Ulrich Martin, Heckel Katharina, Kölle Markus, Grön Georg
Section Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, 89075 Ulm, Germany.
Department of Psychiatry and Psychotherapy, Bonn University, 53127 Bonn, Germany.
Biology (Basel). 2022 Sep 6;11(9):1320. doi: 10.3390/biology11091320.
Positron emission tomography (PET) studies have shown involvement of the striatum when treating adult attention-deficit/hyperactivity disorder (ADHD) with methylphenidate (MPH). Results from resting-state functional magnetic resonance imaging (rs-fMRI) for the same issue were less unequivocal. Here, a new analytical framework was set up to investigate medication effects using seed-based rs-fMRI analysis to infer brain regions with alterations in intrinsic functional connectivity (IFC) corresponding with ADHD symptom reduction. In a within-subjects study design, 53 stimulant-naïve adult ADHD patients were investigated before and after 6 weeks of MPH treatment, using two major clinical symptom scales and rs-fMRI. The same data were acquired in a sample of 50 age- and sex-matched healthy controls at baseline. A consensual atlas provided seeds for five predefined major resting-state networks. In order to avoid biasing of medication effects due to putative treatment failure, the entire ADHD sample was first categorized into treatment Responders (N = 36) and Non-Responders (N = 17) using machine learning-based classification with the clinical scales as primary data. Imaging data revealed medication effects only in Responders. In that group, IFC of bilateral putamen changed significantly with medication and approached almost normal levels of IFC. Present results align well with results from previous PET studies, with seed-based rs-fMRI as an entirely different neuroimaging method.
正电子发射断层扫描（PET）研究表明，使用哌甲酯（MPH）治疗成人注意力缺陷多动障碍（ADHD）时，纹状体受累。针对同一问题的静息态功能磁共振成像（rs-fMRI）结果则不太明确。在此，建立了一个新的分析框架，使用基于种子点的rs-fMRI分析来研究药物疗效，以推断与ADHD症状减轻相对应的内在功能连接（IFC）发生改变的脑区。在一项受试者内研究设计中，对53名未使用过兴奋剂的成年ADHD患者在MPH治疗6周前后进行了研究，使用了两个主要临床症状量表和rs-fMRI。在50名年龄和性别匹配的健康对照样本的基线期采集了相同的数据。一个共识图谱为五个预定义的主要静息态网络提供了种子点。为了避免因假定的治疗失败而使药物疗效产生偏差，首先使用基于机器学习的分类方法，以临床量表作为主要数据，将整个ADHD样本分为治疗反应者（N = 36）和无反应者（N = 17）。成像数据仅在反应者中显示出药物疗效。在该组中，双侧壳核的IFC随药物治疗发生显著变化，且接近IFC的几乎正常水平。目前的结果与先前PET研究的结果非常吻合，而基于种子点的rs-fMRI是一种完全不同的神经成像方法。
