title: Psychostimulant treatment and the developing cortex in attention deficit hyperactivity disorder.
abstract: OBJECTIVE
  While there has been considerable concern over possible adverse effects of psychostimulants on brain development, this issue has not been examined in a prospective study. The authors sought to determine prospectively whether psychostimulant treatment for attention deficit hyperactivity disorder (ADHD) was associated with differences in the development of the cerebral cortex during adolescence.
  
  
  METHODS
  Change in cortical thickness was estimated from two neuroanatomic MRI scans in 43 youths with ADHD. The mean age at the first scan was 12.5 years, and at the second scan, 16.4 years. Nineteen patients not treated with psychostimulants between the scans were compared with an age-matched group of 24 patients who were treated with psychostimulants. Further comparison was made against a template derived from 620 scans of 294 typically developing youths without ADHD.
  
  
  RESULTS
  Adolescents taking psychostimulants differed from those not taking psychostimulants in the rate of change of the cortical thickness in the right motor strip, the left middle/inferior frontal gyrus, and the right parieto-occipital region. The group difference was due to more rapid cortical thinning in the group not taking psychostimulants (mean cortical thinning of 0.16 mm/year [SD=0.17], compared with 0.03 mm/year [SD=0.11] in the group taking psychostimulants). Comparison against the typically developing cohort without ADHD showed that cortical thinning in the group not taking psychostimulants was in excess of age-appropriate rates. The treatment groups did not differ in clinical outcome, however.
  
  
  CONCLUSIONS
  These findings show no evidence that psychostimulants were associated with slowing of overall growth of the cortical mantle.
authors.affiliation: Child Psychiatry Branch, Bldg. 10, Center Dr., NIMH, Bethesda, MD 20892, USA. shawp@mail.nih.gov
authors.forename: Philip
authors.initials: P
authors.lastname: Shaw
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Sharp
authors.forename: Meaghan
authors.initials: M
authors.lastname: Morrison
authors.forename: Kristen
authors.initials: K
authors.lastname: Eckstrand
authors.forename: Deanna K
authors.initials: DK
authors.lastname: Greenstein
authors.forename: Liv S
authors.initials: LS
authors.lastname: Clasen
authors.forename: Alan C
authors.initials: AC
authors.lastname: Evans
authors.forename: Judith L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D000293:Adolescent; D000662:Amphetamines / Q000009:adverse effects / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000187:drug effects* / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use; D010389:Pemoline / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000662:Amphetamines; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D010389:Pemoline
references.citation: Arch Gen Psychiatry. 2006 May;63(5):540-9
references.pmid: 16651511
references.citation: IEEE Trans Med Imaging. 2002 Oct;21(10):1280-91
references.pmid: 12585710
references.citation: Biol Psychiatry. 2007 Jun 15;61(12):1361-9
references.pmid: 16950217
references.citation: IEEE Trans Med Imaging. 1998 Feb;17(1):87-97
references.pmid: 9617910
references.citation: J Neurosci. 2000 Mar 15;20(6):RC65
references.pmid: 10704519
references.citation: Neuroimage. 2007 Jul 15;36(4):1065-73
references.pmid: 17513132
references.citation: Am J Psychiatry. 2004 Nov;161(11):1990-7
references.pmid: 15514398
references.citation: Biol Psychiatry. 1992 Apr 15;31(8):794-807
references.pmid: 1643194
references.citation: J Abnorm Child Psychol. 1975;3(3):217-29
references.pmid: 1214032
references.citation: J Am Acad Child Adolesc Psychiatry. 2002 Nov;41(11):1306-14
references.pmid: 12410072
references.citation: Neuroimage. 2000 Sep;12(3):340-56
references.pmid: 10944416
references.citation: J Neurosci. 2006 Apr 26;26(17):4567-76
references.pmid: 16641236
references.citation: Neuroimage. 2005 Jan 1;24(1):163-73
references.pmid: 15588607
references.citation: Biol Psychiatry. 2003 Dec 15;54(12):1310-1
references.pmid: 14675793
references.citation: Arch Gen Psychiatry. 1983 Jun;40(6):688-93
references.pmid: 6847336
references.citation: J Am Acad Child Adolesc Psychiatry. 2006 Nov;45(11):1304-1313
references.pmid: 17023868
references.citation: J Child Psychol Psychiatry. 1993 Jul;34(5):785-804
references.pmid: 8340445
references.citation: Proc Natl Acad Sci U S A. 2007 Dec 4;104(49):19649-54
references.pmid: 18024590
references.citation: J Am Acad Child Adolesc Psychiatry. 2000 Jan;39(1):59-66
references.pmid: 10638068
references.citation: Neurosci Biobehav Rev. 2006;30(8):1225-45
references.pmid: 17161238
references.citation: Am J Psychiatry. 2007 Apr;164(4):647-55
references.pmid: 17403979
references.citation: Nature. 2006 Mar 30;440(7084):676-9
references.pmid: 16572172
references.citation: Neurology. 2006 Sep 26;67(6):1023-7
references.pmid: 17000972
references.citation: Proc Natl Acad Sci U S A. 1998 Nov 24;95(24):14494-9
references.pmid: 9826728
references.citation: JAMA. 2002 Oct 9;288(14):1740-8
references.pmid: 12365958
references.citation: Neuropsychopharmacology. 1989 Dec;2(4):255-63
references.pmid: 2692588
references.citation: Pediatrics. 2004 Apr;113(4):762-9
references.pmid: 15060225