SPECT Summary Tables – Attention Deficit Disorder

#Patients/Healthy

First Author

Study Date

Type

Age Range

Comments

10

Akay

2006

MPH/HMPAO/SPECT

Children

Treatment effects of chronic MPH treatment may persist long after the discontinuation of the treatment.

20 non-medicated patients

Beauregard

2006

fMRI

Children

Results suggest that neurofeedback training (NFT) has the capacity to functionally normalize the brain systems mediating selective attention and response inhibition in AD/HD children.

34

Cho

2006

MPH/HMPAO/SPECT

Children

Findings suggest that non-responders to MPH may have different patterns of rCBF in brain regions, which have been known as a part of frontal-striatal circuitry and posterior attentional system, respectively.

-

Diaz-Heijtz

2006

[18F]DOPA/PET/SPECT

Children and Adult

Results from the human brain imaging studies are still not definitive because of discrepancies in the findings. There is a great need to replicate and expand these findings in treatment-naive patients with ADHD, taking into consideration potential variables such as drug and smoking history, ethnicity, and presence of comorbidity.

- boys with ADHD & their unaffected siblings

- matched controls

Durston

2006

Event-related fMRI

Children

Findings suggest that the magnitude of activation during successful inhibitions is sensitive to genetic vulnerability for ADHD in a number of regions, including ventral prefrontal cortex. If this can be replicated in future studies, this suggests that neuroimaging measures related to inhibitory control may be suitable as intermediate phenotypes in studies investigating gene effects in ADHD.

16 patients

16 healthy

Konrad

2006

Event-related fMRI

Children

(male)

Results demonstrated altered brain mechanism in ADHD associated with all three attentional networks investigated: alerting, reorienting, and executive control.

29

Krause

2006

TRODAT-1/SPECT

Adult

No higher striatal DAT was found in patients with homozygosity of the 10 allele of the DAT gene in this study.

20 patients

20 controls

Larisch

2006

123I-FP-CIT/SPECT

Adult

Study provides further in-vivo evidence for an involvement of the dopamine transporter in ADHD. Compared to previous studies, the increase of dopamine transporter density in the patient group is less pronounced here.

20 non-medicated patients without comorbidity

Levesque

2006

fMRI

Children

Results suggest that in AD/HD children, neurofeedback training (NFT) has the capacity to normalize the functioning of the ACC, the key neural substrate of selective attention.

11 right-handed with ADHD

11 matched controls

Mostofsky

2006

fMRI

Children

Despite similar speed of sequential finger tapping, children with ADHD showed decreased contralateral motor cortex and right parietal cortex activation during both right-handed finger sequencing (RHFS) and left-handed finger sequencing (LHFS). The fMRI findings suggest that children with ADHD have anomalous development of cortical systems necessary for execution of patterned movements.

17 ADHD-C (combined type)

15 healthy

Pliszka

2006

fMRI

Children

In relation to comparison subjects, ADHD subjects failed to activate the anterior cingulate cortex and the left ventrolateral prefrontal cortex after unsuccessful inhibition.

19 patients

27 matched controls

Smith

2006

fMRI

Children

(male)

Abnormal brain activation was observed in medication-naive children and adolescents with ADHD during tasks involving motor inhibition and task switching, suggesting that hypoactivation in this patient group is unrelated to long-term stimulant exposure.

14 right-handed with ADHD-C (combined type)

12 matched controls

Tamm

2006

Event-related fMRI

Children

(male)

Adolescents with ADHD demonstrated significant impairments in their ability to direct and allocate attentional resources. These difficulties were associated with significant aberrations in the parietal attentional system, which is known to play a significant role in attention shifting and detecting specific or salient targets.

11 bipolar with comorbid ADHD

15 bipolar without comorbid ADHD

Adler

2005

fMRI

Children

Findings suggest that comorbid ADHD in bipolar adolescents is associated with activation of alternative pathways during performance of a simple attention task. The pattern of differences suggests that bipolar adolescents with comorbid ADHD demonstrate decreased activation of prefrontal regions, compared with bipolar adolescents without ADHD, and preferentially recruit portions of posterior parietal and temporal cortex.

12 patients

12 controls

Booth

2005

fMRI

Children

The widespread hypoactivity for the ADHD children on the go/no-go task is consistent with the hypothesis that response inhibition is a specific deficit in attention deficit hyperactivity disorder.

11

Cheon

2005

MPH/SPECT

Children

Findings support an association between homozygosity for 10-repeat allele at DAT1 and the DAT density assessed in vivo and correlation between the homozygosity for 10-repeat allele and poor response to MPH.

5

Feron

2005

MPH/SPECT

Children

Study observed upregulation of dopamine transporter activity might support the assumption that methylphenidate does not lead to permanent damage of the nigrostriatal dopaminergic pathways.

12 patients

10 healthy

Jucaite

2005

[11C]PE2I/[11C]raclopride/

PET

Children and Adults

The lower BP values for DAT in the midbrain suggest that dopamine signaling in subjects with ADHD is altered – indicating a causal relationship to motor hyperactivity and might be considered as a potential endophenotype of ADHD.

18

Krause

2005

MPH/TRODAT-1/SPECT

Adult

ADHD patients with low DAT availability seem not to respond to therapy with MPH.

- patients

- matched controls

Lee

2005

MPH/SPECT

Children

Results indicated that improving ADHD symptom after methylphenidate is associated with normalization of abnormally reduced orbitofrontal activity and abnormally increased somatosensory cortical activity.

29 ADHD

12 epilepsy

Oner

2005

HMPAO/SPECT

Children

Results indicated that the left hemisphere dominance in the prefrontal cortex significantly increases with age in ADHD cases.

19 specific language impairment (SLI),

12 ADHD

Ors

2005

HMPAO/SPECT

Children

19 children with SLI were compared to 12 children with ADHD. Findings give evidence for anomalous neurodevelopment with deviant hemispheric lateralization as an important factor in the aetiology of SLI.

9 patients

Rosa-Neto

2005

MPH/[11C]raclopride/PET

Children

Results link inattention and impulsivity with sensitivity of brain DA receptor availability to an MP challenge, corroborating the hypothesis that MP serves to potentiate decreased DA neurotransmission in ADHD.

16 patients

21 matched controls

Rubia

2005

Event-related fMRI

Children

Study shows that abnormal brain activation during inhibitory challenge in ADHD is specific to the disorder, since it persists when medication history and performance discrepancies are excluded.

8 patients

8 matched controls

Schulz

2005

fMRI

Children

The ADHD group demonstrated significantly greater activation of the left ventrolateral prefrontal cortex during interference control as well as greater activation of the left anterior cingulate cortex, right ventrolateral prefrontal cortex, and left basal ganglia during the dual task of interference control and response competition.

10 patients

Schulz

2005

fMRI

15-19

Preliminary results suggest that developmental changes in ADHD symptomatology are associated with functional changes in ventrolateral prefrontal cortex activity.

- ADHD-C

(combined type)

- matched controls

Silk

2005

fMRI

Children

(male)

Different neuroactivation patterns indicate widespread frontal, striatal and parietal dysfunction in adolescents with ADHD-CT.

34

Szobot

2005

SPECT

Children

(male)

Findings suggest that a higher recruitment in middle temporal gyrus, an area associated to working memory and selective attention, should exist to compensate a putative effect of the interaction between these dopaminergic genes.

10 ADHD-C

(combined type)

10 matched controls

Vaidya

2005

Event-related fMRI

Children

The ADHD children’s inability to activate the caudate nucleus constitutes a core abnormality in ADHD. Observed functional abnormalities did not result from prolonged stimulant exposure, since most children were medication naive.

20 non-medicated patients

20 controls

Valera

2005

fMRI

Adult

ADHD adults showed altered patterns of neural activity despite comparable performance on a verbal working memory task. Findings suggest that the cerebellum is involved in the pathophysiology of at least some cognitive deficits associated with ADHD and emphasize the need for additional research aimed at elucidating the role of the cerebellum in ADHD symptomatology.

9 patients

9 matched controls

Zang

2005

MPH/Event-related fMRI

Children

(male)

Findings are consistent with prior findings of hypofrontality in ADHD children and implicate a compensatory network including basal ganglia, insula and cerebellum for relative lower cognitive load tasks.

8 pure ADHD,

11 comorbid ADHD

9 matched controls

Lorberboym

2004

ECD/SPECT

Children

Study demonstrates that temporal lobe perfusion abnormalities are more common in patients with the comorbid type of ADHD. Findings can have therapeutic implications and explain the decreased response to stimulants in this group of patients.

6

Lou

2004

[11C]raclopride/PET

Children

High dopamine receptor availability was predicted by low neonatal CBF, supporting the hypothesis of cerebral ischaemia as a contributing factor in infants susceptible to ADHD.

15 ADHD,

8 reading disorder,

4 ADHD/reading disorder

14 healthy

Shafritz

2004

MPH/fMRI

12-20

Results suggest that ADHD is associated with abnormal processing in attentional networks, with specific dysfunction in striatal circuitry. MPH may act to normalize activity within this network.

10 patients

9 matched controls

Schulz

2004

fMRI

Children

(male)

Compared with adolescents who had no history of ADHD, adolescents who were diagnosed with ADHD during childhood exhibited enhanced responses during inhibition in ventrolateral prefrontal cortical areas that subserve response inhibition, as well as in anterior cingulate and frontopolar regions implicated in other executive functions.

10 patients

11 healthy

Schweitzer

2004

MPH/PET

Adult

(male)

Methylphenidate does not normalize task-related activity in ADHD. Task-related rCBF decreases in the PFC may be due to improved filtering out of task-irrelevant stimuli by way of MPH-mediated dopamine release in the PFC.

10 patients

12 matched controls

Tamm

2004

fMRI

Children

(male)

Suggest that underactivation in frontal regions reflects core deficits in response/task-switching abilities for the ADHD group.

9 patients

6 healthy

Cheon

2003

[(123)I]IPT/SPECT

Children

Findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

-

Durston

2003

fMRI

Children

ADHD children show a slightly different cognitive profile at 6 to 10 years of age that is paralleled by a relative lack of or delay in the maturation of ventral frontostriatal circuitry.

10 patients

12 matched controls

Ernst

2003

H(2)O PET

Adult

Findings suggest that the neural circuits engaged during decision making differ in subjects with ADHD and healthy comparison subjects.

??-

Krause

2003

SPECT

Adult

Patients with ADHD and with a history of nicotine abuse both displayed lower values of DAT density in [99mTc]TRODAT-1 SPECT than non-smokers with ADHD. DAT seem to be elevated in non-smoking ADHD patients suffering from the purely inattentive subtype of ADHD as well as in those with the combined or purely hyperactive/impulsive subtype.

-

Rohde

2003

DAT1/MPH/SPECT

Children

Findings provide a preliminary connection between pharmacogenetics and neurobiological investigations on stimulant treatment of ADHD.

10

Schweitzer

2003

MPH/PET

Adult

Data suggest that MPH modulates brain regions associated with motor function to achieve a reduction in ADHD symptoms.

36

Szobot

2003

MPH/ECD/SPECT

Children

(male)

Findings suggest that the posterior attentional system, which includes the parietal cortex, may have a role in mediation of therapeutic effects of MPH in ADHD.

6

Vles

2003

MPH/SPECT

Children

(male)

Study suggests that dopamine transporter imaging by SPECT might be used to monitor psychostimulant treatment in children suffering from ADHD.

10

Anderson

2002

MP/fMRI

Children

(male)

Study supports a role for the vermis in ADHD and suggests that further research is needed to clarify the relationship between vermal size, vermal blood flow, stimulant response, and the developmental pathophysiology of ADHD.

-

Castellanos

2002

MRI/PET/SPECT/

Transcranial magnetic stimulation (TMS)

-

Studies suggest that circuits linking prefrontal cortex, striatum, and cerebellum are not functioning normally in ADHD.

13 patients

7 healthy

Kaya

2002

HMPAO/SPECT

Children

Difficulty in self regulating response to stimuli in ADHD is mediated by underfunctioning of the orbital frontal cortex and subsequent connection to the limbic system. Decreased temporal cortex perfusion may dysfunction of the limbic system or the orbito-frontal-limbic axis.

40 patients

17 matched controls

Kim

2002

HMPAO/SPECT

Children

Study confirms the presence of functional defects in the prefrontal cortex and reports new problems in the limbic area, somatosensory areas and in the cerebellum during the resting state of brains of ADHD children. (results should be interpreted cautiously)

11 smokers w/ ADHD

11 non-smokers w/ ADHD

Krause

2002

TRODAT-1/SPECT

Adult

Because stimulants have been shown to reduce primarily elevated DAT density in adults with ADHD, it can be suggested that nicotine acts in a similar way on striatal DAT as do stimulants.

22 patients

7 healthy

Langleben

2002

MPH/SPECT

Children

(male)

Brief discontinuation of MPH treatment is associated with increased motor and anterior cingulate cortical activity. Findings suggest that MPH treatment modulates motor and anterior cingulate cortical activity directly or indirectly.

6 ADHD with birth trauma and/or low birth weight

Rosa-Neto

2002

MPH/[(11)C]raclopride/PET

Children

As the ability to block the reuptake depends on the relative dopamine concentration, the result suggests that the impulsivity in these adolescents is associated with abnormally low extracellular dopamine concentration.

9 patients

9 healthy

van Dyck

2002

[(123)I]beta-CIT/SPECT

Adult

Findings suggest that a hypothesized dysregulation of dopamine function in ADHD does not entail altered dopamine transporter levels.

9

Ilgin

2001

123I IBZM/SPECT

Children

Results indicate that in non-drug treated children with ADHD, higher D2 receptor availability is observed at baseline which is down-regulated back to reported near-normal values after methylphenidate therapy. The effect of methylphenidate on D2 receptor levels in patients with ADHD is similar to that observed in healthy adults; a down-regulation phenomenon within 0 to 30%. In addition, initially higher values of D2 availability seem to indicate better response to methylphenidate therapy in ADHD.

32

Kim

2001

MPH/HMPAO/SPECT

Children

(male)

Findings suggested MPH could affect the function of the fronto-striato-thalamic circuit, which is known as the pathophysiologic site of ADHD and could be used to correct the underlying brain dysfunction of ADHD.

-

Langleben

2001

ECD/SPECT

Children

(male)

The severe hyperactivity group exhibited most prefrontal left>right rCBF asymmetry and left>right occipitoparietal asymmetry. Reversal of functional prefrontal asymmetry in boys with severe motor hyperactivity supports the hypothesis of right prefrontal cortex dysfunction in ADHD.

55

Rubia

2001

fMRI

Children

Attention-deficit hyperactivity disorder is characterised by specific deficits in tasks of motor response inhibition, but not motor timing, and by dysfunction of frontostriatal brain regions.

-

Spalletta

2001

SPECT

Children

Findings highlight the role of the DLPFC blood flow impairment in the pathogenesis of ADHD even in young subjects without structural abnormalities.

17 patients

N/A matched controls

Dresel

2000

MPH/TRODAT-1/SPECT

Adult

The data of this study help to elucidate the complex dysregulation of the dopaminergic neurotransmitter system in patients suffering from ADHD and the effect of treatment with psychoactive drugs.

11 ADHD,

7 ADHD w/ abnormal regional cerebral blood-flow (rCBF),

10 ADHD w/ abnormal EEG

Gustafsson

2000

SPECT

Children

Results suggest that there may be at least two functional disturbances in ADHD, one specific neurodevelopmentally determined disturbance of the frontal lobes, especially of the right hemisphere, related to behaviour deviance, and another disturbance of the integration of the temporal lobes, the cerebellum and subcortical structures, related to motor planning and aspects of cognition.

10 patients

N/A matched controls

Krause

2000

MPH/TRODAT-1/SPECT

Adults

For the first time it could be demonstrated using SPECT that methylphenidate lowers increased striatal DAT availability in adults suffering from ADHD.

-

Mehta

2000

MPH/ – type not specified

Adult

Findings provide insights into the possible neurochemical and neuroanatomical substrates of the action of methylphenidate in ADHD and suggest a useful methodology for further research into this potentially debilitating disorder.

6 patients

6 healthy

Schweitzer

2000

[(15)O]H(2)O/PET

Adult

Data suggest the use of compensatory mental and neural strategies by subjects with ADHD in response to a disrupted ability to inhibit attention to nonrelevant stimuli and the use of internalized speech to guide behavior.

- patients

- healthy

Teicher

2000

fMRI (T2 relaxometry)/MPH

Children

(male)

Daily treatment with methylphenidate significantly changed the T2 relaxation times in the putamen of children with attention-deficit/hyperactivity disorder, although the magnitude and direction of the effect was strongly dependent on the child’s unmedicated activity state. ADHD symptoms may be closely tied to functional abnormalities in the putamen, which is mainly involved in the regulation of motor behavior.

8 patients

8 matched controls

Bush

1999

fMRI

Adult

The data support a hypothesized dysfunction of the anterior cingulate cognitive division (ACcd) in ADHD.

10 patients

10 healthy

Ernst

1999

[18F]DOPA/PET

Children

Findings suggest of dopaminergic dysfunction at the level of the dopaminergic nuclei in children with ADHD. Abnormality in dopa decarboxylase activity may be primary or secondary to deficits in other functional units of the dopamine pathway (e.g., receptor, uptake transporter, vesicular transporter, degradation enzymes).

7 patients

9 controls

Rubia

1999

fMRI

Children

(male)

ADHD is associated with subnormal activation of the prefrontal systems responsible for higher-order motor control. Functional MRI is a feasible technique for investigation of neural correlates of ADHD.

30 marijuana users w/ ADHD

10 control

Amen

1998

SPECT

-

Study demonstrates decreased cerebral perfusion in the temporal lobe regions of the brain on SPECT imaging from chronic marijuana usage.

39 patients

56 healthy

Ernst

1998

18-FDG/PET

Adults

Increased age was associated with reduced global CMRglc in ADHD women, but not in ADHD men, control men, or control women. Better performance on the attention task was significantly associated with increased age only in the ADHD female group.

17 patients

23 healthy

Ernst

1998

[18F]DOPA/PET

Adult

Findings suggest that a prefrontal dopaminergic dysfunction mediates ADHD symptoms in adults and that gender influences this abnormality.

12 patients

6 controls

Lou

1998

Xe-133/SPECT

Children

(male)

Findings suggest that the anterior gyrus cinguli were activated by supramodal attention and that the infero-frontal and striatal regions were activated by semantic processing supports the involvement of these ROI’s in verbal awareness.

- patients

- controls

Vaidya

1998

MPH/fMRI

Children

Results suggest that ADHD is characterized by atypical frontal-striatal function and that methylphenidate affects striatal activation differently in ADHD than in healthy children.

54 patients

- controls

Amen

1997

SPECT

Children

65% of the ADHD group revealed decreased perfusion in the prefrontal cortex with intellectual stress, compared to only 5% of the control group. These are findings consistent with PET and QEEG findings. Of the ADHD group who did not show decreased perfusion, two-thirds had markedly decreased activity in the prefrontal cortices at rest.

1

Powell

1997

HMPAO/SPECT

Adult

Although overreliance on structural imaging or EEG in such an evaluation must be discouraged, brain SPECT may be useful to evaluate patients with symptoms of attention disorders for frontal epilepsy.

10

Sunshine

1997

fMRI (blood oxygen level-dependent)

-

Single-section fMRI revealed activation in brain regions known to be involved in the maintenance of the attention in healthy subjects responding to auditory, tactile, or visual stimulation; additional areas of activity that were identified may represent true abnormal regions in the affected population or artifacts.

10 patients

6 contols

Sieg

1995

I-123 IMP/SPECT

-

Findings are consistent with previous studies of brain physiology in ADHD implicating regional cortical perfusion and metabolism abnormalities in areas which are involved in the control of attentional processes.

8

Ernst

1994

FDG/PET/ dextroamphetamine

Adult

I.V. infusion of dextroamphetamine did not significantly alter brain metabolism in ADHD adults in this preliminary study.

20 patients

19 healthy

Ernst

1994

FDG/PET

Children

(female)

The greater brain metabolism abnormalities in females than males strongly stress that more attention be given to the study of girls with ADHD.

37

Matochik

1994

FDG/PET/MPH/

dextroamphetamine

Adult

While the present study does not demonstrate any robust metabolic effects of chronic stimulant treatment, the behavioral data strongly indicate that methylphenidate and d-amphetamine are effective agents for the treatment of adults with ADHD.

54 patients

18 matched control

Amen

1993

SPECT

Children

Study supports the findings of other researchers regarding decreased prefrontal activity in response to an intellectual stress in children and adolescents who have attention deficit hyperactivity disorder.

-

Matochik

1993

FDG/PET/MPH/ dextroamphetamine

Adults

Each stimulant produced a differential pattern of increases and decreases in regional metabolism throughout the regions of interest that were sampled. Rather than increasing glucose utilization in specific brain regions with lowered metabolic rates in adults with ADHD, stimulants may act by altering glucose use throughout the brain.

10 patients

10 healthy

Zametkin

1993

FDG/PET

Children

Global or absolute measures of metabolism using PET and fludeoxyglucose F18 did not statistically differentiate between normal adolescents with ADHD.

9 pure ADHD,

8 ADHD w/ phonologic-syntactic dysphasia,

7 dysphasia patients w/o hyperactivity,

15 matched

controls

Lou

1990

Xe-133/SPECT

Children

9 children with pure ADHD, the distribution of regional cerebral activity was abnormal–low in striatal and posterior periventricular regions and high in occipital regions. Low activity in striatal and posterior periventricular areas was also seen in the 8 children with ADHD in combination with phonologic-syntactic dysphasia. 7 children with dysphasia, but without hyperactive behaviour, had low cerebral activity in left temporofrontal regions.

25 hyperactive

50 healthy

Zametkin

1990

18-FDG/PET

Adult

Glucose metabolism was reduced in adults who had been hyperactive since childhood. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity.

6 pure ADHD,

13 ADHD-C (combined type)

Lou

1989

Xe-133/PET

-

MPH increased flow to striatal and posterior periventricular regions, and tended to decrease flow to primary sensory regions. Low striatal activity, partially reversible with MPH, appears to be a cardinal feature in ADHD.

13 ADD and/or dysphasia

Lou

1984

MPH/Xe-133/SPECT

Children

MPH increased perfusion in the central region, including the mesencephalon and the basal ganglia, and decreased perfusion of motor and primary sensory cortical areas. The location of hypoperfused structures in cognitive disorders of childhood is consistent with a role for an early hypoxic-ischemic event in their origin.

12 patients

- matched controls

Dresel

Not

Listed

MPH/TRODAT-1/SPECT

Adult

Findings suggest that in patients suffering from ADHD, the number of DAT binding sites is higher as compared to normal controls.

8

Pomoy

Not

Listed

ECD/SPECT

Children

(male)

Administration of methylphenidate resulted in a consistent increase (>5%) in regional cerebral perfusion in ADHD subjects studied while performing a continuous performance task.

7 patients

30 healthy

Rauch

Not

Listed

123I-altropane 9/SPECT

Adult

The DAT site, the principal target of drugs used to treat ADHD, was elevated approximately 70% in subjects with ADHD as compared to healthy controls.

16 patients

21 matched controls

Rubia

Not

Listed

fMRI

Children

Study shows that abnormal brain activation during inhibitory challenge in ADHD is specific to the disorder, since it persists when medication history & performance discrepancies are excluded.

12

Silva

Not

Listed

HMPAO/SPECT

Children

Brain SPECT can identify functional abnormalities in children with ADDH with an inadequate inhibitory mechanism to the sensory output.

-

Vaidya

Not

Listed

fMRI

Children

When performing Go-No-Go task, subjects tended to make fewer false inhibitory processes subserved by anterior frontal regions are enhanced by methylphenidate in ADD.

5 patients

5 controls

Volkow

Not

Listed

PET

Adult

Decreases in DAT, but no change in DA D2 receptors, suggests an involvement of the DA cells but not of DA postsynaptic target cells in ADHD.

Total Patients

Total Authors

Total Studies

SPECT

Studies

PET

Studies

fMRI

Studies

1,988

92

92

43

21

30

Weekly Brain Directed Newsletter

  Subscribe to the newsletter from America's most popular psychiatrist. Receive a 10% coupon for the MindWorks store upon sign up!