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Thinner Medial Temporal Cortex in Adolescents With Attention-Deficit/Hyperactivity Disorder and the Effects of Stimulants - 24/07/15

Doi : 10.1016/j.jaac.2015.05.014 
Lizanne J.S. Schweren, MSc a, , Catharina A. Hartman, PhD a, Dirk J. Heslenfeld, PhD b, Dennis van der Meer, MSc a, Barbara Franke, PhD c, Jaap Oosterlaan, PhD b, Jan K. Buitelaar, MD, PhD c, d, Stephen V. Faraone, PhD e, Pieter J. Hoekstra, MD, PhD a
a University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 
b VU University Amsterdam, The Netherlands 
c Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 
d Karakter Child and Adolescent Psychiatry University Centre Nijmegen 
e State University of New York Upstate Medical University, Syracuse, New York 

Correspondence to Lizanne Schweren, MSc, University Medical Center Groningen, Department of Psychiatry, Huispostcode CC10, 9700 VB Groningen, the Netherlands

Abstract

Objective

Attention-deficit/hyperactivity disorder (ADHD) has been associated with widespread changes in cortical thickness (CT). Findings have been inconsistent, however, possibly due to age differences between samples. Cortical changes have also been suggested to be reduced or to disappear with stimulant treatment. We investigated differences in CT between adolescents/young adults with and without ADHD in the largest ADHD sample to date, the NeuroIMAGE sample. Second, we investigated how such differences were related to age and stimulant treatment.

Method

Participants (participants with ADHD = 306; healthy controls = 184, 61% male, 8–28 years of age, mean age = 17 years) underwent structural magnetic resonance imaging. Participants and pharmacies provided detailed information regarding lifetime stimulant treatment, including cumulative intake and age of treatment initiation and cessation. Vertexwise statistics were performed in Freesurfer, modeling the main effect of diagnosis on CT and its interaction with age. Effects of stimulant treatment parameters on CT were modeled within the sample with ADHD.

Results

After correction for multiple comparisons, participants with ADHD showed decreased medial temporal CT in both left (pCLUSTER = .008) and right (pCLUSTER = .038) hemispheres. These differences were present across different ages and were associated with symptoms of hyperactivity and prosocial behavior. There were no age-by-diagnosis interaction effects. None of the treatment parameters predicted CT within ADHD.

Conclusion

Individuals with ADHD showed thinner bilateral medial temporal cortex throughout adolescence and young adulthood compared to healthy controls. We found no association between CT and stimulant treatment. The cross-sectional design of the current study warrants cautious interpretation of the findings.

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Key Words : ADHD, stimulant treatment, cortical thickness, long-term effects, MRI


Plan


 This article is discussed in an editorial by Dr. Philip Shaw on page 615.
 This article was reviewed under and accepted by ad hoc editor Daniel S. Pine, MD.
 This work was supported by National Institutes of Health Grant R01MH62873, Netherlands Organization for Scientific Research (NWO) Large Investment Grant 1750102007010, ZonMW Priority Medicines for Children Grant 113202005, as well as grants from Radboud University Nijmegen Medical Center, University Medical Center Groningen and Accare, and VU University Amsterdam.
 Dr. Hartman served as the statistical expert for this research.
 Disclosure: Prof. Buitelaar has been in the past 3 years a consultant to/member of advisory board of/and/or speaker for Janssen Cilag BV, Eli Lilly and Co., Shire, Novartis, Lundbeck, and Servier. He is not an employee of any of these companies, or a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents, or royalties. Prof. Faraone has received consulting income, travel expenses, and/or research support from, and/or has served on the advisory board for Pfizer, Ironshore, Shire, Akili Interactive Labs, CogCubed, Alcobra, VAYA Pharma, Neurovance, Impax, NeuroLifeSciences, and research support from the National Institutes of Health (NIH). His institution (SUNY) has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. In previous years, he has received consulting fees or served on advisory boards or participated in continuing medical education programs sponsored by Shire, Alcobra, Otsuka, McNeil, Janssen, Novartis, Pfizer, and Eli Lilly and Co. He has received royalties from books published by Guilford Press (Straight Talk About Your Child’s Mental Health), Oxford University Press (Schizophrenia: The Facts), and Elsevier (ADHD: Non-Pharmacologic Treatments). Prof. Hoekstra has been a paid consultant to Shire and Eli Lilly and Co. Drs. Hartman, Heslenfeld, and Profs. Franke, Oosterlaan, Ms. Schweren, and Mr. van der Meer report no biomedical financial interests or potential conflicts of interest.


© 2015  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 54 - N° 8

P. 660-667 - août 2015 Retour au numéro
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