Leslie A. Hulvershorn, M.D., M.Sc.

Fellow in Child & Adolescent ADHD

Project Details

PROJECT TITLE

The Impact of Methylphenidate Treatment on Emotion Regulation in ADHD: A Functional Connectivity Analysis

PROJECT SUMMARY

A significant proportion of children with attention deficit hyperactivity disorder (ADHD) also display profound emotion regulation deficits resulting in chronic irritability, severe temper outbursts and aggression. In recent years, these children have been variously characterized as having early-onset bipolar disorder, “ADHD-plus,” severe mood dysregulation (SMD) and temper dysregulation disorder with dysphoria. Despite high rates of medication use in this population, little is known about the neurobiology underlying effective medication treatments for the mood regulation component of their symptoms.  Methylphenidate (MPH) is a medication with known benefit for multiple symptom domains of ADHD, including emotion regulation. With this KTGF funding, we plan to conduct the first neuroimaging study on the impact of MPH on emotion regulation in youth with chronic emotion regulation difficulties and ADHD in order to better understand the neural mechanisms of action of a widely used and effective medication treatment. We propose to acquire functional MRI scans before and after 4 weeks of MPH treatment. In addition, to capture the impact of medication on real-life functioning, both prior to the start of medication and after the therapeutic dose has been reached, a brief battery of emotion regulation questionnaires/tasks will be administered to each participant and their parent(s) in the clinic setting. In the long run, evidence of normalization of brain circuitry may support a shift in clinical use toward this effective treatment and away from such significant use of medications with greater side effects.

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