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Research ArticleMETABOLIC BRAIN MAPPING SUPPLEMENT
Open Access

MR Imaging–Detectable Metabolic Alterations in Attention Deficit/Hyperactivity Disorder: From Preclinical to Clinical Studies

L. Altabella, F. Zoratto, W. Adriani and R. Canese
American Journal of Neuroradiology January 2014, DOI: https://doi.org/10.3174/ajnr.A3843
L. Altabella
From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy; and Bambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy.
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F. Zoratto
From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy; and Bambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy.
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W. Adriani
From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy; and Bambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy.
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R. Canese
From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy; and Bambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy.
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Abstract

MR spectroscopy represents one of the most suitable in vivo tool to assess neurochemical dysfunction in several brain disorders, including attention deficit/hyperactivity disorder. This is the most common neuropsychiatric disorder in childhood and adolescence, which persists into adulthood (in approximately 30%–50% of cases). In past years, many studies have applied different MR spectroscopy techniques to investigate the pathogenesis and effect of conventional treatments. In this article, we review the most recent clinical and preclinical MR spectroscopy results on subjects with attention deficit/hyperactivity disorder and animal models, from childhood to adulthood. We found that the most investigated brain regions were the (pre)frontal lobes and striatum, both involved in the frontostriatal circuits and networks that are known to be impaired in this pathology. Neurometabolite alterations were detected in several regions: the NAA, choline, and glutamatergic compounds. The creatine pool was also altered when an absolute quantitative protocol was adopted. In particular, glutamate was increased in children with attention deficit/hyperactivity disorder, and this can apparently be reversed by methylphenidate treatment. The main difficulties in reviewing MR spectroscopy studies were in the nonhomogeneity of the analyzed subjects, the variety of the investigated brain regions, and also the use of different MR spectroscopy techniques. As for possible improvements in future studies, we recommend the use of standardized protocols and the analysis of other brain regions of particular interest for attention deficit hyperactivity disorder, like the hippocampus, limbic structures, thalamus, and cerebellum.

Abbreviations

ACC
anterior cingulate cortex
ADHD
attention deficit/hyperactivity disorder
Cho
total choline (phosphorylcholine + glycerol-phosphorylcholine)
GABA
γ-aminobutyric acid
PFC
prefrontal cortex
PRESS
point-resolved spectroscopy sequence
tCr
total creatine (creatine + phosphorylcreatine)
  • © 2014 American Society of Neuroradiology

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MR Imaging–Detectable Metabolic Alterations in Attention Deficit/Hyperactivity Disorder: From Preclinical to Clinical Studies
L. Altabella, F. Zoratto, W. Adriani, R. Canese
American Journal of Neuroradiology Jan 2014, DOI: 10.3174/ajnr.A3843

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MR Imaging–Detectable Metabolic Alterations in Attention Deficit/Hyperactivity Disorder: From Preclinical to Clinical Studies
L. Altabella, F. Zoratto, W. Adriani, R. Canese
American Journal of Neuroradiology Jan 2014, DOI: 10.3174/ajnr.A3843
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