title: Increased NAA and reduced choline levels in the anterior cingulum following chronic methylphenidate. A spectroscopic test-retest study in adult ADHD.
abstract: The anterior cingulate cortex (ACC) is crucially involved in executive control of attention. Here, seven medication-naïve adult patients suffering from attention deficit/hyperactivity disorder (ADHD) were studied with 2D (1)H-magnetic resonance spectroscopic imaging (MRSI) of the ACC [Brodmann areas 24b'-c' and 32'] twice, once before initiation of stimulant treatment and once after 5-6 weeks of methylphenidate. Upon retest, all patients demonstrated marked clinical improvement. Analysis of regional brain spectra revealed a significantly decreased signal of choline containing compounds as well as increased N-acetyl-aspartate (NAA) levels following treatment with methylphenidate whereas total creatine remained unchanged. Our results add to a growing body of evidence implicating the ACC in the pathophysiology of ADHD and suggest that subtle structural changes might be associated with aspects of clinical improvement under stimulant treatment.
authors.affiliation: Center for ADHD Research, Department of Psychiatry, Charité-University Medicine Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany.
authors.forename: Golo
authors.initials: G
authors.lastname: Kronenberg
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ende
authors.forename: Barbara
authors.initials: B
authors.lastname: Alm
authors.forename: Michael
authors.initials: M
authors.lastname: Deuschle
authors.forename: Isabella
authors.initials: I
authors.lastname: Heuser
authors.forename: Michael
authors.initials: M
authors.lastname: Colla
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D001921:Brain; D002794:Choline / Q000032:analysis / Q000378:metabolism*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D006179:Gyrus Cinguli / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate; D001224:Aspartic Acid; C000179:N-acetylaspartate; D002794:Choline