title: Differential effects of methylphenidate and atomoxetine on intrinsic brain activity in children with attention deficit hyperactivity disorder.
abstract: Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear.
  
  
  
  After baseline evaluation including cognitive testing of the Cambridge Neuropsychological Test Automated Battery (CANTAB), drug-naive children with ADHD (n = 46), aged 7-17 years, were randomly assigned to a 12-week treatment with methylphenidate (n = 22) or atomoxetine (n = 24). Intrinsic brain activity, including the fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo), was quantified via resting-state functional magnetic resonance imaging at baseline and week 12.
  
  
  
  Reductions in inattentive symptoms were related to increased fALFF in the left superior temporal gyrus and left inferior parietal lobule for ADHD children treated with methylphenidate, and in the left lingual gyrus and left inferior occipital gyrus for ADHD children treated with atomoxetine. Hyperactivity/impulsivity symptom reductions were differentially related to increased fALFF in the methylphenidate group and to decreased fALFF in the atomoxetine group in bilateral precentral and postcentral gyri. Prediction analyses in the atomoxetine group revealed negative correlations between pre-treatment CANTAB simple reaction time and fALFF change in the left lingual gyrus and left inferior occipital gyrus, and positive correlations between pre-treatment CANTAB simple movement time and fALFF change in bilateral precentral and postcentral gyri and left precuneus, with a negative correlation between movement time and the fALFF change in the left lingual gyrus and the inferior occipital gyrus.
  
  
  
  Our findings suggest differential neurophysiological mechanisms for the treatment effects of methylphenidate and atomoxetine in children with ADHD.
authors: Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan.
authors: C Y
authors: CY
authors: Shang
authors: Nathan Kline Institute for Psychiatric Research,Orangeburg, NY,USA.
authors: C G
authors: CG
authors: Yan
authors: Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan.
authors: H Y
authors: HY
authors: Lin
authors: Graduate Institute of Brain and Mind Sciences,Taipei,Taiwan.
authors: W Y
authors: WY
authors: Tseng
authors: Nathan Kline Institute for Psychiatric Research,Orangeburg, NY,USA.
authors: F X
authors: FX
authors: Castellanos
authors: Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan.
authors: S S
authors: SS
authors: Gau
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D013003:Somatosensory Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride
keywords: Atomoxetine; attention deficit hyperactivity disorder; fractional amplitude of low-frequency fluctuations; methylphenidate; resting brain imaging