title: Normal Neurochemistry in the Prefrontal and Cerebellar Brain of Adults with Attention-Deficit Hyperactivity Disorder.
abstract: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In an attempt to extend earlier neurochemical findings, we organized a magnetic resonance spectroscopy (MRS) study as part of a large, government-funded, prospective, randomized, multicenter clinical trial comparing the effectiveness of specific psychotherapy with counseling and stimulant treatment with placebo treatment (Comparison of Methylphenidate and Psychotherapy Study). We report the baseline neurochemical data for the anterior cingulate cortex (ACC) and the cerebellum in a case-control setting. For the trial, 1,480 adult patients were contacted for participation, 518 were assessed for eligibility, 433 were randomized, and 187 were potentially eligible for neuroimaging. The control group included 119 healthy volunteers. Single-voxel proton MRS was performed. In the patient group, 113 ACC and 104 cerebellar spectra fulfilled all quality criteria for inclusion in statistical calculations, as did 82 ACC and 78 cerebellar spectra in the control group. We did not find any significant neurometabolic differences between the ADHD and control group in the ACC (Wilks' lambda test: p = 0.97) or in the cerebellum (p = 0.62). Thus, we were unable to replicate earlier findings in this methodologically sophisticated study. We discuss our findings in the context of a comprehensive review of other MRS studies on ADHD and a somewhat skeptical neuropsychiatric research perspective. As in other neuropsychiatric disorders, the unclear nosological status of ADHD might be an explanation for false-negative findings.
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Dominique
authors.initials: D
authors.lastname: Endres
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Evgeniy
authors.initials: E
authors.lastname: Perlov
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Maier
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Feige
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Nickel
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Goll
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Bubl
authors.affiliation: Department of Radiology, Medical Physics, University Medical Center Freiburg , Freiburg , Germany ; Freiburg Institute for Advanced Studies, Albert-Ludwigs-University , Freiburg , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lange
authors.affiliation: Department of Neurology, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Glauche
authors.affiliation: Clinical Trials Unit, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: Graf
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Ebert
authors.affiliation: Clinic for Psychiatry and Psychotherapy, Central Institute for Mental Health Mannheim , Mannheim , Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Sobanski
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Philipsen
authors.affiliation: Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg , Freiburg , Germany.
authors.forename: Ludger
authors.initials: L
authors.lastname: Tebartz van Elst
keywords: MRS; anterior cingulate cortex; attention-deficit hyperactivity disorder; cerebellum; glutamate; nosology