Reference Crunelle, Veltman, van Emmerik-van Oortmerssen, Booij and van den Brink7 A structural magnetic resonance imaging scan was made of each patient for co-registration. Dopamine transporter availability (BP ND) was assessed on a brain-dedicated single-photon emission computed tomography system using the caudate and putamen as regions of interest. Striatal dopamine transporter availability and impulsivity levels were assessed at baseline (before medication) and after a 2-week treatment with extended-release methylphenidate (MPH-OROS 54 mg). Reference Crunelle, van den Brink, Veltman, van Emmerik-van Oortmerssen, Dom and Schoevers6 Eight patients had a comorbid diagnosis of cocaine dependence and were abstinent for >2 weeks prior to inclusion and no other psychiatric comorbidities were present. Recruitment, diagnosis and inclusion/exclusion criteria are described elsewhere (trial registered with Nederlands Trial Register, NTR3127). In this study, we investigated whether striatal dopamine transporter occupancy by methylphenidate is related to improvements in the distinct domains of cognitive and motor impulsivity.Ī total of 24 male medication-naive adult patients with ADHD were included in the study. However, there is no direct evidence that dopamine transporter occupancy by methylphenidate is associated with a reduction of impulsivity symptoms in the cognitive and/or motor domains of impulsivity. Reference Fusar-Poli, Rubia, Rossi, Sartori and Balottin5 Methylphenidate - widely prescribed for the treatment of childhood ADHD but more debated as to its use in adult populations - binds to dopamine transporters and reduces symptoms of ADHD. Reference Burke, van de Giessen, de Win, Schilt, van Herk and van den Brink4 In adults with ADHD, increased dopamine transporter availability was observed, but a recent meta-analysis suggested that this increase was driven by patients that were previously medicated. A recent study reported that impulsivity was positively associated with the availability of striatal dopamine transporters, Reference Costa, la Fougère, Pogarell, Möller, Riedel and Ettinger3 although this was not replicated in a larger study. poor relational or professional stability). impulsive decision-making) remains prominent in adult ADHD and is associated with a range of clinical consequences (e.g. Reference Broos, Schmaal, Wiskerke, Kostelijk, Lam and Stoop1 Although motor and hyperactivity symptoms seem to decline with progression into adulthood, Reference Biederman, Petty, Evans, Small and Faraone2 cognitive impulsivity (i.e. Impulsivity, a key symptom and characteristic of attention-deficit hyperactivity disorder (ADHD), is a multifactorial construct including motor impulsivity and cognitive impulsivity.
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