Abstract
BackgroundMethylphenidate (MPH), a psycho-stimulant, is the most widely administered drug for the pharmacological management of patients with attention deficit hyperactivity disorder (ADHD). This study attempts to determine whether sustainable improvements occur in neurocognitive function among ADHD patients following 12-month treatment with MPH, at drug-free status. Whether age groups, gender or ADHD subtypes differ in neurocognitive performance during MPH treatment is also examined.MethodsStudy participants consisted of 103 ADHD patients (mean age: 9.1 ± 1.9 years old) who were drug naïve or drug free for at least 6 months. The patients were prescribed oral short-acting MPH at each dose range of 0.3–1.0 mg/kg daily. During 12 months of the study, the patients underwent the test of variables of attention (TOVA) at the baseline, month 6 and month12. Patients were instructed to not intake MPH for one week before the second and the third TOVA.ResultsSeventy five patients completed the study. Results of this study indicated that although commission errors and response sensitivity (d’) significantly improved during MPH treatment for 12 months, omission errors, response time, response time variability and ADHD score did not. While younger ADHD patients (<9 y/o) performed better in response time, response time variability, d’ and ADHD score than older ones (≥9 y/o), the latter more significantly improved in response time than the former during 12 months of treatment. Additionally, boys improved more than girls in omission error and d’. Moreover, although ADHD subtypes significantly differed in ADHD score during the treatment, MPH treatment and ADHD subtypes did not interact with each other for all TOVA indices.ConclusionsADHD patients significantly improved in impulsivity and perceptual sensitivity, determined as TOVA, during MPH treatment for 12 months. Age and gender, yet not ADHD subtypes, appear to influence the MPH treatment effects in some indices of TOVA. A future study containing a comparison group is suggested to confirm whether the neurocognitive improvements are attributed to long-term effects of MPH or natural maturation of patients.
Highlights
Methylphenidate (MPH), a psycho-stimulant, is the most widely administered drug for the pharmacological management of patients with attention deficit hyperactivity disorder (ADHD)
This study investigated the extent of the differences in changes of performance in test of variables of attention (TOVA) between age groups, gender and ADHD subtypes, by the linear mixed model
The three ADHD subtypes identified at month 0 did not significantly differ in age, gender, and indices in TOVA (Table 1)
Summary
Methylphenidate (MPH), a psycho-stimulant, is the most widely administered drug for the pharmacological management of patients with attention deficit hyperactivity disorder (ADHD). This study attempts to determine whether sustainable improvements occur in neurocognitive function among ADHD patients following 12-month treatment with MPH, at drug-free status. Gender or ADHD subtypes differ in neurocognitive performance during MPH treatment is examined. Methylphenidate (MPH), a psycho-stimulant, is the most widely administered drug for the pharmacological management of ADHD patients [8]. Numerous studies indicate that various domains of neurocognitive function are enhanced under acute MPH challenge in ADHD patients [12,13,14,15]. Konrad et al demonstrated that children with ADHD did not substantially improve in executive control performance after long-term MPH treatment [17]. Whether long-term prescription of MPH enhances neurocognitive performance in ADHD patients remains unclear
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