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Salience and hedonic experience as predictors of central stimulant treatment response in ADHD: A resting state fMRI study
Örebro University, School of Medical Sciences. Center for Experimental and Biomedical Imaging in Örebro (CEBIO), Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden.ORCID iD: 0000-0001-9402-4756
Örebro University, School of Medical Sciences. Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Center for Experimental and Biomedical Imaging in Örebro (CEBIO), Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department for Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-8351-3367
Örebro University, School of Medical Sciences. Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institute, 17177, Stockholm, Sweden.ORCID iD: 0000-0002-4446-9148
2023 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 163, p. 378-385Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Roughly 20-30% of patients with Attention-deficit/hyperactivity disorder (ADHD) fail to respond to central stimulant (CS) medication. Genetic, neuroimaging, biochemical and behavioral biomarkers for CS response have been investigated, but currently there are no biomarkers available for clinical use that help identify CS responders and non-responders.

METHODS: In the present paper, we studied if incentive salience and hedonic experience evaluated after a single-dose CS medication could predict response and non-response to CS medication. We used a bipolar visual analogue 'wanting' and 'liking' scale to gauge incentive salience and hedonic experience in 25 healthy controls (HC) and 29 ADHD patients. HC received 30 mg methylphenidate (MPH) and ADHD patients received either MPH or lisdexamphetamine (LDX) as selected by their clinician, with dosage individually determined for optimal effect. Clinician-evaluated global impression - severity (CGI-S) and improvement (CGI-I) and patient-evaluated improvement (PGI-I) were used to assess response to CS medication. Resting state functional magnetic resonance imaging (fMRI) was conducted before and after single-dose CS to correlate wanting and liking scores to changes in functional connectivity.

RESULTS: Roughly 20% of the ADHD patients were CS non-responders (5 of 29). CS responders had significantly higher incentive salience and hedonic experience scores compared to healthy controls and CS non-responders. Resting state fMRI showed that wanting scores were significantly associated to changes in functional connectivity in ventral striatum including nucleus accumbens.

CONCLUSION: Incentive salience and hedonic experience evaluated after a single-dose CS medication segregate CS responders and non-responders, with corresponding neuroimaging biomarkers in the brain reward system.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 163, p. 378-385
Keywords [en]
Attention-deficit/hyperactivity disorder, Central stimulant treatment, Incentive salience, Pharmacological challenge, Resting state, Treatment prediction
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-106174DOI: 10.1016/j.jpsychires.2023.05.073ISI: 001013035000001PubMedID: 37269772Scopus ID: 2-s2.0-85160538869OAI: oai:DiVA.org:oru-106174DiVA, id: diva2:1762703
Funder
Nyckelfonden, 93542Region Örebro County, OLL-787911Available from: 2023-06-05 Created: 2023-06-05 Last updated: 2024-01-02Bibliographically approved

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Rode, JuliaRunnamo, RebeckaThunberg, PerMsghina, Mussie

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