caa a22 4500 60547740X CHVBK 20210128100400.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00787-014-0645-5 doi (NATIONALLICENCE)springer-10.1007/s00787-014-0645-5 Combined stimulant and antipsychotic treatment in adolescents with attention-deficit/hyperactivity disorder: a cross-sectional observational structural MRI study [Elektronische Daten] [L. Schweren, C. Hartman, M. Zwiers, D. Heslenfeld, D. van der Meer, B. Franke, J. Oosterlaan, J. Buitelaar, P. Hoekstra] Meta-analyses suggest normalizing effects of methylphenidate on structural fronto-striatal abnormalities in patients with attention-deficit/hyperactivity disorder (ADHD). A subgroup of patients receives atypical antipsychotics concurrent with methylphenidate. Long-term safety and efficacy of combined treatment are unknown. The current study provides an initial investigation of structural brain correlates of combined methylphenidate and antipsychotic treatment in patients with ADHD. Structural magnetic resonance imaging was obtained in 31 patients who had received combined methylphenidate and antipsychotic treatment, 31 matched patients who had received methylphenidate but not antipsychotics, and 31 healthy controls (M age 16.7years). We analyzed between-group effects in total cortical and subcortical volume, and in seven frontal cortical and eight subcortical-limbic volumes of interest, each involved in dopaminergic neurotransmission. Patients in the combined treatment group, but not those in the methylphenidate only group, showed a reduction in total cortical volume compared to healthy controls (Cohen's d=0.69, p<0.004), which was apparent in most frontal volumes of interest. Further, the combined treatment group, but not the methylphenidate group, showed volume reduction in bilateral ventral diencephalon (Left Cohen's d=0.48, p<0.04; Right Cohen's d=0.46, p<0.05) and the left thalamus (Cohen's d=0.47, p<0.04). These findings may indicate antipsychotic treatment counteracting the normalizing effects of methylphenidate on brain structure. However, it cannot be ruled out that pre-existing clinical differences between both patient groups may have resulted in anatomical differences at the time of scanning. The absence of an untreated ADHD group hinders unequivocal interpretation and implications of our findings. Springer-Verlag Berlin Heidelberg, 2014 ADHD nationallicence Neuroimaging nationallicence Treatment nationallicence Antipsychotics nationallicence Adolescents nationallicence Schweren L. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut Hartman C. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut Zwiers M. Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut Heslenfeld D. VU University Amsterdam, Amsterdam, The Netherlands aut van der Meer D. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut Franke B. Departments of Human Genetics and Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut Oosterlaan J. VU University Amsterdam, Amsterdam, The Netherlands aut Buitelaar J. Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut Hoekstra P. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/8(2015-08-01), 959-968 1018-8827 24:8<959 2015 24 787 https://doi.org/10.1007/s00787-014-0645-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00787-014-0645-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schweren L. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut NATIONALLICENCE 700 1- Hartman C. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut NATIONALLICENCE 700 1- Zwiers M. Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Heslenfeld D. VU University Amsterdam, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- van der Meer D. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut NATIONALLICENCE 700 1- Franke B. Departments of Human Genetics and Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Oosterlaan J. VU University Amsterdam, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Buitelaar J. Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Hoekstra P. Department of Psychiatry, University Medical Center Groningen, University of Groningen, Huispostcode CC10, 9700, Groningen, VB, The Netherlands aut NATIONALLICENCE 773 0- European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/8(2015-08-01), 959-968 1018-8827 24:8<959 2015 24 787