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Increased NAA and reduced choline levels in the anterior cingulum following chronic methylphenidate

A spectroscopic test–retest study in adult ADHD

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Abstract

The anterior cingulate cortex (ACC) is crucially involved in executive control of attention. Here, seven medication-naïve adult patients suffering from attention deficit/hyperactivity disorder (ADHD) were studied with 2D 1H-magnetic resonance spectroscopic imaging (MRSI) of the ACC [Brodmann areas 24b′–c′ and 32′] twice, once before initiation of stimulant treatment and once after 5–6 weeks of methylphenidate. Upon retest, all patients demonstrated marked clinical improvement. Analysis of regional brain spectra revealed a significantly decreased signal of choline containing compounds as well as increased N-acetyl-aspartate (NAA) levels following treatment with methylphenidate whereas total creatine remained unchanged. Our results add to a growing body of evidence implicating the ACC in the pathophysiology of ADHD and suggest that subtle structural changes might be associated with aspects of clinical improvement under stimulant treatment.

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Acknowledgements

The authors wish to thank Ulrike Kersting for assistance with neuropsychological testing.

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Authors and Affiliations

  1. Center for ADHD Research, Department of Psychiatry, Charité – University Medicine Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050, Berlin, Germany

    Golo Kronenberg, Isabella Heuser & Michael Colla

  2. Central Institute of Mental Health, J 5, 68159, Mannheim, Germany

    Golo Kronenberg, Gabriele Ende, Barbara Alm, Michael Deuschle & Michael Colla

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  1. Golo Kronenberg
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Correspondence to Michael Colla.

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Kronenberg, G., Ende, G., Alm, B. et al. Increased NAA and reduced choline levels in the anterior cingulum following chronic methylphenidate. Eur Arch Psychiatry Clin Neurosc 258, 446–450 (2008). https://doi.org/10.1007/s00406-008-0810-2

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  • DOI: https://doi.org/10.1007/s00406-008-0810-2

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