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      Methylphenidate significantly improves declarative memory functioning of adults with ADHD

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          Abstract

          Background

          Declarative memory deficits are common in untreated adults with attention-deficit hyperactivity disorder (ADHD), but limited evidence exists to support improvement after treatment with methylphenidate. The objective of this study was to examine the effects of methylphenidate on memory functioning of adults with ADHD.

          Methods

          Eighteen adults with ADHD who were clinical responders to methylphenidate participated in this randomized crossover trial. After 3 days of no treatment, patients received in random order either their usual methylphenidate dose (mean: 14.7 mg; range: 10–30 mg) or placebo, separated by a 6–7-day washout period. Patients performed an immediate word recall test 1 h after treatment administration. Three hours after intake, patients performed the second part of the memory test (delayed word recall and a recognition test).

          Results

          Delayed recognition and immediate recall was similar on treatment and on placebo. Delayed word recall was significantly better in the methylphenidate than in the placebo condition ( F 1, 17 = 7.0, p < 0.017). A significant correlation was found between prestudy CES-D depression scores and difference scores on delayed recall ( r = 0.602, p < 0.008).

          Conclusion

          Methylphenidate improves declarative memory functioning in patients with ADHD. New studies should further examine whether subclinical depressive symptoms mediate the effect of methylphenidate on declarative memory.

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          Most cited references23

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          Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands.

          The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community-based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the 1-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100%; specificity 88%; and positive predictive value 13.2%. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults.
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            Dopamine-dependent facilitation of LTP induction in hippocampal CA1 by exposure to spatial novelty.

            In addition to its role in memory formation, the hippocampus may act as a novelty detector. Here we investigated whether attention to novel events can promote the associative synaptic plasticity mechanisms believed to be necessary for storing those events in memory. We therefore examined whether exposure to a novel spatial environment promoted the induction of activity-dependent persistent increases in glutamatergic transmission (long-term potentiation, LTP) at CA1 synapses in the rat hippocampus. We found that brief exposure to a novel environment lowered the threshold for the induction of LTP. This facilitatory effect was present for a short period following novelty exposure but was absent in animals that explored a familiar environment. Furthermore, the facilitation was dependent on activation of D1/D5 receptors. These findings support an important role for dopamine-regulated synaptic plasticity in the storage of unpredicted information in the CA1 area.
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              Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type.

              Symptom decline in attention deficit hyperactivity disorder (ADHD) was examined with different definitions of remission. Symptoms in 128 boys were measured five times over 4 years. The prevalences of syndromatic (less than full syndrome), symptomatic (less than subthreshold diagnosis), and functional (full recovery) remission were estimated as a function of age with multivariate logistic regression. Age was significantly associated with decline in total ADHD symptoms and symptoms of hyperactivity, impulsivity, and inattention. Symptoms of inattention remitted for fewer subjects than did symptoms of hyperactivity or impulsivity. The proportion of subjects experiencing remission varied considerably with the definition used (highest for syndromatic remission, lowest for functional remission). These results indicate that differences in reported remission rates reflect the definition used rather than the disorder's course. They provide systematic support for the clinical observation that hyperactivity and impulsivity symptoms tend to decline at a higher rate than inattention symptoms.
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                Author and article information

                Contributors
                +31-302-53 6909 , +31-302-537900 , j.c.verster@uu.nl
                Journal
                Psychopharmacology (Berl)
                Psychopharmacology
                Springer-Verlag (Berlin/Heidelberg )
                0033-3158
                1432-2072
                20 July 2010
                20 July 2010
                October 2010
                : 212
                : 2
                : 277-281
                Affiliations
                [1 ]Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacology, Utrecht University, PO Box 80082, 3508 TB Utrecht, the Netherlands
                [2 ]Department of Cognitive Neuroscience, Radboud University Nijmegen, Medical Center, Nijmegen, the Netherlands
                [3 ]PsyQ, Psycho Medical Programmes, The Hague, the Netherlands
                Article
                1952
                10.1007/s00213-010-1952-2
                2937141
                20645078
                386efd90-e2c4-4a8c-b5db-39b31b2355e5
                © The Author(s) 2010
                History
                : 1 April 2010
                : 5 July 2010
                Categories
                Original Investigation
                Custom metadata
                © Springer-Verlag 2010

                Pharmacology & Pharmaceutical medicine
                methylphenidate,adult,memory,adhd
                Pharmacology & Pharmaceutical medicine
                methylphenidate, adult, memory, adhd

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