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

Published online by Cambridge University Press:  30 August 2016

C. Y. Shang ,
C. G. Yan ,
H. Y. Lin ,
W. Y. Tseng ,
F. X. Castellanos  and
S. S. Gau
C. Y. Shang
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
C. G. Yan
Affiliation:
Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA The Center for Neurodevelopmental Disorders at the Child Study Center at NYU Langone Medical Center, New York, NY, USA
H. Y. Lin
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
W. Y. Tseng
Affiliation:
Graduate Institute of Brain and Mind Sciences, Taipei, Taiwan Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
F. X. Castellanos*
Affiliation:
Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA The Center for Neurodevelopmental Disorders at the Child Study Center at NYU Langone Medical Center, New York, NY, USA
S. S. Gau*
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Graduate Institute of Brain and Mind Sciences, Taipei, Taiwan
*
*Address for correspondence: S. S. Gau, M.D., Ph.D., Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan. (Email: [email protected]) [S.S.G] (Email: [email protected]) [F.X.C.]
*Address for correspondence: S. S. Gau, M.D., Ph.D., Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan. (Email: [email protected]) [S.S.G] (Email: [email protected]) [F.X.C.]
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Abstract

Background

Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear.

Method

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.

Results

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.

Conclusions

Our findings suggest differential neurophysiological mechanisms for the treatment effects of methylphenidate and atomoxetine in children with ADHD.

Keywords

Atomoxetineattention deficit hyperactivity disorderfractional amplitude of low-frequency fluctuationsmethylphenidateresting brain imaging
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3173 - 3185
Copyright
Copyright © Cambridge University Press 2016 

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