Neural and Cognitive Predictors of Stimulant Treatment Efficacy in Medication-Naïve ADHD Adults: A Pilot Diffusion Tensor Imaging Study.

IF 2.7 3区医学 Q2 PSYCHIATRY Journal of Attention Disorders Pub Date : 2024-03-01 Epub Date: 2024-02-07 DOI:10.1177/10870547231222261

Yuwen Hung, Allison Green, Caroline Kelberman, Schuyler Gaillard, James Capella, Nicole Rudberg, John D E Gabrieli, Joseph Biederman, Mai Uchida

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Abstract

Objective: Stimulant medications are the main treatment for Attention Deficit Hyperactivity Disorder (ADHD), but overall treatment efficacy in adults has less than a 60% response rate. This study aimed to identify neural and cognitive markers predictive of longitudinal improvement in response to stimulant treatment in drug-naïve adults with ADHD.

Method: We used diffusion tensor imaging (DTI) and executive function measures with 36 drug-naïve adult ADHD patients in a prospective study design.

Results: Structural connectivity (measured by fractional anisotropy, FA) in striatal regions correlated with ADHD clinical symptom improvement following stimulant treatment (amphetamine or methylphenidate) in better medication responders. A significant positive correlation was also found between working memory performance and stimulant-related symptom improvement. Higher pre-treatment working memory scores correlated with greater response.

Conclusion: These findings provide evidence of pre-treatment neural and behavioral markers predictive of longitudinal treatment response to stimulant medications in adults with ADHD.

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药物治疗无效多动症成人的兴奋剂疗效的神经和认知预测因素：弥散张量成像试验研究》。

目的：兴奋剂是治疗注意力缺陷多动障碍（ADHD）的主要药物，但成人患者的总体疗效反应率不足60%。本研究旨在确定神经和认知标记，以预测药物无效的成人注意力缺陷多动障碍患者对兴奋剂治疗反应的纵向改善：我们采用前瞻性研究设计，对 36 名药物无效的成年多动症患者进行了弥散张量成像（DTI）和执行功能测量：结果：纹状体区域的结构连通性（以分数各向异性（FA）测量）与药物反应较好的患者在接受兴奋剂治疗（苯丙胺或哌醋甲酯）后多动症临床症状的改善相关。研究还发现，工作记忆表现与兴奋剂相关症状改善之间存在明显的正相关。治疗前工作记忆得分越高，反应越大：这些研究结果提供了治疗前神经和行为标记的证据，可预测成人多动症患者对兴奋剂药物的纵向治疗反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Attention Disorders PSYCHIATRY-

CiteScore

7.60

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Attention Disorders (JAD) focuses on basic and applied science concerning attention and related functions in children, adolescents, and adults. JAD publishes articles on diagnosis, comorbidity, neuropsychological functioning, psychopharmacology, and psychosocial issues. The journal also addresses practice, policy, and theory, as well as review articles, commentaries, in-depth analyses, empirical research articles, and case presentations or program evaluations.