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Differential effects of methylphenidate and atomoxetine on intrinsic brain activity in children with attention deficit hyperactivity disorder

Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear. After baseline evaluation including cognitive testing of the Cambridge Neuropsychological Test Automated Battery (CANTAB)...

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Published in:Psychological medicine 2016-11, Vol.46 (15), p.3173-3185
Main Authors: Shang, C. Y., Yan, C. G., Lin, H. Y., Tseng, W. Y., Castellanos, F. X., Gau, S. S.
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container_title Psychological medicine
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description Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear. After baseline evaluation including cognitive testing of the Cambridge Neuropsychological Test Automated Battery (CANTAB), drug-naive children with ADHD (n = 46), aged 7-17 years, were randomly assigned to a 12-week treatment with methylphenidate (n = 22) or atomoxetine (n = 24). Intrinsic brain activity, including the fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo), was quantified via resting-state functional magnetic resonance imaging at baseline and week 12. Reductions in inattentive symptoms were related to increased fALFF in the left superior temporal gyrus and left inferior parietal lobule for ADHD children treated with methylphenidate, and in the left lingual gyrus and left inferior occipital gyrus for ADHD children treated with atomoxetine. Hyperactivity/impulsivity symptom reductions were differentially related to increased fALFF in the methylphenidate group and to decreased fALFF in the atomoxetine group in bilateral precentral and postcentral gyri. Prediction analyses in the atomoxetine group revealed negative correlations between pre-treatment CANTAB simple reaction time and fALFF change in the left lingual gyrus and left inferior occipital gyrus, and positive correlations between pre-treatment CANTAB simple movement time and fALFF change in bilateral precentral and postcentral gyri and left precuneus, with a negative correlation between movement time and the fALFF change in the left lingual gyrus and the inferior occipital gyrus. Our findings suggest differential neurophysiological mechanisms for the treatment effects of methylphenidate and atomoxetine in children with ADHD.
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Y.</au><au>Yan, C. G.</au><au>Lin, H. Y.</au><au>Tseng, W. Y.</au><au>Castellanos, F. X.</au><au>Gau, S. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential effects of methylphenidate and atomoxetine on intrinsic brain activity in children with attention deficit hyperactivity disorder</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2016-11</date><risdate>2016</risdate><volume>46</volume><issue>15</issue><spage>3173</spage><epage>3185</epage><pages>3173-3185</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><coden>PSMDCO</coden><abstract>Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear. After baseline evaluation including cognitive testing of the Cambridge Neuropsychological Test Automated Battery (CANTAB), drug-naive children with ADHD (n = 46), aged 7-17 years, were randomly assigned to a 12-week treatment with methylphenidate (n = 22) or atomoxetine (n = 24). Intrinsic brain activity, including the fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo), was quantified via resting-state functional magnetic resonance imaging at baseline and week 12. Reductions in inattentive symptoms were related to increased fALFF in the left superior temporal gyrus and left inferior parietal lobule for ADHD children treated with methylphenidate, and in the left lingual gyrus and left inferior occipital gyrus for ADHD children treated with atomoxetine. Hyperactivity/impulsivity symptom reductions were differentially related to increased fALFF in the methylphenidate group and to decreased fALFF in the atomoxetine group in bilateral precentral and postcentral gyri. Prediction analyses in the atomoxetine group revealed negative correlations between pre-treatment CANTAB simple reaction time and fALFF change in the left lingual gyrus and left inferior occipital gyrus, and positive correlations between pre-treatment CANTAB simple movement time and fALFF change in bilateral precentral and postcentral gyri and left precuneus, with a negative correlation between movement time and the fALFF change in the left lingual gyrus and the inferior occipital gyrus. Our findings suggest differential neurophysiological mechanisms for the treatment effects of methylphenidate and atomoxetine in children with ADHD.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>27574878</pmid><doi>10.1017/S0033291716001938</doi><tpages>13</tpages></addata></record>
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subjects Adolescent
Adrenergic Uptake Inhibitors - therapeutic use
Atomoxetine
Atomoxetine Hydrochloride - therapeutic use
Attention Deficit Disorder with Hyperactivity - drug therapy
Attention Deficit Disorder with Hyperactivity - physiopathology
Attention deficit hyperactivity disorder
Brain - diagnostic imaging
Brain - physiopathology
Brain activity
Brain mapping
Child
Children
Childrens health
Cognitive ability
Cortex (parietal)
Dopamine Uptake Inhibitors - therapeutic use
Female
Fluctuations
Frontal Lobe - diagnostic imaging
Frontal Lobe - physiopathology
Functional magnetic resonance imaging
Functional Neuroimaging
Humans
Impulsive behavior
Impulsivity
Magnetic Resonance Imaging
Male
Mental health
Methylphenidate
Methylphenidate - therapeutic use
Movement time
Neuroimaging
Neuropsychology
NMR
Nuclear magnetic resonance
Occipital Lobe - diagnostic imaging
Occipital Lobe - physiopathology
Original Articles
Parietal Lobe - diagnostic imaging
Parietal Lobe - physiopathology
Prescribed
Reaction time task
Regional variations
Resting
Somatosensory Cortex - diagnostic imaging
Somatosensory Cortex - physiopathology
Superior temporal gyrus
Temporal gyrus
Treatment Outcome
title Differential effects of methylphenidate and atomoxetine on intrinsic brain activity in children with attention deficit hyperactivity disorder
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