Objective:Stimulant medications are the main treatment for Attention Deficit Hyperactivity Disorder (ADHD), but overall treatment efficacy in adults has less than a 60% response rate. This study aimed to identify neural and cognitive markers predictive of longitudinal improvement in response to stimulant treatment in drug-naïve adults with ADHD.Method:We used diffusion tensor imaging (DTI) and executive function measures with 36 drug-naïve adult ADHD patients in a prospective study design.Results:Structural connectivity (measured by fractional anisotropy, FA) in striatal regions correlated with ADHD clinical symptom improvement following stimulant treatment (amphetamine or methylphenidate) in better medication responders. A significant positive correlation was also found between working memory performance and stimulant-related symptom improvement. Higher pre-treatment working memory scores correlated with greater response.Conclusion:These findings provide evidence of pre-treatment neural and behavioral markers predictive of longitudinal treatment response to stimulant medications in adults with ADHD.

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未接受药物治疗的 ADHD 成人兴奋剂治疗效果的神经和认知预测因素：一项试点扩散张量成像研究

目的：兴奋剂药物是注意力缺陷多动障碍（ADHD）的主要治疗方法，但成人总体治疗有效率不足60%。本研究旨在确定神经和认知标记物，这些标记物可预测未接受药物治疗的成人 ADHD 患者对刺激性治疗的纵向改善反应。方法：我们对 36 名未接受药物治疗的成人 ADHD 患者使用弥散张量成像 (DTI) 和执行功能测量。前瞻性研究设计。结果：在药物反应较好的患者中，纹状体区域的结构连接性（通过分数各向异性，FA 测量）与兴奋剂治疗（安非他明或哌醋甲酯）后 ADHD 临床症状的改善相关。工作记忆表现与兴奋剂相关症状改善之间也发现显着正相关。较高的治疗前工作记忆评分与较高的反应相关。结论：这些发现提供了治疗前神经和行为标记物的证据，可以预测患有 ADHD 的成人对刺激性药物的纵向治疗反应。