 10016, USA
| | - Robert James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, 68010, USA
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8
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Stanford SC, Heal DJ. Adrenoceptors: A Focus on Psychiatric Disorders and Their Treatments. Handb Exp Pharmacol 2024; 285:507-554. [PMID: 37495853 DOI: 10.1007/164_2023_675] [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] [Indexed: 07/28/2023]
Abstract
Research into the involvement of adrenoceptor subtypes in the cause(s) of psychiatric disorders is particularly challenging. This is partly because of difficulties in developing animal models that recapitulate the human condition but also because no evidence for any causal links has emerged from studies of patients. These, and other obstacles, are outlined in this chapter. Nevertheless, many drugs that are used to treat psychiatric disorders bind to adrenoceptors to some extent. Direct or indirect modulation of the function of specific adrenoceptor subtypes mediates all or part of the therapeutic actions of drugs in various psychiatric disorders. On the other hand, interactions with central or peripheral adrenoceptors can also explain their side effects. This chapter discusses both aspects of the field, focusing on disorders that are prevalent: depression, schizophrenia, anxiety, attention-deficit hyperactivity disorder, binge-eating disorder, and substance use disorder. In so doing, we highlight some unanswered questions that need to be resolved before it will be feasible to explain how changes in the function of any adrenoceptor subtype affect mood and behavior in humans and other animals.
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Affiliation(s)
- S Clare Stanford
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
| | - David J Heal
- DevelRx Ltd, BioCity, Nottingham, UK
- Department of Life Sciences, University of Bath, Bath, UK
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9
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Laplaud N, Perrochon A, Gallou-Guyot M, Moens M, Goudman L, David R, Rigoard P, Billot M. Management of post-traumatic stress disorder symptoms by yoga: an overview. BMC Complement Med Ther 2023; 23:258. [PMID: 37480017 PMCID: PMC10360332 DOI: 10.1186/s12906-023-04074-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) can occur after trauma. While PTSD management strategies include first-line pharmacotherapy and psychotherapy, mind-body therapies, such as yoga, are applied in the PTSD population. This overview aimed to summarize the effectiveness of yoga interventions on PTSD symptoms in adults in a systematic review (SR) including randomized controlled trials (RCTs). METHOD We searched for SR with or without meta-analysis of RCTs involving adults with PTSD diagnosis or trauma history. The search was conducted until April 2022, through six databases (Cochrane Database, MEDLINE (Pubmed), Scopus, Embase, CINHAL and PEDro). The primary outcome was the evolution of PTSD symptoms throughout the intervention. Secondary outcomes included follow-up, safety, adherence, and cost of the intervention. Two authors independently performed the selection, data extraction and risk of bias assessment with the AMSTAR 2 tool and overlap calculation. This overview is a qualitative summary of the results obtained in the selected studies. RESULTS Eleven SRs were analyzed, of which 8 included meta-analyses. The overlap between studies was considered very high (corrected covered area of 21%). Fifty-nine RCTs involving 4434 participants were included. Yoga had a significant small-to-moderate effect-size on PTSD symptom decrease in 7 SRs and non-significant effects in 1 SR with meta-analysis. All SR without meta-analysis found beneficial effects of yoga on PTSD. Secondary outcomes were not sufficiently assessed to provide clear evidence. Results should be interpreted with caution as 1 SR was rated as at moderate risk of bias, 3 as low and 7 as critically low. CONCLUSIONS While yoga therapy seems promising for decreasing PTSD symptoms, future research should standardize yoga therapy duration/frequency/type and consider long-term efficacy to better delineate yoga therapy efficacy in PTSD patients.
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Affiliation(s)
- Nina Laplaud
- ILFOMER (Institut Limousin de FOrmation Aux Métiers de La Réadaptation), Université de Limoges, Limoges, France
| | - Anaïck Perrochon
- ILFOMER (Institut Limousin de FOrmation Aux Métiers de La Réadaptation), Université de Limoges, Limoges, France
- Laboratoire HAVAE, Université de Limoges, 20217, Limoges, UR, France
| | | | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- STIMULUS Research Consortium (Research and TeachIng Neuromodulation Uz Brussel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Department of Physiotherapy, Pain in Motion (PAIN) Research Group, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- STIMULUS Research Consortium (Research and TeachIng Neuromodulation Uz Brussel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Department of Physiotherapy, Pain in Motion (PAIN) Research Group, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Research Foundation-Flanders (FWO), 1090, Brussels, Belgium
| | - Romain David
- Department of Physical and Rehabilitation Medicine, Poitiers University Hospital, University of Poitiers, 86000, Poitiers, France
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France
| | - Philippe Rigoard
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France
- Department of Spine Neurosurgery & Neuromodulation, Poitiers University Hospital, 86000, Poitiers, France
- ISAE-ENSMA, Pprime Institute UPR 3346, CNRS, University of Poitiers, 86000, Poitiers, France
| | - Maxime Billot
- PRISMATICS (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), University Hospital of Poitiers, Poitiers, France.
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10
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Hartmayer LT, Hoffmann F, Bachmann CJ, Jobski K. Characteristics and outcomes of cases with methylphenidate abuse, dependence or withdrawal: an analysis of spontaneous reports in EudraVigilance. Int Clin Psychopharmacol 2023; 38:169-178. [PMID: 36728576 DOI: 10.1097/yic.0000000000000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Methylphenidate (MPH) is a central nervous stimulant, which is mainly used in attention deficit hyperactivity disorder (ADHD) and narcolepsy. In recent years, rising MPH prescription volumes have drawn attention to possible misuse. We analyzed data on suspected MPH abuse, dependence or withdrawal reported to the EudraVigilance database (1996-2019), comparing case characteristics (e.g. age, indications and outcome). In 1531 cases from 35 countries (median: 29 years, 57.6% male), 42.3% had been diagnosed with ADHD and 8.0% with narcolepsy. Narcolepsy cases were older than ADHD cases (mean age: 47 vs. 22 years), and used co-medications more frequently (79.4 vs. 47.8%). Intravenous MPH administration was most common among individuals not diagnosed with ADHD or narcolepsy. A history of abuse, dependence or withdrawal of any substance was more often documented in fatal than in nonfatal cases (49.0 vs. 22.5%), whereas differences regarding the route of administration were less pronounced. Minors, who presumably received MPH for ADHD treatment, presented less frequently with serious outcomes than older cases or those without an approved indication. Prescribers should exercise caution in adult MPH users and should make a thorough co-medication assessment. Finally, more research on substance abuse in narcolepsy patients is required, which should include comorbidities and co-medication.
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Affiliation(s)
- Lara T Hartmayer
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg
| | - Falk Hoffmann
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg
| | - Christian J Bachmann
- Department of Child and Adolescent Psychiatry, University Hospital Ulm, Ulm, Germany
| | - Kathrin Jobski
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg
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11
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Fiore G, Veneri F, Di Lorenzo R, Generali L, Vinceti M, Filippini T. Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040797. [PMID: 37109754 PMCID: PMC10143272 DOI: 10.3390/medicina59040797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Background and objectives: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological and environmental factors possibly including fluoride exposure. Materials and methods: A literature search was performed on 31 March 2023 in the following databases: PubMed, Embase and Web of Science. We defined the following inclusion criteria according to the PECOS statement: a healthy child and adolescent population (P), fluoride exposure of any type (E), comparison with low or null exposure (C), ADHD spectrum disorder (O), and ecological, cross-sectional, case-control and cohort studies (S). Results: We found eight eligible records corresponding to seven different studies investigating the effect of fluoride exposure on children and adolescents. One study had a cohort design and one a case-control one, while five were cross-sectional. Only three studies applied validated questionnaires for the purpose of ADHD diagnosis. As regards exposure assessment, levels of fluoride in urine and tap water were, respectively used in three and two studies, while two used both. Three studies reported a positive association with ADHD risk, all assessing exposure through fluoride levels. By using urinary fluoride, conversely, a positive correlation with inattention, internalizing symptoms, cognitive and psychosomatic problems was found in three studies, but no relation was found in the other one. Conclusions: The present review suggests that early exposure to fluoride may have neurotoxic effects on neurodevelopment affecting behavioral, cognitive and psychosomatic symptoms related to ADHD diagnosis. However, due to the heterogeneity of the studies included, current evidence does not allow to conclusively confirm that fluoride exposure is specifically linked to ADHD development.
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Affiliation(s)
- Gianluca Fiore
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Federica Veneri
- Unit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences-University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Rosaria Di Lorenzo
- Service of Psychiatric Diagnosis and Care (SPDC), Department of Mental Health and Drug Abuse, AUSL Modena, 41124 Modena, Italy
| | - Luigi Generali
- Unit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA 94704, USA
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12
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Senior D, Ahmed R, Arnavut E, Carvalho A, Lee WX, Blum K, Komatsu DE, Hadjiargyrou M, Badgaiyan RD, Thanos PK. Behavioral, Neurochemical and Developmental Effects of Chronic Oral Methylphenidate: A Review. J Pers Med 2023; 13:jpm13040574. [PMID: 37108960 PMCID: PMC10144804 DOI: 10.3390/jpm13040574] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 04/29/2023] Open
Abstract
The majority of animal studies on methylphenidate (MP) use intraperitoneal (IP) injections, subcutaneous (SC) injections, or the oral gavage route of administration. While all these methods allow for delivery of MP, it is the oral route that is clinically relevant. IP injections commonly deliver an immediate and maximum dose of MP due to their quick absorption. This quick-localized effect can give timely results but will only display a small window of the psychostimulant's effects on the animal model. On the opposite side of the spectrum, a SC injection does not accurately represent the pathophysiology of an oral exposure because the metabolic rate of the drug would be much slower. The oral-gavage method, while providing an oral route, possesses some adverse effects such as potential animal injury and can be stressful to the animal compared to voluntary drinking. It is thus important to allow the animal to have free consumption of MP, and drinking it to more accurately mirror human treatment. The use of a two-bottle drinking method allows for this. Rodents typically have a faster metabolism than humans, which means this needs to be considered when administering MP orally while reaching target pharmacokinetic levels in plasma. With this oral two-bottle approach, the pathophysiological effects of MP on development, behavior, neurochemistry and brain function can be studied. The present review summarizes these effects of oral MP which have important implications in medicine.
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Affiliation(s)
- Daniela Senior
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rania Ahmed
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Eliz Arnavut
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Alexandra Carvalho
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Wen Xuan Lee
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Kenneth Blum
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of the Provost), Western University Health Sciences, Pomona, CA 91766, USA
| | - David E Komatsu
- Department of Orthopaedics and Rehabilitation, Stony Brook University, New York, NY 11794, USA
| | - Michael Hadjiargyrou
- Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, NY 11568, USA
| | | | - Panayotis K Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
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13
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Mizuno Y, Cai W, Supekar K, Makita K, Takiguchi S, Silk TJ, Tomoda A, Menon V. Methylphenidate Enhances Spontaneous Fluctuations in Reward and Cognitive Control Networks in Children With Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:271-280. [PMID: 36717325 DOI: 10.1016/j.bpsc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Methylphenidate, a first-line treatment for attention-deficit/hyperactivity disorder (ADHD), is thought to influence dopaminergic neurotransmission in the nucleus accumbens (NAc) and its associated brain circuitry, but this hypothesis has yet to be systematically tested. METHODS We conducted a randomized, placebo-controlled, double-blind crossover trial including 27 children with ADHD. Children with ADHD were scanned twice with resting-state functional magnetic resonance imaging under methylphenidate and placebo conditions, along with assessment of sustained attention. We examined spontaneous neural activity in the NAc and the salience, frontoparietal, and default mode networks and their links to behavioral changes. Replicability of methylphenidate effects on spontaneous neural activity was examined in a second independent cohort. RESULTS Methylphenidate increased spontaneous neural activity in the NAc and the salience and default mode networks. Methylphenidate-induced changes in spontaneous activity patterns in the default mode network were associated with improvements in intraindividual response variability during a sustained attention task. Critically, despite differences in clinical trial protocols and data acquisition parameters, the NAc and the salience and default mode networks showed replicable patterns of methylphenidate-induced changes in spontaneous activity across two independent cohorts. CONCLUSIONS We provide reproducible evidence demonstrating that methylphenidate enhances spontaneous neural activity in NAc and cognitive control networks in children with ADHD, resulting in more stable sustained attention. Our findings identified a novel neural mechanism underlying methylphenidate treatment in ADHD to inform the development of clinically useful biomarkers for evaluating treatment outcomes.
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Affiliation(s)
- Yoshifumi Mizuno
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
| | - Weidong Cai
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University, Stanford, California; Maternal & Child Health Research Institute, Stanford University, Stanford, California
| | - Kaustubh Supekar
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University, Stanford, California; Maternal & Child Health Research Institute, Stanford University, Stanford, California
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Shinichiro Takiguchi
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Timothy J Silk
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Vinod Menon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Department of Neurology and Neurological Sciences, Stanford University, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University, Stanford, California; Maternal & Child Health Research Institute, Stanford University, Stanford, California.
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14
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Yuan A, Kharas N, King N, Yang P, Dafny N. Methylphenidate cross-sensitization with amphetamine is dose dependent but not age dependent. Behav Brain Res 2023; 438:114178. [PMID: 36341913 DOI: 10.1016/j.bbr.2022.114178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 12/29/2022]
Abstract
Psychostimulants such as methylphenidate (MPD) and amphetamine (AMP) are often prescribed to young children and adolescents to treat behavioral disorders, or used to improve their intellectual performance in our competitive society. This is concerning as the temporal effects of how MPD exposure at a young age influences the response to MPD and AMP administration later in adulthood remains unclear. The objective of this study was to test whether MPD has the characteristics of substances that elicit behavioral symptoms of dependence and whether those effects are influenced by the initial age of MPD exposure. Three control and nine experimental groups of male rats were used. They were exposed to repetitive (chronic) 0.6, 2.5, or 10.0 mg/kg MPD in adolescence only, adulthood only, or adolescence and adulthood respectively. Then all groups were subsequently re-challenged with a single AMP dose in adulthood to test whether cross-sensitization between MPD and AMP was expressed, potentially as a result of prior MPD consumption. Exposure to 2.5 mg/kg and 10.0 mg/kg MPD in adolescence and adulthood or in adulthood alone led to cross-sensitization with AMP while exposure to 0.6 mg/kg MPD in adolescence and adulthood or in adulthood alone did not lead to cross-sensitization with AMP. Thus, these results indicate that MPD cross-sensitization with AMP is dose dependent.
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Affiliation(s)
- Anthony Yuan
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, Houston TX 77030, United States
| | - Natasha Kharas
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, Houston TX 77030, United States
| | - Nicholas King
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, Houston TX 77030, United States
| | - Pamela Yang
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, Houston TX 77030, United States
| | - Nachum Dafny
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, Houston TX 77030, United States.
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15
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ADHD Follow-Up in Adulthood among Subjects Treated for the Disorder in a Child and Adolescent Mental Health Service from 1995 to 2015. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020338. [PMID: 36837537 PMCID: PMC9966311 DOI: 10.3390/medicina59020338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Background and Objectives: ADHD is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity and can persist in adulthood. The aim of this study is to deepen knowledge about adult ADHD follow-up. Materials and Methods: This observational study consists of one retrospective part aimed at collecting records of children and adolescents treated for ADHD in the Children and Adolescent Mental Health Service (CAMHS) from 1995 to 2015 and, successively, at identifying their adult follow-up in Adult Mental Health Service (AMHS); the second part consists of ADHD scale administration, Diagnostic Interview for ADHD in Adults (DIVA 2-0) and Adult Self Rating Scale (ASRSv1.1), for the subjects currently being treated at AMHS who agreed to participate in the study. Results: We observed that among the 55 patients treated at CAMHS between 1995 and 2015 for ADHD and subsequently at the AMHS, none presented a diagnosis of ADHD; instead, they were treated for Intellectual Dysfunction (33%), Borderline Personality Disorder (15%) and Anxiety Disorders (9%), and two individuals were also diagnosed with comorbid substance/alcohol abuse (4%). Of the 55 patients, only 25 (45%) were treated at AMHS during the study period. Though we asked for their informed consent to administer the questionnaires, we were able to test only seven patients. The ASRS-V1.1 score showed that 43% of patients reported symptoms of ADHD persistence in adulthood. For DIVA 2.0, 57% of individuals reported scores indicating the persistence of the ADHD inattention component, and 43% the persistence of both ADHD dimensions. Conclusions: ADHD cannot be considered a disorder confined to childhood/adolescence but instead is a chronic and complex condition that can persist into adulthood. The very small size of our final sample may account for both the high ADHD dropout rate over the long follow-up period and the difficult transition from child to adult health care in ADHD treatment. Our investigation suggests the need for specific training in the diagnosis and treatment of adult ADHD and the implementation of transition protocols between minor and adult services to improve long-term treatments.
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16
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Guo J, Luo X, Kong Y, Li B, Si B, Jensen O, Sun L, Song Y. The effects of first-dose methylphenidate on the neural signatures of visual selective attention in children with attention-deficit/hyperactivity disorder. Biol Psychol 2023; 177:108481. [PMID: 36572273 DOI: 10.1016/j.biopsycho.2022.108481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
Although methylphenidate (MPH) has been shown to significantly improve selective attention in children with attention-deficit/hyperactivity disorder (ADHD), the neural mechanism of this effect remains unclear. We investigated the effects of first-dose MPH on the neural signatures of visual selective attention in children with ADHD. We measured the impact of first-dose MPH on electrophysiological indexes from eighteen children with ADHD (8.9-15.2 years; 15 boys) while they performed a visual search task. MPH was administered in a double-blind placebo-controlled crossover design. MPH led to decreases in behavioral error rates and reaction times. For the electrophysiological indexes, MPH significantly increased the target-elicited N2pc amplitude and posterior P3 amplitude during the selective attention process. The trial-based correlation analysis revealed that the enhanced N2pc (more negative) and P3 (more positive) promoted the behavioral response speed for children with ADHD. The lower individual P3 amplitude was associated with higher severity of inattention symptoms. The severer inattention symptoms were related to weaker MPH effect on N2pc amplitude. These findings suggest that N2pc and P3 are closely related to the mechanism of MPH in the ADHD treatment.
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Affiliation(s)
- Jialiang Guo
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; School of Systems Science, Beijing Normal University, Beijing, China
| | - Xiangsheng Luo
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
| | - Yuanjun Kong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Bingkun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Bailu Si
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Ole Jensen
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
| | - Yan Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.
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17
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Demiral ŞB, Kure Liu C, Benveniste H, Tomasi D, Volkow ND. Activation of brain arousal networks coincident with eye blinks during resting state. Cereb Cortex 2023:6991186. [PMID: 36653022 DOI: 10.1093/cercor/bhad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Eye-blinking has been implicated in arousal and attention. Here we test the hypothesis that blinking-moments represent arousal surges associated with activation of the ascending arousal network (AAN) and its thalamic projections. For this purpose, we explored the temporal relationship between eye-blinks and fMRI BOLD activity in AAN and thalamic nuclei, as well as whole brain cluster corrected activations during eyes-open, resting-state fMRI scanning. We show that BOLD activations in the AAN nuclei peaked prior to the eye blinks and in thalamic nuclei peaked prior to and during the blink, consistent with the role of eye blinking in arousal surges. Additionally, we showed visual cortex peak activation prior to the eye blinks, providing further evidence of the visual cortex's role in arousal, and document cerebellar peak activation post eye blinks, which might reflect downstream engagement from arousal surges.
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Affiliation(s)
- Şükrü Barış Demiral
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda 20892, MD, USA
| | - Christopher Kure Liu
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda 20892, MD, USA
| | - Helene Benveniste
- Department of Anesthesiology, Yale University, New Haven, CT 06510, USA
| | - Dardo Tomasi
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda 20892, MD, USA
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda 20892, MD, USA.,National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
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18
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Kelmanson IA. [Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a network analysis-based model]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:95-104. [PMID: 37276005 DOI: 10.17116/jnevro202312305295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To attempt to identify persistent associations between sleep quality, symptoms of emotional and behavioral disturbances, and characteristics of eating behavior in obese adolescents based on a network analysis. MATERIAL AND METHODS The study included 194 adolescents, aged 12-17 years (76 girls, 118 boys), with a confirmed diagnosis of obesity due to excess calories (ICD-10 code E66.0). Sleep quality was studied on the basis of the Adolescent Sleep Wake Scale (ASWS), emotional and behavioral disturbances were assessed with the Achenbach Youth Self-Report for Ages 11-18 (YSR), eating behavior - with the Dutch Eating Behavior Questionnaire (DEBQ). Network analysis was used to identify the most significant and stable associations between the studied indicators. RESULTS The association of poor sleep quality with manifestations of disinhibited behavior in the form of violations of the rules of behavior, aggressiveness, and impaired attention was revealed. Positive correlations between the manifestations of disinhibited behavior (primarily, rule-breaking behavior) and emotional eating behavior, which, in turn, had a positive relationship with external and a negative relationship with restrictive eating behavior, were noted. The disinhibited adolescent behavior is linked with uncontrolled food intake, which can contribute to the development of obesity. CONCLUSION Impaired sleep quality, symptoms of emotional and behavioral disorders, and eating disorders in obese adolescents present a stable and specific clinical pattern that should be taken into account when justifying therapy.
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Affiliation(s)
- I A Kelmanson
- Almazov National Medical Research Centre, St. Petersburg, Russia
- Saint Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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19
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Yamamoto M, Inada T. Positron emission tomography studies in adult patients with attention-deficit/hyperactivity disorder. Jpn J Radiol 2022; 41:382-392. [PMID: 36480104 DOI: 10.1007/s11604-022-01368-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, motor hyperactivity, impulsivity, and psychosocial as well as cognitive dysfunction. Although characteristic clinical manifestations have been described, no definitive biomarkers to diagnose ADHD have been established. In this review article, we summarize positron emission tomography (PET) studies conducted in adult patients with ADHD. We found that, although, disturbances of dopamine, serotonin, and norepinephrine functions have been implicated in ADHD, no characteristic findings have been identified from PET studies in patients with ADHD. Several previous PET studies on the central dopaminergic transmission-related ligands in patients with ADHD have shown altered binding of dopamine markers in the basal ganglia. However, no consistent results were observed in the binding characteristics for dopamine transporters and receptors. Findings from PET studies with ligands related to serotonin and norepinephrine pathways showed either unclear clinical significance or low replicability. Therefore, whether alterations of monoamine function may be involved in the pathophysiological mechanism remains to be clarified. The limitations of previous PET studies include their small sample sizes, focus on several kinds of existing ligands, and a questionable validity of the diagnosis (lack of biological diagnostic criteria). To determine the characteristic findings for diagnosing ADHD, further research is needed, and particularly, studies that evaluate new active ligands with specific binding to monoamine pathways should be undertaken.
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Affiliation(s)
- Maeri Yamamoto
- Department of Psychiatry, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya-Shi, Aichi, 466-8560, Japan
| | - Toshiya Inada
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, 65 Tsurumai-Cho, Showa-Ku, Nagoya-Shi, Aichi, 466-8550, Japan.
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20
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Pinggal E, Dockree PM, O'Connell RG, Bellgrove MA, Andrillon T. Pharmacological Manipulations of Physiological Arousal and Sleep-Like Slow Waves Modulate Sustained Attention. J Neurosci 2022; 42:8113-8124. [PMID: 36109167 PMCID: PMC9637000 DOI: 10.1523/jneurosci.0836-22.2022] [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: 04/30/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/21/2022] Open
Abstract
Sustained attention describes our ability to keep a constant focus on a given task. This ability is modulated by our physiological state of arousal. Although lapses of sustained attention have been linked with dysregulations of arousal, the underlying physiological mechanisms remain unclear. An emerging body of work proposes that the intrusion during wakefulness of sleep-like slow waves, a marker of the transition toward sleep, could mechanistically account for attentional lapses. This study aimed to expose, via pharmacological manipulations of the monoamine system, the relationship between the occurrence of sleep-like slow waves and the behavioral consequences of sustained attention failures. In a double-blind, randomized-control trial, 32 healthy human male participants received methylphenidate, atomoxetine, citalopram or placebo during four separate experimental sessions. During each session, electroencephalography (EEG) was used to measure neural activity while participants completed a visual task requiring sustained attention. Methylphenidate, which increases wake-promoting dopamine and noradrenaline across cortical and subcortical areas, improved behavioral performance whereas atomoxetine, which increases dopamine and noradrenaline predominantly over frontal cortices, led to more impulsive responses. Additionally, citalopram, which increases sleep-promoting serotonin, led to more missed trials. Based on EEG recording, citalopram was also associated with an increase in sleep-like slow waves. Importantly, compared with a classical marker of arousal such as α power, only slow waves differentially predicted both misses and faster responses in a region-specific fashion. These results suggest that a decrease in arousal can lead to local sleep intrusions during wakefulness which could be mechanistically linked to impulsivity and sluggishness.SIGNIFICANCE STATEMENT We investigated whether the modulation of attention and arousal could not only share the same neuromodulatory pathways but also rely on similar neuronal mechanisms; for example, the intrusion of sleep-like activity within wakefulness. To do so, we pharmacologically manipulated noradrenaline, dopamine, and serotonin in a four-arm, randomized, placebo-controlled trial and examined the consequences on behavioral and electroencephalography (EEG) indices of attention and arousal. We showed that sleep-like slow waves can predict opposite behavioral signatures: impulsivity and sluggishness. Slow waves may be a candidate mechanism for the occurrence of attentional lapses since the relationship between slow-wave occurrence and performance is region-specific and the consequences of these local sleep intrusions are in line with the cognitive functions carried by the underlying brain regions.
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Affiliation(s)
- Elaine Pinggal
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Paul M Dockree
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Redmond G O'Connell
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Mark A Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Thomas Andrillon
- School of Philosophical, Historical, and International Studies, Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Victoria 3168, Australia
- Paris Brain Institute, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale-Centre National de la Recherche Scientifique, Paris 75013, France
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21
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Capuzzi E, Caldiroli A, Auxilia AM, Borgonovo R, Capellazzi M, Clerici M, Buoli M. Biological Predictors of Treatment Response in Adult Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review. J Pers Med 2022; 12:jpm12101742. [PMID: 36294881 PMCID: PMC9605680 DOI: 10.3390/jpm12101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent condition with onset in childhood and in many cases persisting into adulthood. Even though an increasing number of studies have investigated the efficacy of pharmacotherapy in the management of adult ADHD, few authors have tried to identify the biological predictors of treatment response. Objectives: To summarize the available data about the biological markers of treatment response in adults affected by ADHD. Methods: A search on the main biomedical and psychological archives (PubMed, Embase, Scopus, and PsycINFO) was performed. Manuscripts in English, published up to May 2022 and having the biological predictors of treatment response in adults with ADHD as their main topic, were included. Results: A total of 3855 articles was screened. Twenty-two articles were finally included. Most of the manuscripts studied neuroimaging and electrophysiological factors as potential predictors of treatment response in adult ADHD patients. No reliable markers were identified until now. Promising findings on this topic regard genetic polymorphisms in snap receptor (SNARE) proteins and default mode network-striatum connectivity. Conclusions: Even though some biological markers seem promising for the prediction of treatment response in adults affected by ADHD, further studies are needed to confirm the available data in the context of precision medicine.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Correspondence: ; Tel.: +39-0392339670
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Riccardo Borgonovo
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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22
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Ulrich M, Heckel K, Kölle M, Grön G. Methylphenidate Differentially Affects Intrinsic Functional Connectivity of the Salience Network in Adult ADHD Treatment Responders and Non-Responders. BIOLOGY 2022; 11:biology11091320. [PMID: 36138799 PMCID: PMC9495306 DOI: 10.3390/biology11091320] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022]
Abstract
Positron emission tomography (PET) studies have shown involvement of the striatum when treating adult attention-deficit/hyperactivity disorder (ADHD) with methylphenidate (MPH). Results from resting-state functional magnetic resonance imaging (rs-fMRI) for the same issue were less unequivocal. Here, a new analytical framework was set up to investigate medication effects using seed-based rs-fMRI analysis to infer brain regions with alterations in intrinsic functional connectivity (IFC) corresponding with ADHD symptom reduction. In a within-subjects study design, 53 stimulant-naïve adult ADHD patients were investigated before and after 6 weeks of MPH treatment, using two major clinical symptom scales and rs-fMRI. The same data were acquired in a sample of 50 age- and sex-matched healthy controls at baseline. A consensual atlas provided seeds for five predefined major resting-state networks. In order to avoid biasing of medication effects due to putative treatment failure, the entire ADHD sample was first categorized into treatment Responders (N = 36) and Non-Responders (N = 17) using machine learning-based classification with the clinical scales as primary data. Imaging data revealed medication effects only in Responders. In that group, IFC of bilateral putamen changed significantly with medication and approached almost normal levels of IFC. Present results align well with results from previous PET studies, with seed-based rs-fMRI as an entirely different neuroimaging method.
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Affiliation(s)
- Martin Ulrich
- Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, 89075 Ulm, Germany
- Correspondence:
| | - Katharina Heckel
- Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, 89075 Ulm, Germany
| | - Markus Kölle
- Department of Psychiatry and Psychotherapy, Bonn University, 53127 Bonn, Germany
| | - Georg Grön
- Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, 89075 Ulm, Germany
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23
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van den Bosch R, Lambregts B, Määttä J, Hofmans L, Papadopetraki D, Westbrook A, Verkes RJ, Booij J, Cools R. Striatal dopamine dissociates methylphenidate effects on value-based versus surprise-based reversal learning. Nat Commun 2022; 13:4962. [PMID: 36002446 PMCID: PMC9402573 DOI: 10.1038/s41467-022-32679-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Psychostimulants such as methylphenidate are widely used for their cognitive enhancing effects, but there is large variability in the direction and extent of these effects. We tested the hypothesis that methylphenidate enhances or impairs reward/punishment-based reversal learning depending on baseline striatal dopamine levels and corticostriatal gating of reward/punishment-related representations in stimulus-specific sensory cortex. Young healthy adults (N = 100) were scanned with functional magnetic resonance imaging during a reward/punishment reversal learning task, after intake of methylphenidate or the selective D2/3-receptor antagonist sulpiride. Striatal dopamine synthesis capacity was indexed with [18F]DOPA positron emission tomography. Methylphenidate improved and sulpiride decreased overall accuracy and response speed. Both drugs boosted reward versus punishment learning signals to a greater degree in participants with higher dopamine synthesis capacity. By contrast, striatal and stimulus-specific sensory surprise signals were boosted in participants with lower dopamine synthesis. These results unravel the mechanisms by which methylphenidate gates both attention and reward learning. The mechanisms underpinning the variability in methylphenidate’s effects on cognition remain unclear. Here, the authors show that such effects reflect changes in striatal dopamine-related output gating of task-relevant cortical signals, and that these changes depend on baseline dopamine synthesis capacity.
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Affiliation(s)
- Ruben van den Bosch
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
| | - Britt Lambregts
- Radboud University Medical Center, Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Jessica Määttä
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lieke Hofmans
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Danae Papadopetraki
- Radboud University Medical Center, Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Andrew Westbrook
- Cognitive, Linguistic & Psychological Sciences Department, Brown University, Providence, RI, USA
| | - Robbert-Jan Verkes
- Radboud University Medical Center, Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, The Netherlands.,Radboud University Medical Center, Department of Medical Imaging, Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Medical Center, Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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24
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Consequences of Acute or Chronic Methylphenidate Exposure Using Ex Vivo Neurochemistry and In Vivo Electrophysiology in the Prefrontal Cortex and Striatum of Rats. Int J Mol Sci 2022; 23:ijms23158588. [PMID: 35955717 PMCID: PMC9369023 DOI: 10.3390/ijms23158588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 01/27/2023] Open
Abstract
Methylphenidate (MPH) is among the main drugs prescribed to treat patients with attention-deficit and hyperactivity disease (ADHD). MPH blocks both the norepinephrine and dopamine reuptake transporters (NET and DAT, respectively). Our study was aimed at further understanding the mechanisms by which MPH could modulate neurotransmitter efflux, using ex vivo radiolabelled neurotransmitter assays isolated from rats. Here, we observed significant dopamine and norepinephrine efflux from the prefrontal cortex (PFC) after MPH (100 µM) exposure. Efflux was mediated by both dopamine and norepinephrine terminals. In the striatum, MPH (100 µM) triggered dopamine efflux through both sodium- and vesicular-dependent mechanisms. Chronic MPH exposure (4 mg/kg/day/animal, voluntary oral intake) for 15 days, followed by a 28-day washout period, increased the firing rate of PFC pyramidal neurons, assessed by in vivo extracellular single-cell electrophysiological recordings, without altering the responses to locally applied NMDA, via micro-iontophoresis. Furthermore, chronic MPH treatment resulted in decreased efficiency of extracellular dopamine to modulate NMDA-induced firing activities of medium spiny neurons in the striatum, together with lower MPH-induced (100 µM) dopamine outflow, suggesting desensitization to both dopamine and MPH in striatal regions. These results indicate that MPH can modulate neurotransmitter efflux in brain regions enriched with dopamine and/or norepinephrine terminals. Further, long-lasting alterations of striatal and prefrontal neurotransmission were observed, even after extensive washout periods. Further studies will be needed to understand the clinical implications of these findings.
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25
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Kanarik M, Grimm O, Mota NR, Reif A, Harro J. ADHD co-morbidities: A review of implication of gene × environment effects with dopamine-related genes. Neurosci Biobehav Rev 2022; 139:104757. [PMID: 35777579 DOI: 10.1016/j.neubiorev.2022.104757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 02/07/2023]
Abstract
ADHD is a major burden in adulthood, where co-morbid conditions such as depression, substance use disorder and obesity often dominate the clinical picture. ADHD has substantial shared heritability with other mental disorders, contributing to comorbidity. However, environmental risk factors exist but their interaction with genetic makeup, especially in relation to comorbid disorders, remains elusive. This review for the first time summarizes present knowledge on gene x environment (GxE) interactions regarding the dopamine system. Hitherto, mainly candidate (GxE) studies were performed, focusing on the genes DRD4, DAT1 and MAOA. Some evidence suggest that the variable number tandem repeats in DRD4 and MAOA may mediate GxE interactions in ADHD generally, and comorbid conditions specifically. Nevertheless, even for these genes, common variants are bound to suggest risk only in the context of gender and specific environments. For other polymorphisms, evidence is contradictory and less convincing. Particularly lacking are longitudinal studies testing the interaction of well-defined environmental with polygenic risk scores reflecting the dopamine system in its entirety.
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Affiliation(s)
- Margus Kanarik
- Chair of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Ravila 14A Chemicum, 50411 Tartu, Estonia
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Nina Roth Mota
- 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
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Jaanus Harro
- Chair of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Ravila 14A Chemicum, 50411 Tartu, Estonia; Psychiatry Clinic, North Estonia Medical Centre, Paldiski Road 52, 10614 Tallinn, Estonia.
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26
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McCarthy DM, Zhang L, Wilkes BJ, Vaillancourt DE, Biederman J, Bhide PG. Nicotine and the developing brain: Insights from preclinical models. Pharmacol Biochem Behav 2022; 214:173355. [PMID: 35176350 PMCID: PMC9063417 DOI: 10.1016/j.pbb.2022.173355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
Use of tobacco products during pregnancy is associated with increased risk for neurodevelopmental disorders in the offspring. Preclinical models of developmental nicotine exposure have offered valuable insights into the neurobiology of nicotine's effects on the developing brain and demonstrated lasting effects of developmental nicotine exposure on brain structure, neurotransmitter signaling and behavior. These models have facilitated discovery of novel compounds as candidate treatments for attention deficit hyperactivity disorder, a neurodevelopmental disorder associated with prenatal nicotine exposure. Using these models the significance of heritability of behavioral phenotypes from the nicotine-exposed pregnant female or adult male to multiple generations of descendants has been demonstrated. Finally, research using the preclinical models has demonstrated synergistic interactions between developmental nicotine exposure and repetitive mild traumatic brain injury that contribute to "worse" outcomes from the injury in individuals with attention deficit hyperactivity disorder associated with developmental nicotine exposure.
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Affiliation(s)
- Deirdre M McCarthy
- Biomedical Sciences, Florida State University, College of Medicine, Tallahassee, FL 32306, United States of America
| | - Lin Zhang
- Biomedical Sciences, Florida State University, College of Medicine, Tallahassee, FL 32306, United States of America
| | - Bradley J Wilkes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL 32611, United States of America
| | - David E Vaillancourt
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL 32611, United States of America
| | - Joseph Biederman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Pradeep G Bhide
- Biomedical Sciences, Florida State University, College of Medicine, Tallahassee, FL 32306, United States of America.
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27
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Maremmani I, Spera V, Maiello M, Maremmani AGI, Perugi G. Adult Attention-Deficit Hyperactivity Disorder/Substance Use Disorder Dual Disorder Patients: A Dual Disorder Unit Point of View. Curr Top Behav Neurosci 2022; 57:179-198. [PMID: 35507285 DOI: 10.1007/7854_2022_335] [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] [Indexed: 06/14/2023]
Abstract
Substance Use Disorders (SUDs) are often associated with Attention-Deficit Hyperactivity Disorder (ADHD) in adult populations due to multiple neurobiological, genetic, and psychosocial risk factors. This chapter provides a picture of the clinical aspects of adults with both ADHD and SUDs at treatment entry into a Dual Disorder Unit introducing the concept of different types of craving that may lead to substance use and abuse. At treatment entry, the presence of different comorbid SUD clusters, characterized by either stimulants/alcohol or by the use of cannabinoids, has not been shown to influence ADHD-specific symptomatology or severity, despite being crucial for the identification of a specific type of craving. We identified four clinical presentations of adult ADHD: Emotional Dysregulation, Substance Use, Core-ADHD Symptoms, and Positive Emotionality variants, that offer a practical guide in diagnosing and managing adult ADHD patients. Although the evidence of an effective medical treatment for Cocaine Use Disorder is insufficient, in our experience, toxicomanic behavior during stimulant treatment is sharply reduced in ADHD patients with cocaine addiction. Moreover, caffeinated compounds in military soldiers with ADHD may help reduce ADHD symptoms, making caffeine a potential pharmacological tool worth further investigation. Finally, substance use comorbidity does not influence treatment retention rate.
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Affiliation(s)
- Icro Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy.
- V.P. Dole Research Group, G. De Lisio Institute of Behavioral Sciences, Pisa, Italy.
- Saint Camillus International University of Health and Medical Sciences - UniCamillus, Rome, Italy.
| | - Vincenza Spera
- Psychiatric Clinic, Sociopsychiatric Organization, Mendrisio, Switzerland
| | - Marco Maiello
- Drug Addiction Unit, Northern-West Tuscany Region Local Health Unit, Apuan Zone, Massa, Italy
| | - Angelo G I Maremmani
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy
- V.P. Dole Research Group, G. De Lisio Institute of Behavioral Sciences, Pisa, Italy
- Department of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Viareggio, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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Sex differences in methylphenidate-induced dopamine increases in ventral striatum. Mol Psychiatry 2022; 27:939-946. [PMID: 34707237 PMCID: PMC9043036 DOI: 10.1038/s41380-021-01294-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 12/02/2022]
Abstract
Sex differences in the prevalence of dopamine-related neuropsychiatric diseases and in the sensitivity to dopamine-boosting drugs such as stimulants is well recognized. Here we assessed whether there are sex differences in the brain dopamine system in humans that could contribute to these effects. We analyzed data from two independent [11C]raclopride PET brain imaging studies that measured methylphenidate-induced dopamine increases in the striatum using different routes of administration (Cohort A = oral 60 mg; Cohort B = intravenous 0.5 mg/kg; total n = 95; 65 male, 30 female), in blinded placebo-controlled designs. Females when compared to males reported stronger feeling of "drug effects" and showed significantly greater dopamine release in the ventral striatum (where nucleus accumbens is located) to both oral and intravenous methylphenidate. In contrast, there were no significant differences in methylphenidate-induced increases in dorsal striatum for either oral or intravenous administration nor were there differences in levels of methylphenidate in plasma. The greater dopamine increases with methylphenidate in ventral but not dorsal striatum in females compared to males suggests an enhanced sensitivity specific to the dopamine reward system that might underlie sex differences in the vulnerability to substance use disorders and to attention-deficit/hyperactivity disorder (ADHD).
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29
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Heal DJ, Gosden J, Smith SL. New Drugs to Treat ADHD: Opportunities and Challenges in Research and Development. Curr Top Behav Neurosci 2022; 57:79-126. [PMID: 35507283 DOI: 10.1007/7854_2022_332] [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] [Indexed: 06/14/2023]
Abstract
Since the landmark MTA (Multimodal Treatment of ADHD) trial unequivocally demonstrated the efficacy of methylphenidate, catecholaminergic drugs, especially stimulants, have been the therapeutic mainstay in treatment of Attention-Deficit Hyperactivity Disorder (ADHD). We review the new drugs which have entered the ADHD formulary. The lessons learned from drug-candidates that have succeeded in clinical trials together with those that have not have also been considered. What emerges confirms and consolidates the hypothesis that clinically effective ADHD drugs indirectly or directly increase catecholaminergic neurotransmission in the prefrontal cortex (PFC). Attempts to enhance catecholaminergic signalling through modulatory neurotransmitter systems or cognitive-enhancing drugs have all failed. New drugs approved for ADHD are catecholaminergic reuptake inhibitors and releasing agents, or selective noradrenaline reuptake inhibitors. Triple reuptake inhibitors with preferential effects on dopamine have not been successful. The substantial number of failures probably accounts for a continued focus on developing novel catecholaminergic and noradrenergic drugs, and a dearth of drug-candidates with novel mechanisms entering clinical development. However, substantial improvements in ADHD pharmacotherapy have been achieved by the almost exclusive use of once-daily medications and prodrugs, e.g. lisdexamfetamine and Azstarys®, which improve compliance, deliver greater efficacy and reduce risks for diversion and abuse.
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Affiliation(s)
- David J Heal
- DevelRx Ltd, Nottingham, UK.
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
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30
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Aster HC, Romanos M, Walitza S, Gerlach M, Mühlberger A, Rizzo A, Andreatta M, Hasenauer N, Hartrampf PE, Nerlich K, Reiners C, Lorenz R, Buck AK, Deserno L. Responsivity of the Striatal Dopamine System to Methylphenidate-A Within-Subject I-123-β-CIT-SPECT Study in Male Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. Front Psychiatry 2022; 13:804730. [PMID: 35492708 PMCID: PMC9046584 DOI: 10.3389/fpsyt.2022.804730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/15/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescent patients are rare but can provide insight on how the effects of MPH affect DAT availability. The aim of our within-subject study was to investigate the effect of MPH on DAT availability and how responsivity to MPH in DAT availability is linked to clinical symptoms and cognitive functioning. METHODS Thirteen adolescent male patients (9-16 years) with a diagnosis of ADHD according to the DSM-IV and long-term stimulant medication (for at least 6 months) with MPH were assessed twice within 7 days using SPECT after application of I-123-β-CIT to examine DAT binding potential (DAT BP). SPECT measures took place in an on- and off-MPH status balanced for order across participants. A virtual reality continuous performance test was performed at each time point. Further clinical symptoms were assessed for baseline off-MPH. RESULTS On-MPH status was associated with a highly significant change (-29.9%) of striatal DAT BP as compared to off-MPH (t = -4.12, p = 0.002). A more pronounced change in striatal DAT BP was associated with higher off-MPH attentional and externalizing symptom ratings (Pearson r = 0.68, p = 0.01). Striatal DAT BP off-MPH, but not on-MPH, was associated with higher symptom ratings (Pearson r = 0.56, p = 0.04). CONCLUSION Our findings corroborate previous reports from mainly adult samples that MPH changes striatal DAT BP availability and suggest higher off-MPH DAT BP, likely reflecting low baseline DA levels, as a marker of symptom severity.
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Affiliation(s)
- Hans-Christoph Aster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Würzburg, Würzburg, Germany.,Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Würzburg, Würzburg, Germany
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Würzburg, Würzburg, Germany
| | - Andreas Mühlberger
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Albert Rizzo
- Department of Psychiatry and Behavioral Sciences, University of Southern California (USC) Davis School of Gerontology and USC Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Marta Andreatta
- Clinical Psychology, Erasmus School of Social and Behavioural Sciences, Rotterdam, Netherlands
| | - Natalie Hasenauer
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | | | - Kai Nerlich
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Christoph Reiners
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Reinhard Lorenz
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Lorenz Deserno
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Würzburg, Würzburg, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Samadi M, Gholami F, Seyedi M, Jalali M, Effatpanah M, Yekaninejad MS, Abdolahi M, Chamari M, Mohammadzadeh Honarvar N. Effect of Vitamin D Supplementation on Inflammatory Biomarkers in School-Aged Children with Attention Deficit Hyperactivity Disorder. Int J Clin Pract 2022; 2022:1256408. [PMID: 36052304 PMCID: PMC9423974 DOI: 10.1155/2022/1256408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
METHOD This randomized double-blind, placebo-controlled trial was conducted on 75 school-aged children with a diagnosis of ADHD based on DSM-V criteria. Children were randomly allocated to receive either vitamin D3 (2000 IU/day) or a placebo for 3 months. Serum IL-6, TNF-α, and 25(OH) D were assessed before and after the intervention to determine the effects of vitamin D on the highlighted parameters. RESULTS Serum levels of 25(OH) D increased significantly in the vitamin D group (P=0.01). However, no significant differences in serum IL-6 and TNF-α were found between both groups at the baseline and at the end of the intervention. CONCLUSION The findings revealed that vitamin D supplementation for 3 months is not efficacious in reducing inflammatory cytokines in children with ADHD. Further studies are required to confirm these results.
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Affiliation(s)
- Mahsa Samadi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Gholami
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Seyedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Jalali
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Effatpanah
- School of Medicine, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeid Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Mina Abdolahi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chamari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Niyaz Mohammadzadeh Honarvar
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Duval F, Erb A, Mokrani M, Weiss T, Carcangiu R. First‐Dose Methylphenidate‐Induced Changes in the Anti‐Saccade Task Performance and Outcome in Adults with Attention‐Deficit/Hyperactivity Disorder. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2021; 3:146-152. [PMID: 36101656 PMCID: PMC9175892 DOI: 10.1176/appi.prcp.20210010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022] Open
Abstract
Objective We examined whether the anti‐saccade task (AST) performance after the first methylphenidate (MPH) dose could be associated with subsequent clinical outcome in adults with attention‐deficit/hyperactivity disorder (ADHD). Methods Ninety‐seven drug‐naive DSM‐5 ADHD adults participated in this study. The AST parameters were measured at baseline, after the first MPH‐dose (10 mg orally), and 6 months after chronic MPH treatment. Results were compared with those of 50 healthy control (HC) subjects. Results At baseline, ADHDs showed longer saccadic reaction times and more direction errors than HCs (both p < 0.00001). Acute and chronic MPH administration resulted in normalization of the AST performances. Multivariate regression analysis after adjusting for age, sex, weight, and severity of symptoms at baseline, revealed that a low percentage of direction errors after the first MPH‐dose (i.e., ≤10%) could predict remission at month 6 (OR: 5.84; 95% CI: 2.00–17.11; p = 0.001). Conclusions Our findings indicate that: (1) impairments of motor planning and response inhibition in adults with ADHD are improved with MPH, and (2) a low direction error percentage after the first MPH‐dose may be an independent predictor of remission. ClinicalTrials.gov identifier: NCT03411434 The antisaccade task (AST) is useful to reveal impairments in inhibitory control in ADHD. Never‐medicated adult ADHD subjects show delays in reaction times and increased direction errors. Methyphenidate (MPH) administration, either acute or chronic, normalizes AST performances. Direction error percentages after the first MPH‐dose could predict treatment outcome.
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Affiliation(s)
- Fabrice Duval
- Pôle 8/9 Psychiatry, APF2R, Centre Hospitalier, Rouffach, France (F. Duval, A. Erb, M. Mokrani, T. Weiss, R. Carcangiu)
| | - Alexis Erb
- Pôle 8/9 Psychiatry, APF2R, Centre Hospitalier, Rouffach, France (F. Duval, A. Erb, M. Mokrani, T. Weiss, R. Carcangiu)
| | - Marie‐Claude Mokrani
- Pôle 8/9 Psychiatry, APF2R, Centre Hospitalier, Rouffach, France (F. Duval, A. Erb, M. Mokrani, T. Weiss, R. Carcangiu)
| | - Thomas Weiss
- Pôle 8/9 Psychiatry, APF2R, Centre Hospitalier, Rouffach, France (F. Duval, A. Erb, M. Mokrani, T. Weiss, R. Carcangiu)
| | - Roberta Carcangiu
- Pôle 8/9 Psychiatry, APF2R, Centre Hospitalier, Rouffach, France (F. Duval, A. Erb, M. Mokrani, T. Weiss, R. Carcangiu)
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Pignalosa FC, Desiderio A, Mirra P, Nigro C, Perruolo G, Ulianich L, Formisano P, Beguinot F, Miele C, Napoli R, Fiory F. Diabetes and Cognitive Impairment: A Role for Glucotoxicity and Dopaminergic Dysfunction. Int J Mol Sci 2021; 22:ijms222212366. [PMID: 34830246 PMCID: PMC8619146 DOI: 10.3390/ijms222212366] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia, responsible for the onset of several long-term complications. Recent evidence suggests that cognitive dysfunction represents an emerging complication of DM, but the underlying molecular mechanisms are still obscure. Dopamine (DA), a neurotransmitter essentially known for its relevance in the regulation of behavior and movement, modulates cognitive function, too. Interestingly, alterations of the dopaminergic system have been observed in DM. This review aims to offer a comprehensive overview of the most relevant experimental results assessing DA’s role in cognitive function, highlighting the presence of dopaminergic dysfunction in DM and supporting a role for glucotoxicity in DM-associated dopaminergic dysfunction and cognitive impairment. Several studies confirm a role for DA in cognition both in animal models and in humans. Similarly, significant alterations of the dopaminergic system have been observed in animal models of experimental diabetes and in diabetic patients, too. Evidence is accumulating that advanced glycation end products (AGEs) and their precursor methylglyoxal (MGO) are associated with cognitive impairment and alterations of the dopaminergic system. Further research is needed to clarify the molecular mechanisms linking DM-associated dopaminergic dysfunction and cognitive impairment and to assess the deleterious impact of glucotoxicity.
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Affiliation(s)
- Francesca Chiara Pignalosa
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Antonella Desiderio
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Paola Mirra
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Cecilia Nigro
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Giuseppe Perruolo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Luca Ulianich
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Francesco Beguinot
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
| | - Claudia Miele
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-746-3248
| | - Raffaele Napoli
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
| | - Francesca Fiory
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.C.P.); (A.D.); (P.M.); (C.N.); (G.P.); (L.U.); (P.F.); (F.B.); (R.N.); (F.F.)
- URT “Genomic of Diabetes”, Institute of Experimental Endocrinology and Oncology, National Research Council, 80131 Naples, Italy
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Natsheh JY, Espinoza D, Bhimani S, Shiflett MW. The effects of the dopamine D2/3 agonist quinpirole on incentive value and palatability-based choice in a rodent model of attention-deficit/hyperactivity disorder. Psychopharmacology (Berl) 2021; 238:3143-3153. [PMID: 34313801 DOI: 10.1007/s00213-021-05931-7] [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: 11/04/2020] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE Palatability and incentive value influence animal food choice. Dopamine D2/3 receptor signaling may mediate the effects of palatability and incentive value on choice. Dopamine signaling is disrupted in attention-deficit hyperactivity disorder (ADHD). Investigating behavioral choice processes under D2/3 receptor agonists will help elucidate behavioral and pharmacological correlates of ADHD. OBJECTIVES To determine (1) how changes in incentive value affects choice of actions for outcomes that differ in palatability; (2) the effects of the D2/3 agonist quinpirole on choice based on palatability and incentive value; (3) how choice differs in spontaneously hypertensive rats (SHR; ADHD model) compared with control strains. METHODS Rats responded instrumentally for two food outcomes (chocolate and grain pellets) that differed in palatability. Following specific satiety of one outcome, rats underwent a choice test. Prior to the choice test, rats were given intra-peritoneal quinpirole (0.01-0.1 mg/kg) body weight. These manipulations were conducted in three strains of rats: SHR rats; the normotensive Wistar-Kyoto (WKY) controls; and Wistar outbred (WIS) controls. RESULTS All rat strains responded more vigorously for chocolate pellets compared with grain pellets. Quinpirole reduced the effects of palatability and dose-dependently increased the effects of incentive value on choice. SHR rats were the least influenced by incentive value, whereas WKY rats were the least influenced by palatability. CONCLUSIONS These results show that D2/3 signaling modulates choice based on palatability and incentive value. Disruption of this process in SHR rats may mirror motivational impairments observed in ADHD.
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Affiliation(s)
- Joman Y Natsheh
- Children's Specialized Hospital Research Center, New Brunswick, NJ, USA.,Palestinian Neuroscience Initiative, Al-Quds University, Jerusalem, Palestine.,Kessler Foundation, East Hanover, NJ, USA.,Departments of Physical Medicine and Rehabilitation, and Neurology, Rutgers, New Jersey Medical School, Newark, NJ, USA
| | - Diego Espinoza
- Department of Psychology, Rutgers, The State University of New Jersey, 101 Warren St., 301 Smith Hall, Newark, NJ, 07102, USA
| | - Shaznaan Bhimani
- Department of Psychology, Rutgers, The State University of New Jersey, 101 Warren St., 301 Smith Hall, Newark, NJ, 07102, USA
| | - Michael William Shiflett
- Department of Psychology, Rutgers, The State University of New Jersey, 101 Warren St., 301 Smith Hall, Newark, NJ, 07102, USA.
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Gross J, Faber NS, Kappes A, Nussberger AM, Cowen PJ, Browning M, Kahane G, Savulescu J, Crockett MJ, De Dreu CK. When Helping Is Risky: The Behavioral and Neurobiological Trade-off of Social and Risk Preferences. Psychol Sci 2021; 32:1842-1855. [PMID: 34705578 PMCID: PMC7614101 DOI: 10.1177/09567976211015942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Helping other people can entail risks for the helper. For example, when treating infectious patients, medical volunteers risk their own health. In such situations, decisions to help should depend on the individual's valuation of others' well-being (social preferences) and the degree of personal risk the individual finds acceptable (risk preferences). We investigated how these distinct preferences are psychologically and neurobiologically integrated when helping is risky. We used incentivized decision-making tasks (Study 1; N = 292 adults) and manipulated dopamine and norepinephrine levels in the brain by administering methylphenidate, atomoxetine, or a placebo (Study 2; N = 154 adults). We found that social and risk preferences are independent drivers of risky helping. Methylphenidate increased risky helping by selectively altering risk preferences rather than social preferences. Atomoxetine influenced neither risk preferences nor social preferences and did not affect risky helping. This suggests that methylphenidate-altered dopamine concentrations affect helping decisions that entail a risk to the helper.
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Affiliation(s)
- Jörg Gross
- Institute of Psychology, Leiden University,Corresponding author: Jörg Gross, Leiden University, Institute of Psychology, Wassenaarseweg 52, 2300 RB Leiden, , +31 71 527 2727
| | - Nadira S. Faber
- College of Life and Environmental Sciences, University of Exeter,Oxford Uehiro Centre for Practical Ethics, University of Oxford
| | | | | | - Philip J Cowen
- Department of Psychiatry, University of Oxford,Oxford Health NHS Foundation Trust, Oxford
| | - Michael Browning
- Department of Psychiatry, University of Oxford,Oxford Health NHS Foundation Trust, Oxford
| | - Guy Kahane
- Oxford Uehiro Centre for Practical Ethics, University of Oxford
| | | | | | - Carsten K.W. De Dreu
- Institute of Psychology, Leiden University,Center for Research in Experimental Economics and Political Decision Making (CREED), University of Amsterdam
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Lee J, Son JW, Kim S, Kim JE, Chung S, Ghim HR, Lee SI, Shin CJ, Ju G. Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2021; 32:129-136. [PMID: 34671185 PMCID: PMC8499037 DOI: 10.5765/jkacap.210009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/25/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer. Results Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group. Conclusion The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.
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Affiliation(s)
- Jeonghwan Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jung-Woo Son
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Siekyeong Kim
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Ji-Eun Kim
- Ma-Eum Pyong-On Psychiatric Clinic, Yongin, Korea
| | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Hei-Rhee Ghim
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Sang-Ick Lee
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Chul-Jin Shin
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Gawon Ju
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.,Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju, Korea
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Jhang CL, Lee HY, Chen JC, Liao W. Dopaminergic loss of cyclin-dependent kinase-like 5 recapitulates methylphenidate-remediable hyperlocomotion in mouse model of CDKL5 deficiency disorder. Hum Mol Genet 2021; 29:2408-2419. [PMID: 32588892 DOI: 10.1093/hmg/ddaa122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 05/24/2020] [Accepted: 06/11/2020] [Indexed: 12/20/2022] Open
Abstract
Cyclin-dependent kinase-like 5 (CDKL5), a serine-threonine kinase encoded by an X-linked gene, is highly expressed in the mammalian forebrain. Mutations in this gene cause CDKL5 deficiency disorder, a neurodevelopmental encephalopathy characterized by early-onset seizures, motor dysfunction, and intellectual disability. We previously found that mice lacking CDKL5 exhibit hyperlocomotion and increased impulsivity, resembling the core symptoms in attention-deficit hyperactivity disorder (ADHD). Here, we report the potential neural mechanisms and treatment for hyperlocomotion induced by CDKL5 deficiency. Our results showed that loss of CDKL5 decreases the proportion of phosphorylated dopamine transporter (DAT) in the rostral striatum, leading to increased levels of extracellular dopamine and hyperlocomotion. Administration of methylphenidate (MPH), a DAT inhibitor clinically effective to improve symptoms in ADHD, significantly alleviated the hyperlocomotion phenotype in Cdkl5 null mice. In addition, the improved behavioral effects of MPH were accompanied by a region-specific restoration of phosphorylated dopamine- and cAMP-regulated phosphoprotein Mr 32 kDa, a key signaling protein for striatal motor output. Finally, mice carrying a Cdkl5 deletion selectively in DAT-expressing dopaminergic neurons, but not dopamine receptive neurons, recapitulated the hyperlocomotion phenotype found in Cdkl5 null mice. Our findings suggest that CDKL5 is essential to control locomotor behavior by regulating region-specific dopamine content and phosphorylation of dopamine signaling proteins in the striatum. The direct, as well as indirect, target proteins regulated by CDKL5 may play a key role in movement control and the therapeutic development for hyperactivity disorders.
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Affiliation(s)
- Cian-Ling Jhang
- Institute of Neuroscience, National Cheng-Chi University, Taipei 116, Taiwan
| | - Hom-Yi Lee
- Department of Psychology, Chung Shan Medical University, Taichung 402, Taiwan.,Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung 402, Taiwan
| | - Jin-Chung Chen
- Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan 333, Taiwan
| | - Wenlin Liao
- Institute of Neuroscience, National Cheng-Chi University, Taipei 116, Taiwan.,Research Center for Mind, Brain and Learning, National Cheng-Chi University, Taipei 116, Taiwan
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Castells X, Ramon M, Cunill R, Olivé C, Serrano D. Relationship Between Treatment Duration and Efficacy of Pharmacological Treatment for ADHD: A Meta-Analysis and Meta-Regression of 87 Randomized Controlled Clinical Trials. J Atten Disord 2021; 25:1352-1361. [PMID: 32075485 DOI: 10.1177/1087054720903372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: To determine the relationship between treatment duration and the efficacy of pharmacological treatment for reducing ADHD symptoms. Method: We conducted a systematic review of randomized, double-blind, placebo-controlled clinical trials investigating the efficacy of pharmacological interventions in patients with ADHD. The last bibliographic search was performed in April 15, 2019. The effect of treatment duration on efficacy was studied using meta-regression. Results: A total of 87 studies lasting from 3 to 28 weeks were included. Pharmacological treatment improved ADHD symptom severity by -7.35 points. Treatment duration did not moderate the efficacy of pharmacological treatment. Consistent results were found for psychostimulant drugs, methylphenidate, amphetamine derivatives, atomoxetine, and α2-agonists. A negative correlation was found between baseline ADHD severity efficacy (Coefficient = -.250, p = .013). Conclusion: The efficacy of pharmacological treatment for ADHD remains stable over time. A greater efficacy in more severe patients is suggested.
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Affiliation(s)
| | | | - Ruth Cunill
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | | | - Domènec Serrano
- University of Girona, Spain.,Institut d'Assistència Sanitària, Girona, Spain
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Zhang X, Talpos J, Berridge MS, Apana SM, Slikker W, Wang C, Paule MG. MicroPET/CT assessment of neurochemical effects in the brain after long-term methylphenidate treatment in nonhuman primates. Neurotoxicol Teratol 2021; 87:107017. [PMID: 34265415 DOI: 10.1016/j.ntt.2021.107017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 01/23/2023]
Abstract
Methylphenidate (MPH) is a psychostimulant approved by the FDA to treatment Attention-Deficit Hyperactivity Disorder (ADHD). MPH is believed to exert its pharmacological effects via preferential blockade of the dopamine transporter (DAT) and the norepinephrine transporter (NET), resulting in increased monoamine levels in the synapse. We used a quantitative non-invasive PET imaging technique to study the effects of long-term methylphenidate use on the central nervous system (CNS). We conducted microPET/CT scans on young adult male rhesus monkeys to monitor changes in the dopaminergic system. We used [18F] AV-133, a ligand for the vesicular monoamine transporter 2 (VMAT2), and [18F]FESP a ligand for the D2 and 5HT2 receptors. In this study we evaluated the effects if chronic MPH treatment in the nonhuman primates (NHP). Two-year-old, male rhesus monkeys were orally administered MPH diluted in the electrolyte replenisher, Prang, twice a day, five days per week (M-F) over an 8-year period. The dose of MPH was gradually escalated from 0.15 mg/kg initially to 2.5 mg/kg/dose for the low dose group, and 1.5 mg/kg to 12.5 mg/kg/dose for the high dose group (Rodriguez et al., 2010). Scans were performed on Mondays, about 60 h after their last treatment, to avoid the acute effects of MPH. Tracers were injected intravenously ten minutes before microPET/CT scanning. Sessions lasted about 120 min. The Logan reference tissue model was used to determine the Binding Potential (BP) of each tracer in the striatum with the cerebellar cortex time activity curve as an input function. Both MP treatment groups had a lower [18F] AV-133 BP, although this failed to reach statistical significance. MPH treatment did not have a significant effect on The BP of [18F] FESP in the striatum. Long-term administration of MPH did not significant change any of the marker of monoamine function used here. These data suggest that, despite lingering concerns, long-term use of methylphenidate does not negatively impact monoamine function. This study also demonstrates that microPET imaging can distinguish differences in binding potentials of a variety of radiotracers in the CNS of NHPs. This approach may provide minimally-invasive biomarkers of neurochemical processes associated with chronic exposure to CNS medications. (Supported by NCTR).
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Affiliation(s)
- X Zhang
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, United States of America.
| | - J Talpos
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, United States of America
| | - M S Berridge
- 3D Imaging, LLC, Little Rock, AR 72113 and University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America
| | - S M Apana
- 3D Imaging, LLC, Little Rock, AR 72113 and University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America
| | - W Slikker
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, United States of America
| | - C Wang
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, United States of America
| | - M G Paule
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, United States of America
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Luderer M, Ramos Quiroga JA, Faraone SV, Zhang James Y, Reif A. Alcohol use disorders and ADHD. Neurosci Biobehav Rev 2021; 128:648-660. [PMID: 34265320 DOI: 10.1016/j.neubiorev.2021.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/18/2022]
Abstract
Despite a growing literature on the complex bidirectional relationship of ADHD and substance use, reviews specifically focusing on alcohol are scarce. ADHD and AUD show a significant genetic overlap, including genes involved in gluatamatergic and catecholaminergic neurotransmission. ADHD drives risky behavior and negative experiences throughout the lifespan that subsequently enhance a genetically increased risk for Alcohol Use Disorders (AUD). Impulsive decisions and a maladaptive reward system make individuals with ADHD vulnerable for alcohol use and up to 43 % develop an AUD; in adults with AUD, ADHD occurs in about 20 %, but is vastly under-recognized and under-treated. Thus, routine screening and treatment procedures need to be implemented in AUD treatment. Long-acting stimulants or non-stimulants can be used to treat ADHD in individuals with AUD. However, it is crucial to combine medical treatment for ADHD with pharmacotherapy and psychotherapy for AUD, and other comorbid disorders. Identification of individuals at risk for AUD, especially those with ADHD and conduct disorder or oppositional defiant disorder, is a key factor to prevent negative outcomes.
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Affiliation(s)
- Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany.
| | - Josep Antoni Ramos Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatryand Forensic Medicine, Universitat Autònoma deBarcelona, Bellaterra, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Yanli Zhang James
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany
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41
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19th Latest Advances in Psychiatry International Symposium. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2021. [DOI: 10.1002/pnp.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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42
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Tamminga HGH, Reneman L, Schrantee A, Bottelier MA, Bouziane C, Geurts HM, Groenman AP. Do effects of methylphenidate on cognitive performance last beyond treatment? A randomized placebo-controlled trial in boys and men with ADHD. Eur Neuropsychopharmacol 2021; 46:1-13. [PMID: 33735707 DOI: 10.1016/j.euroneuro.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/22/2020] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
Methylphenidate (MPH) is the first-choice pharmacological treatment for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) across the lifespan. However, it is unclear whether MPH affects cognitive development, while recent (pre-) clinical studies suggest effects on the developing brain. The present randomized, placebo-controlled trial aims to determine whether MPH has short-term, age-dependent effects on cognitive performance in ADHD after a 1-week washout. Effects of 16 weeks MPH treatment were assessed after a one-week washout on cognitive functioning. Boys (age=10-12) and men (age=23-40) with ADHD were assigned to MPH treatment (boys n=25, men n=24) or placebo (boys n=25, men n=24). Outcome measures were working memory, response inhibition, response speed, episodic memory, and delay aversion. Differences in task performances over time (pre-, mid-, and post-treatment, following a 1-week wash-out) were compared between age and treatment conditions with mixed ANOVAs. MPH improved working memory and response speed, but only during treatment. No lasting age*treatment effects were observed post intervention. Overall, the results from the present randomized, placebo-controlled trial show that the effects of MPH on cognition do not extend past treatment in children or adults. While treatment with MPH improves cognition during treatment, these effects appear transient after 16-weeks of treatment. (Title trial: "Effects of methylphenidate on the developing brain"; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3103).
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Affiliation(s)
- Hyke G H Tamminga
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands; Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe achtergracht 129, 1018 Amsterdam, The Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Marco A Bottelier
- Center for child- and adolescent psychiatry Triversum, Alkmaar, The Netherlands
| | - Cheima Bouziane
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Hilde M Geurts
- Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe achtergracht 129, 1018 Amsterdam, The Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands; Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
| | - Annabeth P Groenman
- Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe achtergracht 129, 1018 Amsterdam, The Netherlands.
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43
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Kim S, Kim JS, Kwon YJ, Lee HY, Yoo JH, Lee YJ, Shim SH. Altered cortical functional network in drug-naive adult male patients with attention-deficit hyperactivity disorder: A resting-state electroencephalographic study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110056. [PMID: 32777325 DOI: 10.1016/j.pnpbp.2020.110056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/08/2020] [Accepted: 08/03/2020] [Indexed: 02/03/2023]
Abstract
Relatively little is known about the neurophysiology of adult Attention-deficit/hyperactivity disorder (ADHD). Brain network analysis can yield important insights into the neuropathology in adult ADHD. The objective of this study was to investigate source-level cortical functional network using resting-state electroencephalography (EEG) in drug-naive adult patients with ADHD. Resting-state EEG was performed for 30 adult male patients with ADHD and 27 male healthy controls. Source-level weighted functional networks based on graph theory were evaluated, including strength, clustering coefficient (CC) and path length (PL) in six frequency bands. At the global level, strength (η2 = 0.167) and CC (η2 = 0.156) were lower while PL (η2 = 0.159) was higher for the high beta band in the ADHD patient group compared to healthy controls. At the nodal level, CCs of the high beta band were lower in the left middle temporal gyrus (η2 = 0.244), right inferior occipital cortex (η2 = 0.214), right posterior transverse collateral sulcus (η2 = 0.237), and right anterior occipital sulcus (η2 = 0.251) for the adult ADHD group. Furthermore, the nodal-level high beta band CCs of the left middle temporal gyrus and right anterior occipital sulcus were significantly negatively correlated with ADHD symptoms. The altered cortical functional network showed inefficient connectivity in the left middle temporal gyrus, belonging to the default mode network, the right inferior occipital cortex, belonging to the extrastriate visual resting state network, the right posterior transverse collateral sulcus, belonging to the visual network, and the anterior occipital sulcus, reflecting visual attention, which might affect the pathophysiology of ADHD. Taken together, these attenuated network inefficiencies in adult patients with ADHD may lead to suboptimal information processing and affect symptoms of ADHD, such as inattention and hyperactivity. Our findings should be further replicated using longitudinal study designs.
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Affiliation(s)
- Sungkean Kim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Young Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Hwa Young Lee
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
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44
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Dopaminergic modulation of reward discounting in healthy rats: a systematic review and meta-analysis. Psychopharmacology (Berl) 2021; 238:711-723. [PMID: 33215269 DOI: 10.1007/s00213-020-05723-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 01/11/2023]
Abstract
RATIONALE Although numerous studies have suggested that pharmacological alteration of the dopamine (DA) system modulates reward discounting, these studies have produced inconsistent findings. OBJECTIVES Here, we conducted a systematic review and pre-registered meta-analysis to evaluate DA drug-mediated effects on reward discounting of time, probability, and effort costs in studies of healthy rats. This produced a total of 1343 articles to screen for inclusion/exclusion. From the literature, we identified 117 effects from approximately 1549 individual rats. METHODS Using random effects with maximum-likelihood estimation, we meta-analyzed placebo-controlled drug effects for (1) DA D1-like receptor agonists and (2) antagonists, (3) D2-like agonists and (4) antagonists, and (5) DA transporter-modulating drugs. RESULTS Meta-analytic effects showed that DAT-modulating drugs decreased reward discounting. While D1-like and D2-like antagonists both increased discounting, agonist drugs for those receptors had no significant effect on discounting behavior. A number of these effects appear contingent on study design features like cost type, rat strain, and microinfusion location. CONCLUSIONS These findings suggest a nuanced relationship between DA and discounting behavior and urge caution when drawing generalizations about the effects of pharmacologically manipulating dopamine on reward-based decision-making.
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45
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Moreno M, Azocar V, Vergés A, Fuentealba JA. High impulsive choice is accompanied by an increase in dopamine release in rat dorsolateral striatum. Behav Brain Res 2021; 405:113199. [PMID: 33636234 DOI: 10.1016/j.bbr.2021.113199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 02/05/2023]
Abstract
Dopamine neurotransmission has been consistently associated with individual differences in impulsive choice. Clinical and preclinical evidence suggests that low striatal dopamine D2 signaling predisposes to engage in impulsive behaviors. Although dopamine D2 signaling controls dopamine (DA) extracellular levels, the relationship between striatal dopamine extracellular levels and impulsive choice remains poorly understood. Using quantitative microdialysis, we investigated whether extracellular DA levels in rat dorsolateral striatum (DLS) correlates with preference for an immediate small reward or for a delayed larger reward. Rats were tested in a delay-discounting task and classified as high impulsive (HI) or low impulsive (LI) according to the area under the discounting curve (AUC). No-net flux microdialysis experiments, assessing basal DA release, DA-uptake, and DA extracellular concentration (DA Cext), were carried out in dorsolateral striatum (DLS) of urethane-anesthetized rats. Rats classified as HI showed a higher DA release compared with LI rats. Differences in DLS DA-uptake and DA Cext were non-significant. Importantly, a significant negative correlation was observed between AUC and DA release, indicating that the lower the AUC, the higher the DLS DA release. This finding shows that DA release is augmented in the DLS of rats classified as HI, suggesting that a hyper-activated nigro-striatal pathway contributes to impulsive choice.
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Affiliation(s)
- Macarena Moreno
- Department of Pharmacy and Interdisciplinary Center of Neuroscience, Faculty of Chemistry and Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Victor Azocar
- Department of Pharmacy and Interdisciplinary Center of Neuroscience, Faculty of Chemistry and Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alvaro Vergés
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Antonio Fuentealba
- Department of Pharmacy and Interdisciplinary Center of Neuroscience, Faculty of Chemistry and Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile.
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46
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Fluegge K. Influence of Seasonality and Altitude in ADHD Prevalence: A Role for Environmental Nitrous Oxide Exposure. J Atten Disord 2021; 25:233-234. [PMID: 29681218 DOI: 10.1177/1087054718770290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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47
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Elton A, Allen JH, Yorke M, Khan F, Lin Q, Boettiger CA. High Trait Attention Promotes Resilience and Reduces Binge Drinking Among College Students With a Family History of Alcohol Use Disorder. Front Psychiatry 2021; 12:672863. [PMID: 34054623 PMCID: PMC8155514 DOI: 10.3389/fpsyt.2021.672863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023] Open
Abstract
Binge patterns of alcohol use among post-high school emerging adults are associated with both immediate negative consequences and increased risk of long-term drinking problems, particularly among individuals with a family history (FH) of alcohol use disorder (AUD). Therefore, the developmental time period of emerging adulthood, paired with the high-risk environment of college campuses, represents an important target for interventions. Attentional ability has recently emerged as a mediator of resilience to stress-related psychopathology and offers a potential neurocognitive target for interventions. We tested the hypothesis that attentional ability promotes resilience to binge drinking in a sample of 464 college students with (n = 221) or without (n = 243) familial risk for AUD. Two-way analyses of covariance (ANCOVA) tested effects of FH and self-reported binge drinking on attention scores from the Barratt Impulsiveness Scale (BIS). In addition, mediation analyses tested whether BIS attention scores mediated the relationship between Conner-Davidson Resilience Scale scores and binge drinking. ANCOVA results indicated a significant FH-by-binge drinking interaction (p = 0.008) in which FH positive subjects who did not binge drink had the fewest attention problems, consistent with a marker of resilience. Furthermore, BIS attention scores significantly mediated the effect of Conner-Davidson Resilience Scale scores on binge drinking, with stronger effects in FH positive subjects (p < 0.001) than FH negative subjects (p = 0.49). The findings suggest that attention promotes resilience to binge drinking in individuals with familial risk for AUD. Interventions targeting attentional ability in this high-risk population, particularly FH positive individuals with attention deficits, may serve to reduce binge drinking and its consequences.
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Affiliation(s)
- Amanda Elton
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J Hunter Allen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mya Yorke
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Farhan Khan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Qiaosen Lin
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Charlotte A Boettiger
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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48
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Effects of methylphenidate on reinforcement learning depend on working memory capacity. Psychopharmacology (Berl) 2021; 238:3569-3584. [PMID: 34676440 PMCID: PMC8629893 DOI: 10.1007/s00213-021-05974-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022]
Abstract
RATIONALE Brain catecholamines have long been implicated in reinforcement learning, exemplified by catecholamine drug and genetic effects on probabilistic reversal learning. However, the mechanisms underlying such effects are unclear. OBJECTIVES AND METHODS Here we investigated effects of an acute catecholamine challenge with methylphenidate (20 mg, oral) on a novel probabilistic reversal learning paradigm in a within-subject, double-blind randomised design. The paradigm was designed to disentangle effects on punishment avoidance from effects on reward perseveration. Given the known large individual variability in methylphenidate's effects, we stratified our effects by working memory capacity and trait impulsivity, putatively modulating the effects of methylphenidate, in a large sample (n = 102) of healthy volunteers. RESULTS Contrary to our prediction, methylphenidate did not alter performance in the reversal phase of the task. Our key finding is that methylphenidate altered learning of choice-outcome contingencies in a manner that depended on individual variability in working memory span. Specifically, methylphenidate improved performance by adaptively reducing the effective learning rate in participants with higher working memory capacity. CONCLUSIONS This finding emphasises the important role of working memory in reinforcement learning, as reported in influential recent computational modelling and behavioural work, and highlights the dependence of this interplay on catecholaminergic function.
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49
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Womack KB, Dubiel R, Callender L, Dunklin C, Dahdah M, Harris TS, Devous MD, Juengst SB, Bell K, Diaz-Arrastia R, Ding K. 123I-Iofluopane Single-Photon Emission Computed Tomography as an Imaging Biomarker of Pre-Synaptic Dopaminergic System after Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2020; 37:2113-2119. [PMID: 32216525 DOI: 10.1089/neu.2019.6892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Dopaminergic (DA) system function is frequently disrupted after traumatic brain injury (TBI). However, published interventions that target the DA system with the hope of enhancing functional outcomes are inconclusive, partially because of the lack of DA signaling biomarkers that can be used to select patients likely to benefit from DA-directed therapies or to monitor treatment efficacy. The aim of this study was to evaluate the feasibility of using 123I-iofluopane single-photon emission computerized tomography (SPECT) to assess pre-synaptic DA system dysfunction after severe TBI. Eighteen patients with severe TBI were enrolled in this study. 123I-iofluopane SPECT imaging was performed at baseline and again 2.5 h after a single dose of methylphenidate (MP) administered enterally. DA transporter (DAT) specific binding ratio (SBR) before and after MP was measured. Functional outcomes included the Disability Rating Scale, JFK Coma Recovery Scale-Revised, Functional Independence Measure, and Functional Assessment Measure. Thirteen of 18 patients completed the study. Average time from injury to SPECT scan was 48 days (standard deviation [SD], 24 days; median, 31). Baseline ioflupane striatal SBR was 1.51 ± 0.46 (median, 1.67). A 43.1% (SD, 16; median, 46.5) displacement of ioflupane from pre-synaptic DAT was observed after MP administration. Baseline SBR positively correlated with functional status at baseline and 4 weeks after completion of the study. Serum MP levels correlated with relative change in SBR (rs = 0.60; p = 0.04). Our findings suggest that 123I-iofluopane SPECT is a promising tool to determine the severity of pre-synaptic DA terminal disruption and for monitoring pharmacokinetics and pharmacodynamics of therapeutic interventions targeting the DA system.
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Affiliation(s)
- Kyle B Womack
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rosemary Dubiel
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas, USA.,Baylor Scott & White Health, Dallas, Texas, USA
| | - Librada Callender
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas, USA.,Baylor Scott & White Health, Dallas, Texas, USA
| | - Cynthia Dunklin
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas, USA.,Baylor Scott & White Health, Dallas, Texas, USA
| | | | - Thomas S Harris
- Avid Radiopharmaceuticals Inc, Philadelphia, Pennsylvania, USA
| | | | - Shannon B Juengst
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kan Ding
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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50
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Piacentino D, De Rossi P, Kotzalidis GD, Maniscalco I, Pompili M, Giupponi G, Hiemke C, Conca A. Methylphenidate challenge test in adults with attention deficit/hyperactivity disorder (ADHD): Clinical effects and their predictors. Hum Psychopharmacol 2020; 35:e2740. [PMID: 32785944 DOI: 10.1002/hup.2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/11/2020] [Accepted: 04/24/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Adult and children attention deficit/hyperactivity disorder (ADHD) share similar symptoms and responses to drugs such as methylphenidate (MPH). Yet, in Europe, these drugs remain unlicensed for adults. We aimed to assess the effects of an acute MPH challenge on the four dimensions concentration, impulsivity, tension, and general well-being in ADHD adults, and identify predictors of improvement. METHODS Therapeutic Drug Monitoring was performed to measure MPH plasma levels. A Visual Analogue Scale was administered to patients before and after the acute MPH challenge to measure self-reported changes in the four dimensions. RESULTS After the acute MPH challenge, our 71 patients showed significant improvement in concentration and tension. The MPH challenge dose correlated with lower patients' age, greater side effects, increased concentration (p = .008) and decreased tension (p = .001). At multiple linear regression MPH plasma levels and absence of postdose side effects predicted concentration improvement, MPH plasma levels predicted tension improvement. MPH plasma levels were significantly higher in patients who reported an improvement in concentration, tension, and impulsivity compared to nonimprovers (p's from .001 to .004). CONCLUSIONS These findings point to the efficacy of MPH challenge in improving concentration and tension in adult ADHD, thus emphasizing the need for a broader treatment access for these patients.
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Affiliation(s)
- Daria Piacentino
- Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy.,NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pietro De Rossi
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,ASL RM5, SPDC Monterotondo, Rome, Italy
| | - Georgios D Kotzalidis
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ignazio Maniscalco
- Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
| | - Maurizio Pompili
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giancarlo Giupponi
- Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
| | - Christoph Hiemke
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Mainz, Mainz, Germany
| | - Andreas Conca
- Department of Psychiatry, Central Hospital, Sanitary Agency of South Tyrol, Bolzano-Bozen, Italy
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