Regional cerebral blood flow in children with attention deficit hyperactivity disorder: comparison before and after methylphenidate treatment.
Differences in brain activity of children with attention deficit hyperactivity disorder (ADHD) have been compared to normal healthy controls, suggesting neural correlates of cognitive/behavioral symptoms. Symptoms are improved with methylphenidate treatment but limited sources can be cited to show how brain activity in ADHD is altered after pharmacologic treatment. We investigated how long-term oral medication of methylphenidate affects the resting regional cerebral blood flow (rCBF) in ADHD children, using single photon emission computerized tomography (SPECT). rCBF was decreased in the orbitofrontal cortex and middle temporal gyrus in the right hemisphere whereas it was increased in the dorsomedial prefrontal and somatosensory area bilaterally in drug-naive ADHD children compared to control child subjects. After treatment with methylphenidate, the extent of hyperperfusion in the somatosensory area was reduced and significant reduction of rCBF was found in the right striatum for the first time. Methylphenidate treatment also resulted in rCBF increase in superior prefrontal and reduction in ventral higher visual areas bilaterally. The results indicated that improving ADHD symptom after methylphenidate is associated with normalization of abnormally reduced orbitofrontal activity and abnormally increased somatosensory cortical activity. These changes were accompanied with reduced striatum activity lower than that of normal controls. These changes might be associated with improving ADHD to control attention and motor response to irrelevant environmental stimuli after methylphenidate treatment.
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
Jae Sung
JS
Lee
Boong Nyun
BN
Kim
Eunjoo
E
Kang
Dong Soo
DS
Lee
Yu Kyeong
YK
Kim
June-Key
JK
Chung
Myung Chul
MC
Lee
Soo Churl
SC
Cho
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001921:Brain / Q000098:blood supply* / Q000187:drug effects; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D012039:Regional Blood Flow / Q000187:drug effects; D015899:Tomography, Emission-Computed, Single-Photon
D000697:Central Nervous System Stimulants; D008774:Methylphenidate