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KMID : 0311120090500050650
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Yonsei Medical Journal
2009 Volume.50 No. 5 p.650 ~ p.655
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Variability of Response Time as a Predictor of Methylphenidate Treatment Response in Korean Children with Attention Deficit Hyperactivity Disorder
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Lee Seung-Hye
Joo I-Jin
Song Dong-Ho
Shin Yee-Jin
Shin Dong-Won
Ha Eun-Hye
Yoo Hee-Jeong
Kim Bung-Nyun
Cheon Keun-Ah
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Abstract
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Purpose:Methylphenidate (MPH) is an effective medication for the treatment of attention deficit hyperactivity disorder (ADHD). However, about 30% of patients do not respond to or are unable to tolerate MPH. Based on previous findings, we hypothesized that great variability in response time (RT) among Korean children with ADHD on a computerized continuous performance attention test would be related to poor MPH treatment response.
Materials and Methods:Children (ages 6-18 years) with ADHD were recruited for a prospective 12-week, open-labeled, multicenter study to examine optimal dosage of OROS methylphenidate. Of the 144 subjects selected, 28 dropped out due to adverse events, medication noncompliance, or follow-up loss, and an additional 26 subjects with comorbid disorders were excluded from statistical analyses. We defined ’responders’ as subjects who received a score of less than 18 on the attention deficit hyperactivity disorder rating scale (ARS; Korean version, K-ARS) and a score of 1 or 2 on the Clinical Global Impression-Improvement scale (CGI-I). RT variability was assessed with the ADHD diagnostic system (ADS).
Results:Fifty-nine (67%) subjects responded to MPH treatment. The non-responders showed greater RT variability at baseline (Mann Whitney U = 577.0, p < 0.01). Baseline RT variability was a significant predictor of MPH response (Nagelkerke R2 = 0.136, p < 0.01). It predicted 94.9% of responder, 17.2% of non-responder and 69.3% of overall group.
Conclusion:High RT variability may predict poor response to MPH treatment in children with ADHD.
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KEYWORD
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ADHD, methylphenidate, response time variability
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