Tag Archives: What is ADHD

University of Amsterdam study: MRI scans show how ADHD medication affects brain structure in children

19 Aug

The National Institute of Mental Health defined ADHD:

Attention-Deficit/Hyperactivity Disorder
Overview
Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
• Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
• Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.
• Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.
Signs and Symptoms
Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD.
In preschool, the most common ADHD symptom is hyperactivity.
It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors:
• are more severe
• occur more often
• interfere with or reduce the quality of how they functions socially, at school, or in a job…. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Resources:

What Is Attention Deficit Hyperactivity Disorder?                                         https://wb.md/2NvF1Dx

Attention-Deficit/Hyperactivity Disorder https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml#part_145450

What Is ADHD?                                                                                   https://www.psychiatry.org/patients-families/adhd/what-is-adhd

What is ADHD? https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/ADHD_Resource_Center/ADHD_A_Guide_for_Families/What_is_ADHD.aspx

Lois Zoppi, BA Reviewed by Kate Anderton, B.Sc. (Editor) reported in the Medical Life Sciences News article, MRI scans show how ADHD medication affects brain structure in children:

Attention deficit/hyperactivity disorder (ADHD) affects an increasing number of people worldwide, with an estimated 6.1 million children were living with ADHD in 2016, according to the National Survey of Children’s Health.
Now, MRI scans have revealed that children taking the common medication methylphenidate experience alterations in the distribution of white matter in the brain. This has led to the researchers warning doctors not to over-prescribe the medication and only use it when it is absolutely necessary, as the long-term effects of the medication are not yet known.
Methylphenidate is a stimulant medication commonly prescribed for ADHD and works by blocking norepinephrine and dopamine transporters. Deficits in the prefrontal cortex are associated with ADHD symptoms, and increased dopamine and norepinephrine levels in the prefrontal cortex may have beneficial effects on the condition.
White matter is tissue found in the deepest part of the brain and facilitates quick thinking, learning, co-ordination between different parts of the brain, and the ability to walk and balance. The effects of methylphenidate on white matter, and by extension brain development, is not fully understood….
To chart any changes seen in the participants’ brains, they all underwent an MRI scan one week before their treatment began, and one week after their treatment stopped. Changes were found in the left hemisphere of the brain, with approximately double the rate of fractional anisotropy (nerve fiber density, size, and myelination).
The results suggest that the brain is susceptible to structural changes while it is still developing during childhood and adolescence, with the authors writing:
“The adolescent brain is a rapidly developing system maintaining high levels of plasticity. For instance, the maturation and development of white matter continues well into adulthood.”
“The results show that ADHD medications can have different effects on the development of brain structure in children versus adults. In adult men with ADHD, and both boys and adult men receiving placebo, changes in FA [fractional anisotropy] measures were not present, suggesting that the effects of methyphenidate on brain white matter are modulated by age,” Reneman said.
Reneman warned that they “do not yet know whether these effects are reversible or not and whether they are related to functional or behavioral changes over a longer period of time.”
“What our data already underscores is that the use of ADHD medications in children must be carefully considered until more is known about the long-term consequences of prescribing methylphenidate at a young age,” she said.
The study highlights the key results it produced through its experiments.
“In boys with attention-deficit/hyperactivity disorder (ADHD), four months of treatment with methylphenidate (MPH) was associated with increased white matter fractional anisotropy (FA) after 16 weeks.
“In adult men with ADHD and in both boys and adult men receiving placebo, changes in FA measures were not present, suggesting that the effects of MPH on brain white matter are modulated by age….” https://www.news-medical.net/news/20190815/MRI-scans-show-how-ADHD-medication-affects-brain-structure-in-children.aspx

Citation

Journal reference:
Bouziane, C., et al. (2019). White Matter by Diffusion MRI Following Methylphenidate Treatment: A Randomized Control Trial in Males with Attention-Deficit/Hyperactivity Disorder. RSNA Radiology. https://doi.org/10.1148/radiol.2019182528.

Here is the abstract and key results:

Original ResearchFree Access
Neuroradiology
White Matter by Diffusion MRI Following Methylphenidate Treatment: A Randomized Control Trial in Males with Attention-Deficit/Hyperactivity Disorder
Cheima Bouziane*, Olena G. Filatova*, Anouk Schrantee, Matthan W. A. Caan, Frans M. Vos, Liesbeth Reneman
* C.B. and O.G.F. contributed equally to this work.
Author Affiliations
Published Online:Aug 13 2019https://doi.org/10.1148/radiol.2019182528
• Sections
• PDF
• Tools
• Share
Abstract
Background
Methylphenidate (MPH) is highly effective in treating attention-deficit/hyperactivity disorder (ADHD). However, not much is known about its effect on the development of human brain white matter (WM).
Purpose
To determine whether MPH modulates WM microstructure in an age-dependent fashion in a randomized double-blind placebo-controlled trial (Effects of Psychotropic Medication on Brain Development–Methylphenidate, or ePOD-MPH) among ADHD referral centers between October 13, 2011, and June 15, 2015, by using diffusion-tensor imaging (DTI).
Materials and Methods
In this prospective study (NTR3103 and NL34509.000.10), 50 stimulant treatment–naive boys and 49 young adult men diagnosed with ADHD (all types) according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria were randomized to undergo treatment with MPH or placebo for 16 weeks. Before and 1 week after treatment cessation, study participants underwent MRI, including DTI. The outcome measure was change in fractional anisotropy (FA), which was assessed in three regions of interest (ROIs), as well as in a voxel-based analysis in brain WM. Data were analyzed by using intention-to-treat linear mixed models for ROI analysis and a permutation-based method for voxel-based analysis with family-wise error correction.
Results
Fifty boys (n = 25 MPH group, n = 25 placebo group; age range, 10–12 years) and 48 men (n = 24 MPH group, n = 24 placebo group; age range, 23–40 years) were included. ROI analysis of FA yielded no main effect of time in any of the conditions. However, voxel-based analysis revealed significant (P < .05) time-by-medication-by-age interaction effects in several association tracts of the left hemisphere, as well as in the lateral aspect of the truncus of the corpus callosum, due to greater increase in FA (standardized effect size, 5.25) in MPH-treated boys. Similar changes were not present in boys receiving a placebo, nor in adult men.
Conclusion
Four months of treatment with methylphenidate affects specific tracts in brain white matter in boys with attention-deficit/hyperactivity disorder. These effects seem to be age dependent, because they were not observed in adults treated with methylphenidate.
© RSNA, 2019
Online supplemental material is available for this article.
Download as PowerPointOpen in Image Viewer
Summary
This randomized clinical trial on the influence of methylphenidate on brain development using diffusion-tensor MRI found fractional anisotropy to increase in specific brain areas of boys with attention-deficit/hyperactivity disorder but not in young adult men or boys receiving a placebo.
Key Results
• ■ In boys with attention-deficit/hyperactivity disorder (ADHD), 4 months of treatment with methylphenidate (MPH) was associated with increased white matter fractional anisotropy (FA) after 16 weeks (standardized effect size of 5.25 at whole-brain voxel-based analysis)
• ■ In adult men with ADHD and in both boys and adult men receiving placebo, changes in FA measures were not present, suggesting that the effects of MPH on brain white matter are modulated by age.
https://pubs.rsna.org/doi/10.1148/radiol.2019182528

If you suspect that your child might have ADHD, you should seek an evaluation from a competent professional who has knowledge of this specialized area of medical practice.

Reference Links:

Edge Foundation ADHD Coaching Study Executive Summary
http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

Edge Foundation ADHD Coaching Study Full Report
http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

ADHD and College Success: A free guide
http://www.edgefoundation.org/howedgehelps/add-2.html

ADHD and Executive Functioning
http://edgefoundation.org/blog/2010/10/08/the-role-of-adhd-and-your-brains-executive-functions/

Executive Function, ADHD and Academic Outcomes
http://www.helpforld.com/efacoutcomes.pdf

Related:
Louisiana study: Fit children score higher on standardized tests
https://drwilda.com/2012/05/08/louisiana-study-fit-children-score-higher-on-standardized-tests/

Studies: ADHD drugs don’t necessarily improve academic performance
https://drwilda.com/2013/07/14/studies-adhd-drugs-dont-necessarily-improve-academic-performance/

ADHD coaching to improve a child’s education outcome
https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

An ADHD related disorder: ‘Sluggish Cognitive Tempo’
https://drwilda.com/2014/04/12/an-adhd-related-disorder-sluggish-cognitive-tempo/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

University of Central Florida study: Kids with ADHD must fidget to learn

19 Apr

Moi wrote in ADHD coaching to improve a child’s education outcome:
The American Academy of Child and Adolescent Psychiatry discusses the primary symptoms of ADHD in the article, What Is ADHD:

The primary symptoms of ADHD are hyperactivity, impulsivity, and inattention.
Hyperactive children always seem to be in motion. A child who is hyperactive may move around touching or playing with whatever is around, or talk continually. During story time or school lessons, the child might squirm around, fidget, or get up and move around the room. Some children wiggle their feet or tap their fingers. A teenager or adult who is hyperactive may feel restless and need to stay busy all the time.
Impulsive children often blurt out comments without thinking first. They may often display their emotions without restraint. They may also fail to consider the consequences of their actions. Such children may find it hard to wait in line or take turns. Impulsive teenagers and adults tend to make choices that have a small immediate payoff rather than working toward larger delayed rewards….

ADHD News has a synopsis of the ADHD news
http://www.medicalnewstoday.com/categories/adhd
https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

Science Daily reported in Kids with ADHD must squirm to learn, study says:

But new research conducted at UCF shows that if you want ADHD kids to learn, you have to let them squirm. The foot-tapping, leg-swinging and chair-scooting movements of children with attention-deficit/hyperactivity disorder are actually vital to how they remember information and work out complex cognitive tasks, according to a study published in an early online release of the Journal of Abnormal Child Psychology.

The findings show the longtime prevailing methods for helping children with ADHD may be misguided.

“The typical interventions target reducing hyperactivity. It’s exactly the opposite of what we should be doing for a majority of children with ADHD,” said one of the study’s authors, Mark Rapport, head of the Children’s Learning Clinic at the University of Central Florida. “The message isn’t ‘Let them run around the room,’ but you need to be able to facilitate their movement so they can maintain the level of alertness necessary for cognitive activities.”
The research has major implications for how parents and teachers should deal with ADHD kids, particularly with the increasing weight given to students’ performance on standardized testing. The study suggests that a majority of students with ADHD could perform better on classroom work, tests and homework if they’re sitting on activity balls or exercise bikes, for instance.

The study at the UCF clinic included 52 boys ages 8 to 12. Twenty-nine of the children had been diagnosed with ADHD and the other 23 had no clinical disorders and showed normal development….. http://www.sciencedaily.com/releases/2015/04/150417190003.htm

Citation:

Kids with ADHD must squirm to learn, study says
Date: April 17, 2015

Source: University of Central Florida

Summary:

Excessive movement common among children with attention-deficit/hyperactivity disorder is actually vital to how they remember information and work out complex cognitive tasks, a new study shows. The findings show the longtime prevailing methods for helping children with ADHD may be misguided.

Journal Reference:
1. Dustin E. Sarver, Mark D. Rapport, Michael J. Kofler, Joseph S. Raiker, Lauren M. Friedman. Hyperactivity in Attention-Deficit/Hyperactivity Disorder (ADHD): Impairing Deficit or Compensatory Behavior? Journal of Abnormal Child Psychology, 2015; DOI: 10.1007/s10802-015-0011-1

Here is the press release from the University of Central Florida:

Kids with ADHD Must Squirm to Learn, UCF Study Says

For decades, frustrated parents and teachers have barked at fidgety children with ADHD to “Sit still and concentrate!”

But new research conducted at UCF shows that if you want ADHD kids to learn, you have to let them squirm. The foot-tapping, leg-swinging and chair-scooting movements of children with attention-deficit/hyperactivity disorder are actually vital to how they remember information and work out complex cognitive tasks, according to a study published in an early online release of the Journal of Abnormal Child Psychology.

The findings show the longtime prevailing methods for helping children with ADHD may be misguided.

“The typical interventions target reducing hyperactivity. It’s exactly the opposite of what we should be doing for a majority of children with ADHD,” said one of the study’s authors, Mark Rapport, head of the Children’s Learning Clinic at the University of Central Florida. “The message isn’t ‘Let them run around the room,’ but you need to be able to facilitate their movement so they can maintain the level of alertness necessary for cognitive activities.”
The research has major implications for how parents and teachers should deal with ADHD kids, particularly with the increasing weight given to students’ performance on standardized testing. The study suggests that a majority of students with ADHD could perform better on classroom work, tests and homework if they’re sitting on activity balls or exercise bikes, for instance.

The study at the UCF clinic included 52 boys ages 8 to 12. Twenty-nine of the children had been diagnosed with ADHD and the other 23 had no clinical disorders and showed normal development.

Each child was asked to perform a series of standardized tasks designed to gauge “working memory,” the system for temporarily storing and managing information required to carry out complex cognitive tasks such as learning, reasoning and comprehension.

Children were shown a series of jumbled numbers and a letter that flashed onto a computer screen, then asked to put the numbers in order, followed by the letter. A high-speed camera recorded the kids, and observers recorded their every movement and gauged their attention to the task.

Rapport’s previous research had already shown that the excessive movement that’s a trademark of hyperactive children – previously thought to be ever-present – is actually apparent only when they need to use the brain’s executive brain functions, especially their working memory.

The new study goes an important step further, proving the movement serves a purpose.
“What we’ve found is that when they’re moving the most, the majority of them perform better,” Rapport said. “They have to move to maintain alertness.”

By contrast, the children in the study without ADHD also moved more during the cognitive tests, but it had the opposite effect: They performed worse.

In addition to Rapport, the study was co-authored by Dustin Sarver of the University of Mississippi Medical Center, Michael Kofler of Florida State University, Lauren Friedman of the University of Central Florida, and Joe Raiker of Florida International University. http://today.ucf.edu/kids-with-adhd-must-squirm-to-learn/

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Reference Links:

Edge Foundation ADHD Coaching Study Executive Summary
http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

Edge Foundation ADHD Coaching Study Full Report
http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

ADHD and College Success: A free guide
http://www.edgefoundation.org/howedgehelps/add-2.html

ADHD and Executive Functioning
http://edgefoundation.org/blog/2010/10/08/the-role-of-adhd-and-your-brains-executive-functions/

Executive Function, ADHD and Academic Outcomes
http://www.helpforld.com/efacoutcomes.pdf

Louisiana study: Fit children score higher on standardized tests
https://drwilda.com/2012/05/08/louisiana-study-fit-children-score-higher-on-standardized-tests/

If you suspect that your child might have ADHD, you should seek an evaluation from a competent professional who has knowledge of this specialized area of medical practice.

Related:

Studies: ADHD drugs don’t necessarily improve academic performance
https://drwilda.com/2013/07/14/studies-adhd-drugs-dont-necessarily-improve-academic-performance/

ADHD coaching to improve a child’s education outcome
https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

An ADHD related disorder: ‘Sluggish Cognitive Tempo’
https://drwilda.com/2014/04/12/an-adhd-related-disorder-sluggish-cognitive-tempo/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews ©                                                                                       http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/