Simon Maier1, Evgeniy Perlov2, Erika Graf3, Elena Dieter1, Esther Sobanski4, Marthe Rump1, Andreas Warnke5, Dieter Ebert6, Mathias Berger6, Swantje Matthies6, Alexandra Philipsen6, Ludger Tebartz van Elst7. 1. Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Freiburg, Germany.; Freiburg Brain Imaging, Freiburg, Germany. 2. Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Freiburg, Germany. 3. Clinical Trials Unit, Medical Center-University of Freiburg, Freiburg, Germany. 4. Central Institute for Mental Health, Mannheim, Germany. 5. Department for Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany. 6. Clinic of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Freiburg, Germany. 7. Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Freiburg, Germany.; Freiburg Brain Imaging, Freiburg, Germany.. Electronic address: tebartzvanelst@uniklinik-freiburg.de.
Abstract
BACKGROUND: Gray matter reduction mainly in the anterior cingulate cortex, the basal ganglia, and the cerebellum has been reported in attention-deficit/hyperactivity disorder (ADHD). Yet, respective data remain contradictory and inconclusive. To clarify if structural alteration in these brain areas can be verified in a large cohort of adult patients and if a history of stimulant medication has an effect on brain structure, magnetic resonance imaging was performed in the context of a clinical trial on the efficacy of group psychotherapy, clinical management, methylphenidate, and placebo (Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study Trial). METHODS:Between January 2007 and August 2010, 1480 patients from seven study centers across Germany, aged 18 to 58, were prescreened; 518 were assessed for eligibility; 433 were randomized; and 187 were eligible for neuroimaging. The control group included 121 healthy volunteers. Structural magnetic resonance imaging data sets were acquired. Following strict quality control, 131 patient and 95 control data sets could be analyzed. All patients were unmedicated for at least 6 months. The established method of voxel-based morphometry (VBM8 segmentation and diffeomorphic anatomical registration through exponentiated lie normalization) was used to assess global and regional brain volumes. RESULTS: Patients displayed subtle global cerebral volume reductions. There was no evidence of regional gray matter volume abnormalities. The inattentive ADHD subtype was linked to smaller volumes in the left dorsolateral prefrontal cortex. A history of previous medication did not modulate brain volumes. CONCLUSIONS: ADHD in adulthood is associated with global rather than regional volumetric abnormalities. Previous use of stimulant medication does not seem to modify subsequent brain volumes in a significant way.
RCT Entities:
BACKGROUND: Gray matter reduction mainly in the anterior cingulate cortex, the basal ganglia, and the cerebellum has been reported in attention-deficit/hyperactivity disorder (ADHD). Yet, respective data remain contradictory and inconclusive. To clarify if structural alteration in these brain areas can be verified in a large cohort of adult patients and if a history of stimulant medication has an effect on brain structure, magnetic resonance imaging was performed in the context of a clinical trial on the efficacy of group psychotherapy, clinical management, methylphenidate, and placebo (Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study Trial). METHODS: Between January 2007 and August 2010, 1480 patients from seven study centers across Germany, aged 18 to 58, were prescreened; 518 were assessed for eligibility; 433 were randomized; and 187 were eligible for neuroimaging. The control group included 121 healthy volunteers. Structural magnetic resonance imaging data sets were acquired. Following strict quality control, 131 patient and 95 control data sets could be analyzed. All patients were unmedicated for at least 6 months. The established method of voxel-based morphometry (VBM8 segmentation and diffeomorphic anatomical registration through exponentiated lie normalization) was used to assess global and regional brain volumes. RESULTS:Patients displayed subtle global cerebral volume reductions. There was no evidence of regional gray matter volume abnormalities. The inattentive ADHD subtype was linked to smaller volumes in the left dorsolateral prefrontal cortex. A history of previous medication did not modulate brain volumes. CONCLUSIONS:ADHD in adulthood is associated with global rather than regional volumetric abnormalities. Previous use of stimulant medication does not seem to modify subsequent brain volumes in a significant way.
Authors: Matthew D Albaugh; Masha Ivanova; Bader Chaarani; Catherine Orr; Nicholas Allgaier; Robert R Althoff; Nicholas D' Alberto; Kelsey Hudson; Scott Mackey; Philip A Spechler; Tobias Banaschewski; Rüdiger Brühl; Arun L W Bokde; Uli Bromberg; Christian Büchel; Anna Cattrell; Patricia J Conrod; Sylvane Desrivières; Herta Flor; Vincent Frouin; Jürgen Gallinat; Robert Goodman; Penny Gowland; Yvonne Grimmer; Andreas Heinz; Viola Kappel; Jean-Luc Martinot; Marie-Laure Paillère Martinot; Frauke Nees; Dimitri Papadopoulos Orfanos; Jani Penttilä; Luise Poustka; Tomáš Paus; Michael N Smolka; Maren Struve; Henrik Walter; Robert Whelan; Gunter Schumann; Hugh Garavan; Alexandra S Potter Journal: Cereb Cortex Date: 2019-05-01 Impact factor: 5.357
Authors: Matthew D Albaugh; Catherine Orr; Bader Chaarani; Robert R Althoff; Nicholas Allgaier; Nicholas D'Alberto; Kelsey Hudson; Scott Mackey; Philip A Spechler; Tobias Banaschewski; Rüdiger Brühl; Arun L W Bokde; Uli Bromberg; Christian Büchel; Anna Cattrell; Patricia J Conrod; Sylvane Desrivières; Herta Flor; Vincent Frouin; Jürgen Gallinat; Robert Goodman; Penny Gowland; Yvonne Grimmer; Andreas Heinz; Viola Kappel; Jean-Luc Martinot; Marie-Laure Paillère Martinot; Frauke Nees; Dimitri Papadopoulos Orfanos; Jani Penttila; Luise Poustka; Tomáš Paus; Michael N Smolka; Maren Struve; Henrik Walter; Robert Whelan; Gunter Schumann; Hugh Garavan; Alexandra S Potter Journal: Biol Psychiatry Date: 2017-01-13 Impact factor: 13.382
Authors: Peter Sörös; Katharina Bachmann; Alexandra P Lam; Manuela Kanat; Eliza Hoxhaj; Swantje Matthies; Bernd Feige; Helge H O Müller; Christiane Thiel; Alexandra Philipsen Journal: Front Psychiatry Date: 2017-09-13 Impact factor: 4.157
Authors: A Marten H Onnink; Barbara Franke; Kimm van Hulzen; Marcel P Zwiers; Jeanette C Mostert; Aart H Schene; Dirk J Heslenfeld; Jaap Oosterlaan; Pieter J Hoekstra; Catharina A Hartman; Alejandro Arias Vasquez; Cornelis C Kan; Jan Buitelaar; Martine Hoogman Journal: J Neural Transm (Vienna) Date: 2016-03-02 Impact factor: 3.575