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Annual variation in attentional response after methylphenidate treatment

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Abstract

Prevalence rates of attention-deficit/hyperactivity disorder (ADHD) differ with geographical areas varying in sunlight intensity. Sun- or daylight reaching the retina establishes entrainment of the circadian clock to daylight. Changes herein, hence, alterations in clock alignment, could be reflected indirectly in inattention via sleep duration. We here studied (1) annual variation in inattention at treatment initiation; (2) annual variation in response to ADHD treatment [methylphenidate (MPH)] by day of treatment initiation; and (3) dose dependence. We predicted least baseline inattention during a period of high sunlight intensity implying more room for improvement (i.e., a better treatment response) when sunlight intensity is low. These hypotheses were not confirmed. High-dose treated patients, however, had significantly better attention after treatment than low-dosed treated patients, only when treated in the period from winter to summer solstice. Change in solar irradiance (SI) during low-dosed treatment period was negatively related to attentional improvement. The above described findings were primarily found in inattention ratings and replicated in omission errors on a continuous performance task. Daylight and inattention have been proposed to be related via mediation of the circadian system. One mechanism of MPH may be to enhance sensitivity to the diurnal entrainment to sunlight and the question can be raised whether appropriate lighting could potentiate the effects of stimulants.

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Acknowledgements

We acknowledge the iSPOT-A Investigators Group, the contributions of iSPOT-A principal investigators at each site, and the central management team (global coordinator Claire Day, PhD).

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Authors and Affiliations

  1. Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, The Netherlands

    Madelon A. Vollebregt & Martijn Arns

  2. Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands

    Jan K. Buitelaar

  3. Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands

    J. Leon Kenemans & Martijn Arns

  4. Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands

    Jan K. Buitelaar

  5. Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands

    Tom Deboer

  6. School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Clayton, VIC, Australia

    Sean W. Cain

  7. Brain Resource Ltd, Sydney, NSW, Australia

    Donna Palmer & Evian Gordon

  8. Brain Resource Ltd, San Francisco, CA, USA

    Donna Palmer & Evian Gordon

  9. Brain Dynamics Center, Sydney Medical School and Westmead Millenium Institute, University of Sydney, Sydney, NSW, Australia

    Donna Palmer

  10. Children’s Health Council, Palo Alto, CA, USA

    Glen R. Elliott

  11. Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA

    Glen R. Elliott

  12. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Kamran Fallahpour

  13. Brain Resource Center, New York, NY, USA

    Kamran Fallahpour

  14. neuroCare Group, Munich, Germany

    Martijn Arns

Authors
  1. Madelon A. Vollebregt
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  2. J. Leon Kenemans
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  3. Jan K. Buitelaar
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  4. Tom Deboer
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  5. Sean W. Cain
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  6. Donna Palmer
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  7. Glen R. Elliott
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  8. Evian Gordon
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  9. Kamran Fallahpour
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  10. Martijn Arns
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Corresponding author

Correspondence to Madelon A. Vollebregt.

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Conflict of interest

MA reports research grants and options from Brain Resource (Sydney, Australia) and shares from neuroCare Group (Munich, Germany); DP has received income and stock options with the role of science and data processing manager as an employee with Brain Resource Ltd.; EG is founder and receives income as Chief Executive Officer and Chairman for Brain Resource Ltd. He has stock options in Brain Resource Ltd. JKB has been a consultant to/member of advisory board of/and/or speaker for Janssen Cilag BV, Eli Lilly, and Servier in the past years. He is not an employee of any of these companies, and not a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents, royalties. MV, LK, TD, and GE report no financial disclosures.

Ethical approval

The study complies with the principles of the “Declaration of Helsinki 2008,” the International Conference on Harmonization (ICH) guidelines, and the laws and regulations of the country in which the research is conducted, including the principles of “Good Clinical Practice” as outlined in the U.S. Code of Federal Regulations. All sites received approval from their Institutional Review Board (IRB)/Independent Ethics Committee (IEC) prior to participant enrollment and each participant (and/or guardian) provided their informed consent to be involved in the study.

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Vollebregt, M.A., Kenemans, J.L., Buitelaar, J.K. et al. Annual variation in attentional response after methylphenidate treatment. Eur Child Adolesc Psychiatry 29, 1231–1236 (2020). https://doi.org/10.1007/s00787-019-01434-1

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  • DOI: https://doi.org/10.1007/s00787-019-01434-1

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