Cumulative exposure to ADHD medication is inversely related to hippocampus subregional volume in children.

TitleCumulative exposure to ADHD medication is inversely related to hippocampus subregional volume in children.
Publication TypeJournal Article
Year of Publication2021
AuthorsFotopoulos NH, Devenyi GA, Guay S, Sengupta SM, Chakravarty MM, Grizenko N, Karama S, Joober R
JournalNeuroimage Clin
Volume31
Pagination102695
Date Published2021
ISSN2213-1582
KeywordsAttention Deficit Disorder with Hyperactivity, Brain, Child, Cross-Sectional Studies, Hippocampus, Humans, Magnetic Resonance Imaging
Abstract

BACKGROUND: Although there is some evidence for a normalization of brain structure following exposure to ADHD medication, literature on the effects of duration and dose of continued use on the brain is scarce. Here, we investigated the association between cumulative exposure to medication (range 1 week to 4.69 years) and cortical structures and subcortical volumes in a clinical sample of children with ADHD taking medication (n = 109). To the best of our knowledge, this is the first structural MRI study investigating the effects of cumulative exposure to medication on subregional volumes in children treated for ADHD.METHODS: Cumulative exposure to ADHD medication (CEM) was defined as the product of duration on medication (days) and dose (mg/day), yielding the area under the curve (total mg). Cortical thickness and surface area measurements (CIVET-1.1.12), and subcortical volumes in 51 regions (MAGeT-Brain) were analyzed using general linear modelling.RESULTS: Significant effects of CEM were found in two subregions of the left hippocampus, the CA1 (df = 95; q = 0.003) and the strata radiatum/lacunosum/moleculare (df = 95; q = 0.003). Specifically, higher CEM was associated with smaller volumes within these subregions. No effects of medication exposure were detected on cortical thickness or surface area.CONCLUSIONS: Although this study is cross-sectional, the results found within this sample of children show that prolonged ADHD medication use at higher doses is significantly associated with smaller hippocampus volumes in specific subregions. More research is required to determine whether these results are reproduced in other samples of children of ADHD, and further, whether these are beneficial or off-target effects of the medication.

DOI10.1016/j.nicl.2021.102695
Alternate JournalNeuroimage Clin
PubMed ID34015673
PubMed Central IDPMC8141923
Grant List / / CIHR / Canada