Attention-deficit/hyperactivity disorder(ADHD) is highly prevalent among children and adolescents and often associated with poor long-term outcomes in adulthood. it is thus a serious public health problem. Methylphenidate(MPH) and Atomoxetine(ATX) are most frequently used for treating ADHD in many countries but the individual treatment response varies. Some patients present good response to either MPH or ATX with minimal or no symptoms left and optimal functioning(remission) after treatment, while others are poor responders to one of the two or even both. The underlying mechanism for the heterogenous responsiveness remains unknown. Thus we proposed to use multimodule magnetic resonance imaging(MRI) technology to explore the neural mechanisms of remission in children with ADHD treated with MPH or ATX.
the main aim of the current study is to explore the mechanism of remission in children with ADHD treated by MPH or ATX. Baseline information including demographic information, clinical features including ADHD symptoms, cognitive assessments such as executive function, MRI scans including resting state functional MRI, structural MRI, and DTI would be acquired in each participant. after 8-12 weeks of treating with MPH or ATX, patients would be classified into subgroups of remitted and unremitted groups. all baseline tests would be acquired again at the end of the study. comparisons would be done to explore the remission mechanism induced by MPH or ATX
Study Type
OBSERVATIONAL
Enrollment
250
the drug would be prescribed to patients without any contraindication
the drug would be prescribed to patients without any contraindication
Swanson, Nolan and Pelham , Version Ⅳ Rating Scale (SNAP-Ⅳ)
to define remission, using Swanson, Nolan and Pelham , Version Ⅳ Rating Scale (SNAP-Ⅳ), both in baseline and follow-up
Time frame: 8 to 12 weeks
Clinical Global Impressions-Improvement scale (CGI-I)
to define remission, participants will assessed by CGI-I in follow-up, and Clinical Global Impressions-Severity scale (CGI-S) in baseline.
Time frame: 8 to 12 weeks
resting state functional magnetic resonance imaging (rs-fMRI)
participants undergo resting state functional MRI (rs-fMRI) scan both in baseline and follow-up, and the duration for each rs-fMRI is 8 minutes.
Time frame: 8 to 12 weeks
side effect assessment
with clinical global impression scale
Time frame: 8 to 12 weeks
Structural magnetic resonance imaging (sMRI)
participants undergo structural magnetic resonance imaging (sMRI) scan both in baseline and follow-up, and the duration for each sMRI is 5 minutes.
Time frame: 8 to 12 week
Diffusion Tensor Imaging (DTI)
participants undergo DTI scan both in baseline and follow-up, and the duration for each sMRI is 10 minutes.
Time frame: 8 to 12 weeks
WEISS Functional Impairment Rating Scale-parent report (WFIRS-P)
to assess the improvement of social function impairment in ADHD, participants will finish the WFIRS-P both in baseline and follow-up
Time frame: 8 to 12 weeks
Behavior Rating Inventory of Executive Function (BRIEF)
to assess the improvement of ecological executive function in ADHD, participants will finish the BRIEF both in baseline and follow-up
Time frame: 8 to 12 weeks
The Cambridge Neuropsychological Tests Automated Battery（CANTAB）
to assess the improvement of neuropsychological executive function in ADHD, participants will finish the executive functional test measured by CANTAB both in baseline and follow-up
Time frame: 8 to 12 weeks
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