First-Dose Methylphenidate-Induced Changes in the Anti-Saccade Task Performance and Outcome in Adults with Attention-Deficit/Hyperactivity Disorder

Fabrice Duval, Alexis Erb, Marie-Claude Mokrani, Thomas Weiss, Roberta Carcangiu, Fabrice Duval, Alexis Erb, Marie-Claude Mokrani, Thomas Weiss, Roberta Carcangiu

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.

© 2021 The Authors. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC on behalf of American Psychiatric Association.

Figures

FIGURE 1
FIGURE 1
Ocular performances during the anti‐saccade task in 50 healthy control subjects, and in 97 adults with attention‐deficit/hyperactivity disorder (ADHD) at baseline (T1), after the first methylphenidate‐dose (10 mg orally [T2]), and after 6 months' administration of MPH (T3). A. Correct saccade reaction times (SRTs). B. Percentage of trials with regular latency direction errors. Histograms represent the group mean (±SD). Comparisons between control and ADHD subjects by U‐test, within ADHD subjects by T‐test; all p are corrected with Bonferroni's adjustment
FIGURE 2
FIGURE 2
Predicted probability of remission at month 6 based on regular latency direction error percentages after the first methylphenidate‐dose (10 mg orally) using logistic regression prediction curve. Logistic regression produces the regression coefficient (and standard error [SE] of estimate, and significance level) and odds ratio (OR, with 95% confidence interval [CI]) associated with error value

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