Journal of child psychology and psychiatry, and allied disciplines · 2025
Psychostimulant treatment uniquely reduces left uncinate fasciculus microstructural integrity in ADHD youth with a familial risk for bipolar I disorder: a 12-week DTI study.
СтатьяРандомизированное исследованиеПоддержка службы здравоохранения СШАПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Qin Kun, Chen Wen, Lei Du, Zhu Ziyu, Tallman Maxwell J, Pan Nanfang, Zhang Lisha, Rodrigo Patino Luis, Sweeney John A, DelBello Melissa P, McNamara Robert K
Аннотация
BACKGROUND: Bipolar I disorder (BD) is associated with reduced white matter microstructural integrity in the uncinate fasciculus (UF), a primary fiber tract connecting frontolimbic systems. Although familial history for BD, attention-deficit/hyperactivity disorder (ADHD), and psychostimulants are important risk factors implicated in BD pathoetiology, their impact on UF microstructure remains poorly understood.
METHODS: This diffusion tensor imaging study investigated UF microstructural integrity prior to and following 12 weeks of psychostimulant treatment in ADHD youth with ('high-risk', HR) and without ('low-risk', LR) a first-degree relative with BD. Healthy controls were included for comparative purposes. LR youth received 12-week open-label mixed amphetamine salts-extended release (MAS-XR), and HR youth were randomized to either MAS-XR or placebo (PLA). Bilateral UF fractional anisotropy (FA) and axial diffusivity (AD) were assessed using automated fiber quantification.
RESULTS: A total of 137 participants were included in the analyses. At baseline, there were no significant group differences in bilateral UF microstructural metrics. Following 12-week MAS-XR treatment, significant group-by-time interactions were found for left UF FA and AD between HR-MAS and LR-MAS, as well as for left UF FA between HR-MAS and HR-PLA. Specifically, left UF FA and UF AD decreased significantly in HR-MAS but remained unchanged in LR-MAS and HR-PLA groups. At week 12, left UF FA was lower in HR-MAS relative to HC but not in LR-MAS or HR-PLA. Segment-wise analyses further revealed that UF microstructural changes in the HR-MAS group were localized to the anterior segments.
CONCLUSIONS: These results suggest that HR-ADHD youth are uniquely vulnerable to reductions in left UF microstructural integrity following psychostimulant treatment, suggesting potential relevance to BD pathoprogression.
METHODS: This diffusion tensor imaging study investigated UF microstructural integrity prior to and following 12 weeks of psychostimulant treatment in ADHD youth with ('high-risk', HR) and without ('low-risk', LR) a first-degree relative with BD. Healthy controls were included for comparative purposes. LR youth received 12-week open-label mixed amphetamine salts-extended release (MAS-XR), and HR youth were randomized to either MAS-XR or placebo (PLA). Bilateral UF fractional anisotropy (FA) and axial diffusivity (AD) were assessed using automated fiber quantification.
RESULTS: A total of 137 participants were included in the analyses. At baseline, there were no significant group differences in bilateral UF microstructural metrics. Following 12-week MAS-XR treatment, significant group-by-time interactions were found for left UF FA and AD between HR-MAS and LR-MAS, as well as for left UF FA between HR-MAS and HR-PLA. Specifically, left UF FA and UF AD decreased significantly in HR-MAS but remained unchanged in LR-MAS and HR-PLA groups. At week 12, left UF FA was lower in HR-MAS relative to HC but not in LR-MAS or HR-PLA. Segment-wise analyses further revealed that UF microstructural changes in the HR-MAS group were localized to the anterior segments.
CONCLUSIONS: These results suggest that HR-ADHD youth are uniquely vulnerable to reductions in left UF microstructural integrity following psychostimulant treatment, suggesting potential relevance to BD pathoprogression.