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Areas of the Brain Modulated by Single-Dose Methylphenidate Treatment in Youth with ADHD During Task-Based fMRI: A Systematic Review

Czerniak, Suzanne M. BA; Sikoglu, Elif M. PhD; King, Jean A. PhD; Kennedy, David N. PhD; Mick, Eric ScD; Frazier, Jean MD; Moore, Constance M. PhD

doi: 10.1097/HRP.0b013e318293749e

Objective Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric disorder affecting 5% of children. Methylphenidate (MPH) is a common medication for ADHD. Studies examining MPH’s effect on pediatric ADHD patients’ brain function using functional magnetic resonance imaging (fMRI) have not been compiled. The goals of this systematic review were to determine (1) which areas of the brain in pediatric ADHD patients are modulated by a single dose of MPH, (2) whether areas modulated by MPH differ by task type performed during fMRI data acquisition, and (3) whether changes in brain activation due to MPH relate to clinical improvements in ADHD-related symptoms.

Methods We searched the electronic databases PubMed and PsycINFO (1967–2011) using the following terms: ADHD AND (methylphenidate OR MPH OR ritalin) AND (neuroimaging OR MRI OR fMRI OR BOLD OR event related), and identified 200 abstracts, 9 of which were reviewed based on predefined criteria.

Results In ADHD patients the middle and inferior frontal gyri, basal ganglia, and cerebellum were most often affected by MPH. The middle and inferior frontal gyri were frequently affected by MPH during inhibitory control tasks. Correlation between brain regions and clinical improvement was not possible due to the lack of symptom improvement measures within the included studies.

Conclusions Throughout nine task-based fMRI studies investigating MPH’s effect on the brains of pediatric patients with ADHD, MPH resulted in increased activation within frontal lobes, basal ganglia, and cerebellum. In most cases, this increase “normalized” activation of at least some brain areas to that seen in typically developing children.

From the University of Massachusetts Medical School.

Original manuscript received 4 June 2012, accepted for publication subject to revision 5 August 2012; revised manuscript received 23 August 2012.

Supported, in part, by a start-up grant (to Dr. Moore) from the University of Massachusetts Medical School.

Correspondence: Constance M. Moore, PhD, Psychiatry/CCNI, 303 Belmont St., Worcester MA 01604. Email:

© 2013 President and Fellows of Harvard College
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