Abstract
BackgroundDespite the effectiveness of methylphenidate for treating ADHD, up to 30% of individuals with ADHD show poor responses to methylphenidate. Neuroimaging biomarkers to predict medication responses remain elusive. This study characterized neuroanatomical features that differentiated between clinically good and poor methylphenidate responders with ADHD.MethodsUsing a naturalistic observation design selected from a larger cohort, we included 79 drug-naive individuals (aged 6–42 years) with ADHD without major psychiatric comorbidity, who had acceptable baseline structural MRI data quality. Based on a retrospective chart review, we defined responders by individuals’ responses to at least one-month treatment with methylphenidate. A nonparametric mass-univariate voxel-based morphometric analysis was used to compare regional gray matter volume differences between good and poor responders. A multivariate pattern recognition based on the support vector machine was further implemented to identify neuroanatomical indicators to predict an individual’s response.Results63 and 16 individuals were classified in the good and poor responder group, respectively. Using the small-volume correction procedure based on the hypothesis-driven striatal and default-mode network masks, poor responders had smaller regional volumes of the left putamen as well as larger precuneus volumes compared to good responders at baseline. The machine learning approach identified that volumetric information among these two regions alongside the left frontoparietal regions, occipital lobes, and posterior/inferior cerebellum could predict clinical responses to methylphenidate in individuals with ADHD.ConclusionOur results suggest regional striatal and precuneus gray matter volumes play a critical role in mediating treatment responses in individuals with ADHD.
Highlights
Despite the effectiveness of methylphenidate for treating Attention-deficit hyperactivity disorder (ADHD), up to 30% of individuals with ADHD show poor responses to methylphenidate
There were no significant differences among patients with ADHD with good methylphenidate response and those of poor responders in terms of age, sex, handedness, and Intelligence quotient (IQ) profiles, core ADHD symptoms, and ratios of ADHD subtypes (Table 1)
Mass-univariate analysis: whole brain No significant differences were found in the global brain volume measures, including total gray matter (GM), white matter (WM), and intracranial volume between these two ADHD subgroups (Table 1)
Summary
Despite the effectiveness of methylphenidate for treating ADHD, up to 30% of individuals with ADHD show poor responses to methylphenidate. This study characterized neuroanatomical features that differentiated between clinically good and poor methylphenidate responders with ADHD. Methylphenidate is effective in reducing core symptoms and associated behavioral problems of ADHD, as well as improving academic performance, quality of life, and neuropsychological functions [3, 4]. Around 30% of individuals with ADHD exhibit poor responses to methylphenidate [5]. Studies indicate that individuals with ADHD having poor intelligence quotient, higher disease severity, and a family history of a psychiatric disorder [6] show a poor response to methylphenidate. Higher anxiety levels [7], as well as co-occurring personality, substance use [8], alongside anxiety disorders [9] are related to suboptimal methylphenidate responses in individuals with ADHD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
