ADHD medications and preadolescent brain structure: patterns of cortical attenuation from the ABCD study

Area of Science:

• Neuroscience
• Developmental Neuroscience
• Neuroimaging

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder.
• Pharmacotherapy, including amphetamine (AMP), methylphenidate (MPH), and nonstimulants (NS), is a primary ADHD treatment.
• Neurostructural effects of ADHD medications are not well understood.

Purpose of the Study:

• To investigate the neuroanatomical targets of ADHD medications using machine learning.
• To estimate the effects of ADHD status and medication use on brain structure.

Main Methods:

• Utilized the ABCD Study dataset.
• Employed machine learning to identify medication targets (N=1306).
• Applied linear mixed-effects modeling to analyze brain structure (N=8762) in relation to ADHD and medication status (AMP, MPH, NS).

Main Results:

• ADHD status showed minimal, bidirectional brain structure differences.
• AMP and MPH use were associated with structural changes opposite to ADHD effects, suggesting attenuation toward a control phenotype.
• AMP and MPH use correlated with reduced surface area in specific brain regions (superior temporal sulcus, posterior cingulate).
• AMP was linked to reduced left posterior cingulate volume, while MPH was linked to increased right temporal pole volume.

Conclusions:

• ADHD pharmacotherapies, particularly stimulants (AMP, MPH), exhibit distinct neurostructural effects.
• These effects appear partly independent of ADHD-related structural alterations and extend beyond the ADHD phenotype.
• Medication-induced structural changes may represent an attenuation of ADHD-associated patterns toward a typical neurodevelopmental trajectory.