Department de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Spain; Fundació IMIM (Institut Municipal d'Investigacions Mèdiques), Barcelona, Spain.
Department de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Spain; Department of Psychiatry. Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
Eur Neuropsychopharmacol. 2017 Dec;27(12):1238-1247. doi: 10.1016/j.euroneuro.2017.10.035. Epub 2017 Nov 10.
Long-term effects of psychostimulants such as methylphenidate on ADHD patients have been proved to be difficult to capture in cross-sectional studies comparing medicated and non-medicated samples and in longitudinal studies with children, with age-related maturational processes possibly confounding independent effects of medication. However, chronic psychostimulant administration at therapeutic doses has been proven to yield profound neuroadaptive changes in rodent models. Here, we present for the first time the effect of psychostimulant treatment on brain volumes in a sample of medication-naïve adult ADHD patients. We investigated grey matter volume changes in a sample of 41 medication-naïve adult ADHD patients before and after three years of psychostimulant treatment (N = 25) or no treatment (N = 16) compared to healthy adults (N = 25). We found a significant group x time interaction effect on left putamen grey matter volumes, with a decrease in left putamen volumes in the non-medicated group compared to both the medicated group and controls, and no differences between the medicated group and controls. Our results suggest a normalizing effect of psychostimulant treatment on the left putamen volume loss detected in non-medicated ADHD patients.
长期以来,人们一直难以通过比较用药和未用药样本的横断面研究以及针对儿童的纵向研究来捕捉到哌甲酯等精神兴奋剂对 ADHD 患者的长期影响,因为与年龄相关的成熟过程可能会混淆药物的独立作用。然而,在治疗剂量下长期使用精神兴奋剂已被证明会在啮齿动物模型中产生深刻的神经适应性变化。在这里,我们首次提出了在一组未经药物治疗的成年 ADHD 患者样本中,精神兴奋剂治疗对脑容量的影响。我们调查了 41 名未经药物治疗的成年 ADHD 患者在接受 3 年精神兴奋剂治疗(N = 25)或不治疗(N = 16)前后的灰质体积变化,与健康成年人(N = 25)进行了比较。我们发现,左侧壳核灰质体积存在显著的组 x 时间交互效应,未用药组的左侧壳核体积较用药组和对照组均有下降,而用药组与对照组之间无差异。我们的结果表明,精神兴奋剂治疗对未用药 ADHD 患者检测到的左侧壳核体积损失具有正常化作用。