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 (1H-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 1H-MRS scan was acquired from the right prefrontal cortex and left striatum in all subjects. Compounds that can be visualized with 1H-MRS include N-acetyl-aspartate (NAA), glutamate/glutamine/γ-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.