Article

Striatal neuronal loss or dysfunction and choline rise in children with attention-deficit hyperactivity disorder: A 1H-magnetic resonance spectroscopy study

Peking University, Peping, Beijing, China
Neuroscience Letters (Impact Factor: 2.06). 12/2001; 315(1-2):45-8. DOI: 10.1016/S0304-3940(01)02315-1
Source: PubMed

ABSTRACT Twelve previously untreated boys suffering from attention-deficit hyperactivity disorder (ADHD) were investigated by using proton magnetic resonance spectroscopy (1H MRS) before and after one dose (10 mg) of methylphenidate. Pre- and post-methylphenidate spectra were acquired bilaterally in the globus pallidus. Peaks of N-acetylaspartate (NAA), choline (Cho), myo-inositol, glutamate and creatine (Cr) were measured and the ratios of the peaks were calculated and compared with data from ten matched controls. In children having ADHD, NAA/Cr ratio decreased significantly in the bilateral striatum while Cho/Cr ratio showed a mild unilateral increase. One oral dose of methylphenidate did not affect the ratios significantly. These findings suggest that the striatum was bilaterally involved in pediatric ADHD patients. Approximately 20-25% of neurons may have died or may be severely dysfunctional. There seems to be a mild hyperactivity of the cholinergic system.

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    • "However, most of the available MRS studies of ADHD were focused on childhood, and only two studies reporting neurometabolites ratios addressed subjects with average age in the adolescent range (Jin et al., 2001; Sun et al., 2005) . In these two studies, single-voxel 1 H-MRS was applied to investigate the basal ganglia of adolescents with ADHD, yielding a decreased NAA/Cr ratio in bilateral striatum (Jin et al., 2001) and right lenticular nucleus (Sun et al., 2005). Given that not all the children with ADHD will be clinically affected as adolescents, one could speculate that adolescents/adult patients with ADHD represent a distinct subpopulation, possibly with a different neurobiological or environmental underpinning . "
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    • "The hyperactivation of cortical – striatal neuronal pathways could lead to the increased levels of glutamate in basal ganglia (Carrey et al. 2007; MacMaster et al. 2003; Ferreira et al. 2009) and glutamate decrease in basal ganglia after 13/14–18 weeks lasting therapy (Carrey et al. 2003; Carrey et al. 2002). Higher levels of choline resonances were found in basal ganglia in both – adults and children with ADHD (Ferreira et al. 2009; Jin et al. 2001); particularly in the frontal lobe in ADHD children (Courvoisie et al. 2004) and in anterior cingulate cortex in ADHD adults (Colla et al. 2007). The hypermetabolism and increased levels of glutamate with its neurotoxic effect might explain the increased levels of choline as an indicator of membrane turnover. "
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    • "from magnetic resonance spectroscopy (MRS) studies has implicated glutamate in the PFC and striatum (Carrey et al. 2002; Carrey et al. 2003; MacMaster et al. 2003; Courvoisie et al. 2004), although other studies have not reported this (Hesslinger et al. 2001; Jin et al. 2001; Yeo et al. 2003). Our previous pilot data had three main limitations: (1) heterogeneity of subtypes of ADHD, (2) most subjects were not treatment naïve, and (3) metabolite ratios rather than absolute metabolite levels were used. "
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