Different Changes in Brain Functional Networks Following 12-Week Psychostimulant Treatment in
Kun Qin1, Nanfang Pan2, Du Lei3
1Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China; University of Cincinnati College of Medicine, Cincinnati, Ohio.
Summary
Psychostimulant treatment for attention-deficit/hyperactivity disorder (ADHD) impacts brain networks differently in youth with and without bipolar disorder (BD) risk. This suggests personalized treatment approaches for ADHD may be necessary.
Area of Science:
- Neuroscience
- Psychiatry
- Pediatric Mental Health
Background:
- Psychostimulants are first-line ADHD treatment, normalizing brain network abnormalities.
- Neural effects of psychostimulants in ADHD youth with bipolar disorder (BD) familial risk are understudied.
- The Neuroimaging Study of Risk Factors for Adolescent Bipolar Disorder (NERF) investigated these effects.
Purpose of the Study:
- To investigate the 12-week effects of mixed amphetamine salts-extended release (MAS-XR) on brain functional networks and symptoms in ADHD youth.
- To compare neural and symptomatic changes between ADHD youth with high-risk (HR) for BD and low-risk (LR) for BD.
- To include healthy controls (HC) for comparative analysis.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) acquired at baseline and 12 weeks.
- Graph theoretical analysis of functional connectivity matrices to evaluate global and nodal network topology.
- LR youth received open-label MAS-XR; HR youth were randomized to MAS-XR or placebo (PLA).
Main Results:
- Significant group-by-time interactions in global efficiency, characteristic path length, and nodal efficiency (left superior parietal gyrus, right amygdala) were found between HR-MAS and LR-MAS groups.
- ADHD youth without BD risk (LR-MAS) showed normalization of baseline brain abnormalities, while those with BD risk (HR-MAS) developed decreased right amygdala efficiency.
- Network topology changes correlated with ADHD symptom changes; baseline network dysconnectivity predicted treatment outcomes in the HR-MAS group only.
Conclusions:
- ADHD youth with and without familial BD risk exhibit distinct brain network topological changes after 12 weeks of psychostimulant treatment.
- Findings highlight potential differences in treatment response and neural mechanisms based on bipolar disorder familial risk.
- This suggests a need for tailored psychostimulant treatment strategies for ADHD youth considering their familial risk for BD.
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