The “VIP-ADHD trial”: Does brain arousal have prognostic value for predicting response to psychostimulants in adult ADHD patients?

Strauß, Maria; Petroff, David; Huang, Jue; Ulke, Christine; Paucke, Madlen; Bogatsch, Holger; Böhme, Pierre; Hoffmann, Knut; Reif, Andreas; Kittel‐Schneider, Sarah; Heuser, Isabella; Ahlers, Eike; Gallinat, Juergen; Schöttle, Daniel; Fallgatter, Andreas J.; Ethofer, Thomas; Unterecker, Stefan; Hegerl, Ulrich

doi:10.1016/j.euroneuro.2020.12.003

Cited by 3 publications

(9 citation statements)

References 54 publications

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“…First, the T-score in the CAARS DSM-Global subscale [ 23 ] is probably less adequate as a measurement of treatment response. In a previous study [ 21 ], 22.3% of ADHD patients reached very high CAARS values that were all transformed to 90 as T-scores. In this study, this percentage reached 40%.…”

Section: Discussionmentioning

confidence: 99%

“…About 30% to 42% patients cannot benefit from their medication [ 19 , 20 ]. In the most recent clinical trial, more than 90% of patients showed symptomatology improvement, but only 30% of them reached the defined remission [ 21 ]. Explanations for the varied responses include personal clinical characteristics, gene type, symptom severity, dosage, therapy duration and co-occurrence of comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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Association between Individual Norepinephrine Transporter (NET) Availability and Response to Pharmacological Therapy in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

et al. 2022

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Background: The role of the norepinephrine transporter (NET) has received increased focus in recent studies on the pathogenesis of attention-deficit/hyperactivity disorder (ADHD). The predictive value for pharmacological treatment and its link to other health or social limitations has been little-studied. This follow-up research on adult patients with ADHD aimed to explore whether the therapy response and health and social impairments depend on baseline individual NET availability. Methods: Data were collected from 10 patients on personal, family and professional situations, mental and physical health and treatments received after baseline via online and telephone surveys and were compared to baseline data to evaluate treatment-related changes. Results: The majority of our ADHD patients did not show therapy responses but showed improvements due to pharmacological treatment. There was no evidence of relationships between pre-treatment NET availability and therapy response or health/social limitations. Conclusions: Pharmacological monotherapy was insufficient to promote symptom remission, especially for participants with extreme insufficiency in NET availability, but improved outcomes in academic and social functioning. Psychotherapy should be considered as an add-on to the standard treatment approach due to its positive outcome in reducing social limitations. The prognostic value of individual NET availability in predicting the response to therapy needs further studies with large sample sizes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between Individual Norepinephrine Transporter (NET) Availability and Response to Pharmacological Therapy in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

et al. 2022

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“…These results suggest that the core symptoms of most of aADHD were reduced following treatment with methylphenidate with some of the patients (about 30%) even reaching therapy remission. The description and discussion of these results has already been published elsewhere [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Data of the current study were taken from a previously published multicenter, single-arm, open label clinical trial in ADHD patients [ 44 ] with a recruitment period from April 2016 to June 2018. This study was reviewed and approved by the local ethics committee (Registration: EudraCT 2015–000,488–15; German Clinical Trial Register DRKS00009971, University of Leipzig ethics committee 337/15-ff).…”

Section: Methodsmentioning

confidence: 99%

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The role of comorbid depressive symptoms on long-range temporal correlations in resting EEG in adults with ADHD

Huang

Ahlers

Bogatsch

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, characterized by core symptoms of inattention, hyperactivity and impulsivity. Comorbid depression is commonly observed in ADHD-patients. Psychostimulants are recommended as first-line treatment for ADHD. Aberrant long-range temporal correlations (LRTCs) of neuronal activities in resting-state are known to be associated with disorganized thinking and concentrating difficulties (typical in ADHD) and with maladaptive thinking (typical in depression). It has yet to be examined whether (1) LRTC occur in ADHD-patients, and if so, (2) whether LRTC might be a competent biomarker in ADHD comorbid with current depression and (3) how depression affects psychostimulant therapy of ADHD symptoms. The present study registered and compared LRTCs in different EEG frequency bands in 85 adults with ADHD between groups with (n = 28) and without (n = 57) additional depressive symptoms at baseline. Treatment-related changes in ADHD, depressive symptoms and LRTC were investigated in the whole population and within each group. Our results revealed significant LRTCs existed in all investigated frequency bands. There were, however, no significant LRTC-differences between ADHD-patients with and without depressive symptoms at baseline and no LRTC-changes following treatment. However, depressed ADHD patients did seem to benefit more from the therapy with psychostimulant based on self-report.

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The impact of emotional dysregulation and comorbid depressive symptoms on clinical features, brain arousal, and treatment response in adults with ADHD

Huang,

Mauche,

Ahlers

et al. 2024

Front. Psychiatry

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IntroductionThe role of emotional dysregulation (ED) in attention-deficit/hyperactivity disorder (ADHD) has become an important issue. This study, in which we analyzed data from a predictive pharmaco-EEG-trial, aimed to examine whether symptoms of ED in adult ADHD affect ADHD symptom severity, brain arousal regulation as measured by resting EEG, and the response to stimulant medication.MethodsED is defined as having a sex- and age-corrected T-score of >70 on the emotional lability subscale of the German version of Conners’ Adult ADHD Rating Scale. A total of 115 participants were included in the study, 56 of whom had ED. Participants with ED were more impaired in terms of the severity of core ADHD symptoms, especially inattentive symptoms, comorbid depressive symptoms, interpersonal relationships, and quality of life. In addition, participants with ED were more likely to report a total score above 13 on the Beck Depression Inventory-II, which was considered to be the cutoff for mild depression.ResultsNo differences were found between the ED and non-ED groups in response to stimulant medication or in brain arousal regulation. In addition, there was no significant effect of ED with comorbid depressive symptoms on treatment response. There was a trend for subgroups that showed a change in brain arousal regulation associated with symptom improvement.DiscussionOur findings may support the assumption that ED may be an important feature of ADHD. The use of EEG-based brain arousal regulation as a diagnostic and predictive tool in ADHD in the presence of ED and comorbid depressive symptoms should be further investigated.

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The “VIP-ADHD trial”: Does brain arousal have prognostic value for predicting response to psychostimulants in adult ADHD patients?

Cited by 3 publications

References 54 publications

Association between Individual Norepinephrine Transporter (NET) Availability and Response to Pharmacological Therapy in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

Association between Individual Norepinephrine Transporter (NET) Availability and Response to Pharmacological Therapy in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

The role of comorbid depressive symptoms on long-range temporal correlations in resting EEG in adults with ADHD

The impact of emotional dysregulation and comorbid depressive symptoms on clinical features, brain arousal, and treatment response in adults with ADHD

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