A Counting Stroop Functional Magnetic Resonance Imaging Study on the Effects of ORADUR-Methylphenidate in Drug-Naive Children with Attention-Deficit/Hyperactivity Disorder

Chi-Yung Shang, Tai-Li Chou, Cheng-Yu Hsieh, Susan Shur-Fen Gau, Chi-Yung Shang, Tai-Li Chou, Cheng-Yu Hsieh, Susan Shur-Fen Gau

Abstract

Objective: Methylphenidate is effective in reducing the clinical symptoms of patients with attention-deficit/hyperactivity disorder (ADHD). ORADUR®-methylphenidate is a new extended-release preparation of methylphenidate. This study aimed at identifying brain regions with activation changes and their correlations with neuropsychological functions after treatment with ORADUR-methylphenidate in children with ADHD. Methods: We recruited drug-naive children with ADHD and age- and sex-matched typically developing (TD) children. They were all scanned with the functional magnetic resonance imaging (fMRI) during the counting Stroop task at baseline, and those with ADHD had the second fMRI assessment after 8-week treatment with ORADUR-methylphenidate. The Rapid Visual Information Processing (RVP) and Conners' Continuous Performance Test (CCPT) were used to assess the attention performance of the ADHD (before and after treatment) and TD groups. Results: ORADUR-methylphenidate significantly decreased inattention (Cohen d = 2.17) and hyperactivity-impulsivity (Cohen d = 0.98) symptoms. We found less activation in the right inferior frontal gyrus (rIFG) in the pre-treatment ADHD children than TD children and greater treatment-induced activation in the dorsal anterior cingulate cortex (dACC) and the right dorsolateral prefrontal cortex (rDLPFC). There was no significant difference between the post-treatment ADHD and TD groups. However, the treatment-related activations in the dACC, rDLPFC, and rIFG were significantly correlated with CCPT and RVP measures. Conclusions: Our findings indicated that ORADUR-methylphenidate increased brain activations in the dACC, rDLPFC, and rIFG in children with ADHD, associated with improved focused attention, reduced impulsivity, and enhanced inhibition control. Activities of these brain regions might be biomarkers for the treatment effectiveness of methylphenidate for ADHD. Clinical Trials Registration: ClinicalTrials.gov number, NCT02450890.

Keywords: Conners' Continuous Performance Test; Rapid Visual Information Processing; attention-deficit/hyperactivity disorder; counting Stroop task; functional brain imaging; methylphenidate.

Figures

FIG. 1.
FIG. 1.
(a) Greater activation in the dACC and the rDLPFC from pre-treatment to post-treatment in children with ADHD for the incongruent versus congruent condition. (b) Greater activation in the rIFG in the TD group relative to the ADHD group at pre-treatment for the incongruent versus congruent condition. Reported areas of activation indicate the significance using uncorrected p < 0.005, a voxel size larger than 10. ADHD, attention-deficit/hyperactivity disorder; dACC, dorsal anterior cingulate cortex; rDLPFC, right dorsolateral prefrontal cortex; rIFG, right inferior frontal gyrus; TD, typically developing.

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Source: PubMed

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