Proton spectroscopy in medication-free pediatric attention-deficit/hyperactivity disorder

Background: The frontal-striatal pathway has been previously implicated in the neuropathology of attention-deficit/hyperactivity, disorder (ADHD). Hence, we used proton magnetic resonance spectroscopy (H-1-MRS) to examine metabolite levels in the prefrontal cortex of children with ADHD. Methods: Nine age- and gender-matched case-control pairs were examined, ages 7 to 16 years. A long-echo H-1-MRS scan was acquired from the right prefrontal cortex and left striatum in all subjects. Compounds that can be visualized with H-1-MRS include N-acetyl-aspartate (NAA), glutamate/glutamine/gamma-aminobutyric acid (Glx), creatine/phosphocreatine (Cr), and choline compounds (Cho). Results: Frontal-striatal glutamatergic resonances were elevated in the children with ADHD as compared to healthy, control subjects. No differences were noted in NAA, Cho, or Cr metabolite ratios. Conclusions: These findings suggest that frontal-striatal Glx resonances may be increased in children with ADHD in comparison with healthy control subjects. (C) 2003 Society of Biological Psychiatry.