Stimulant medications in children with ADHD normalize the structure of brain regions associated with attention and reward.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8904907 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1740-634X (Electronic) Linking ISSN: 0893133X NLM ISO Abbreviation: Neuropsychopharmacology Subsets: MEDLINE

Publication: 2003- : London : Nature Publishing Group
Original Publication: [New York, NY] : Elsevier, [c1987-

Attention Deficit Disorder with Hyperactivity*/drug therapy ; Attention Deficit Disorder with Hyperactivity*/diagnostic imaging ; Central Nervous System Stimulants*/therapeutic use ; Central Nervous System Stimulants*/pharmacology ; Brain*/diagnostic imaging ; Brain*/drug effects ; Brain*/pathology ; Reward* ; Magnetic Resonance Imaging* ; Attention*/drug effects ; Attention*/physiology; Humans ; Child ; Male ; Female ; Cross-Sectional Studies

Children with ADHD show abnormal brain function and structure. Neuroimaging studies found that stimulant medications may improve brain structural abnormalities in children with ADHD. However, prior studies on this topic were conducted with relatively small sample sizes and wide age ranges and showed inconsistent results. In this cross-sectional study, we employed latent class analysis and linear mixed-effects models to estimate the impact of stimulant medications using demographic, clinical measures, and brain structure in a large and diverse sample of children aged 9-11 from the Adolescent Brain and Cognitive Development Study. We studied 273 children with low ADHD symptoms and received stimulant medication (Stim Low-ADHD), 1002 children with high ADHD symptoms and received no medications (No-Med ADHD), and 5378 typically developing controls (TDC). After controlling for the covariates, compared to Stim Low-ADHD and TDC, No-Med ADHD showed lower cortical thickness in the right insula (INS, d = 0.340, P FDR  = 0.003) and subcortical volume in the left nucleus accumbens (NAc, d = 0.371, P FDR  = 0.003), indicating that high ADHD symptoms were associated with structural abnormalities in these brain regions. In addition, there was no difference in brain structural measures between Stim Low-ADHD and TDC children, suggesting that the stimulant effects improved both ADHD symptoms and ADHD-associated brain structural abnormalities. These findings together suggested that children with ADHD appear to have structural abnormalities in brain regions associated with saliency and reward processing, and treatment with stimulant medications not only improve the ADHD symptoms but also normalized these brain structural abnormalities.
(© 2024. The Author(s), under exclusive licence to American College of Neuropsychopharmacology.)

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82172023, 82202252 National Natural Science Foundation of China (National Science Foundation of China); Y1AA3009 U.S. Department of Health & Human Services | NIH | National Institute on Alcohol Abuse and Alcoholism (NIAAA)

0 (Central Nervous System Stimulants)

Date Created: 20240226 Date Completed: 20240704 Latest Revision: 20240707

20240707

PMC11224385

10.1038/s41386-024-01831-4

38409281