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Reward processing in male adults with childhood ADHD—a comparison between drug-naïve and methylphenidate-treated subjects

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Abstract

Rationale

Dysfunctional reward processing has been proposed as a main deficit in attention-deficit/hyperactivity disorder (ADHD), which could be modulated by treatment with methylphenidate (MPH).

Objectives

We examined differences in reward processing in adulthood (independent of actual ADHD) depending on MPH treatment during childhood.

Methods

Eleven males with childhood ADHD treated with MPH, 12 drug-naïve males with childhood ADHD, and 12 controls matched by age, handedness, and smoking behavior were studied drug-free using functional magnetic resonance imaging. BOLD-responses were compared during a monetary incentive delay task using an ANOVA design focusing on the ventral striatum during anticipation and the orbitofrontal cortex during outcome.

Results

Controls, drug-naïve, and treated subjects did not differ significantly in their activations in the ventral striatum and orbitofrontal cortex. Explorative analyses revealed decreased insula activation during outcome of loss avoidance in drug-naïve subjects in comparison to both groups, while treated subjects did not differ from controls. Insula activation correlated significantly positive with harm avoidance in the treated group. Furthermore, comparing subjects with actual ADHD symptoms, remitters and controls we observed decreased putamen activition in ADHD persisters.

Conclusions

Basal ganglia reward processing seemed to be unrelated to MPH pretreatment, but was related to remission. On the other hand, the revealed differences between treated and drug-naïve subjects with childhood ADHD, i.e., in the insula, give evidence for more pronounced abnormal activation in reward-associated brain regions in untreated subjects with childhood ADHD and underpin the need of prospective studies on long-term effects of psychostimulant treatment.

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Acknowledgments

Author contributions

A. Ströhle had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Additional contributions

We thank the participants for their patience and willingness to participate after many years and followed through with an extensive neuropsychological testing and fMRI-scanning. We thank the colleagues of the laboratory of emotional neuroscience for the assistance with the fMRI-scanning.

Conflicts of interest

None

Funding/support

None

Financial disclosures

Prof. A. Ströhle received research funding from the German Federal Ministry of Education and Research and speaker honoraria from Pfizer, Eli Lilly & Co, Wyeth, Lundbeck and a research grant from Lundbeck. Prof. A. Heinz received research funding from the German Research Foundation and the Bernstein Center for Computational Neuroscience Berlin (German Federal Ministry of Education and Research), Eli Lilly & Company, Janssen-Cilag, and Bristol-Myers Squibb. A. Heinz also received speaker Honoraria from Janssen-Cilag, Johnson & Johnson, Lilly, Pfizer and Servier. Prof. U. Lehmkuhl received research funding from the Deutsche Krebshilfe Research Foundation; the BfArM (Bundesinstitut für Arzneimittelforschung und Medizinprodukte); RTL Foundation “Wir helfen Kindern”; BMFSFJ Research Funding from the German Federal Ministry of Health; Steiner Arzneimittel. Mrs. Stoy, Mrs. Schlochtermeier, Dr. Schlagenhauf, Dr. Wrase, Prof. Huss, Prof. Knutson reported no conflicts of interest.

Ethical standards

This study complies with the current laws of Germany.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    Meline Stoy, Florian Schlagenhauf, Lorna Schlochtermeier, Jana Wrase, Andreas Heinz & Andreas Ströhle

  2. Department of Emotion Psychology and Affective Neuroscience, Freie Universität Berlin, Berlin, Germany

    Lorna Schlochtermeier

  3. Psychology Department, Stanford University, Stanford, CA, USA

    Brian Knutson

  4. Department of Child and Adolescent Psychiatry and Psychotherapy, Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, Berlin, Germany

    Ulrike Lehmkuhl

  5. Department of Child and Adolescent Psychiatry and Psychotherapy, Johannes Gutenberg University, Mainz, Germany

    Michael Huss

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  1. Meline Stoy
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  2. Florian Schlagenhauf
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  3. Lorna Schlochtermeier
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  4. Jana Wrase
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  5. Brian Knutson
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  6. Ulrike Lehmkuhl
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  7. Michael Huss
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  8. Andreas Heinz
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  9. Andreas Ströhle
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Correspondence to Andreas Ströhle.

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Figure S1

Plot of reaction times of the three groups (controls, childhood ADHD-drug-naïve, and childhood ADHD-MPH) in the seven conditions (loss, −3 to −0.10 €, neutral, gain, +0.10 to 3 €) (JPEG 195 kb)

Figure S2

Plot of subjective effort of the three groups (controls, childhood ADHD-drug-naïve, and childhood ADHD-MPH) in the seven conditions (loss, −3 to −0.10 €, neutral, gain, +0.10 to 3 €) (JPEG 174 kb)

Figure S3

Anticipation of gain (controls/childhood ADHD-drug-naïve/-MPH). Effect of group in the left inferior frontal gyrus (BA 45) for the contrast ‘anticipation of gain > anticipation of neutral’ with the parameter estimates (Tal: −50, 35, 4; F = 10.16). b Effect of group in the right inferior frontal gyrus (BA 46) for the contrast ‘anticipation of gain > anticipation of neutral’ with the parameter estimates (Tal: 42, 38, 4; F = 11.60) (PPT 968 kb)

Table S1

ANOVA (controls/childhood ADHD-drug-naïve/-MPH) (DOC 75 kb)

Table S2

Within-group activations (controls/childhood ADHD-drug-naïve/-MPH) (DOC 47.0 kb)

Table S3

Remitters vs. persisters: behavioural, neuropsychological data and personality (DOC 40.5 kb)

Table S4

Remitters vs. persisters: group characteristics and clinical data (DOC 44 kb)

Table S5

ANOVA (controls/ADHD-remitted/-non-remitted) (DOC 60 kb)

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Stoy, M., Schlagenhauf, F., Schlochtermeier, L. et al. Reward processing in male adults with childhood ADHD—a comparison between drug-naïve and methylphenidate-treated subjects. Psychopharmacology 215, 467–481 (2011). https://doi.org/10.1007/s00213-011-2166-y

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