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Objective: Recent pediatric studies have suggested a correlation between decreased amygdala volume and attention deficitand hyperactivity disorder (ADHD) symptoms, including the emotional dysregulation. To investigate the hypothesis that medicationtreatment of ADHD specifically improves amygdala function, we used 1H magnetic resonance spectroscopy (MRS) to study theeffect of 12 weeks of treatment with daily 20 mg long-acting methylphenidate on the Glu/Cr, NAA/Cr, Cho/Cr, and mI/Cr ratiosin the amygdala of medication-naïve children with ADHD. Methods: This was a prospective study, using a pre- and post-test design, on a single group of 21 children (average age8.52 years, 17 males and 4 females) diagnosed with ADHD. Low Time Echo MRS scans sampled voxels of interest (1.5×1.5×2.0)from both the right and left amygdala. Results: There was significant clinical improvement after 12 weeks of treatment with 20 mg long-acting methylphenidate. On1H MRS, there were no statistical significant differences of NAA/Cr ratio, Cho/Cr ratio, mI/Cr ratio before and after 12 weeksadministration of 20 mg long-acting methylphenidate both in the right and left amygdala. In addition, Glu/Cr ratio decreased14.1% in the right amygdala (p=0.029) and 11.4% in the left amygdala (p=0.008). Standardized mean effect sizes ranged from0.14-0.32. Conclusion: The findings are consistent with the possibility that hyperglutamatergic processes in the amygdale are related tothe hyperactive-impulsive symptoms of ADHD.

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