RESULTS In ADHD patients the middle and inferior frontal gyri , basal ganglia , and cerebellum were most often affected by MPH .
The middle and inferior frontal gyri were frequently affected by MPH during inhibitory control tasks .
Throughout nine task-based fMRI studies investigating MPH 's effect on the brains of pediatric patients with ADHD , MPH result ed in increased activation within frontal lobes , basal ganglia , and cerebellum .
In most cases , this increase " normalized " activation of at least some brain areas to that seen in typically developing children
OBJECTIVE Attention-deficit/hyperactivity disorder ( ADHD ) is a psychiatric disorder affecting 5 % of children .
Methylpheni date ( MPH ) is a common medication for ADHD .
Studies examining MPH 's effect on pediatric ADHD patients ' brain function using functional magnetic resonance imaging ( fMRI ) have not been compiled .
The goals of this systematic review were to determine ( 1 ) which areas of the brain in pediatric ADHD patients are modulated by a single dose of MPH , ( 2 ) whether areas modulated by MPH differ by task type performed during fMRI data acquisition , and ( 3 ) whether changes in brain activation due to MPH relate to clinical improvements in ADHD-related symptoms .
A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD.
BACKGROUND Previous studies have demonstrated the short-term efficacy of pharmacotherapy and behavior therapy for attention-deficit/hyperactivity disorder ( ADHD ) , but no longer-term ( i.e. , > 4 months ) investigations have compared these 2 treatments or their combination . METHODS A group of 579 children with ADHD Combined Type , aged 7 to 9.9 years , were assigned to 14 months of medication management ( titration followed by monthly visits ) ; intensive behavioral treatment ( parent , school , and child components , with therapist involvement gradually reduced over time ) ; the two combined ; or st and ard community care ( treatments by community providers ) . Outcomes were assessed in multiple domains before and during treatment and at treatment end point ( with the combined treatment and medication management groups continuing medication at all assessment points ) . Data were analyzed through intent-to-treat r and om-effects regression procedures . RESULTS All 4 groups showed sizable reductions in symptoms over time , with significant differences among them in degrees of change . For most ADHD symptoms , children in the combined treatment and medication management groups showed significantly greater improvement than those given intensive behavioral treatment and community care . Combined and medication management treatments did not differ significantly on any direct comparisons , but in several instances ( oppositional/aggressive symptoms , internalizing symptoms , teacher-rated social skills , parent-child relations , and reading achievement )  combined treatment proved superior to intensive behavioral treatment and /or community care while medication management did not . Study medication strategies were superior to community care treatments , despite the fact that two thirds of community-treated subjects received medication during the study period . CONCLUSIONS For ADHD symptoms , our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication . Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms , but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes
RESULTS In ADHD patients the middle and inferior frontal gyri , basal ganglia , and cerebellum were most often affected by MPH .
The middle and inferior frontal gyri were frequently affected by MPH during inhibitory control tasks .
Throughout nine task-based fMRI studies investigating MPH 's effect on the brains of pediatric patients with ADHD , MPH result ed in increased activation within frontal lobes , basal ganglia , and cerebellum .
In most cases , this increase " normalized " activation of at least some brain areas to that seen in typically developing children
OBJECTIVE Attention-deficit/hyperactivity disorder ( ADHD ) is a psychiatric disorder affecting 5 % of children .
Methylpheni date ( MPH ) is a common medication for ADHD .
Studies examining MPH 's effect on pediatric ADHD patients ' brain function using functional magnetic resonance imaging ( fMRI ) have not been compiled .
The goals of this systematic review were to determine ( 1 ) which areas of the brain in pediatric ADHD patients are modulated by a single dose of MPH , ( 2 ) whether areas modulated by MPH differ by task type performed during fMRI data acquisition , and ( 3 ) whether changes in brain activation due to MPH relate to clinical improvements in ADHD-related symptoms .