Atomoxetine treatment of ADHD in Tourette Syndrome: Reduction in motor cortex inhibition correlates with clinical improvement

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• 作者：Donald L. Gilbert ; Jie Zhang ; Tara D. Lipps ; Nina Natarajan ; Jared Br ; yberry ; Zhewu Wang ; F. R ; y Sallee ; Eric M. Wassermann
• 关键词：Cortical inhibition ; Transcranial magnetic stimulation ; Attention deficit hyperactivity disorder ; Tourette Syndrome ; Atomoxetine
• 刊名：Clinical Neurophysiology
• 出版年：2007
• 期刊代码：61_13882457
• 类别：med
• 出版时间：August 2007
• 卷：118
• 期：8
• 页码：1835-1841
• 文件大小：155 K

摘要

In children with attention deficit hyperactivity disorder (ADHD), clinical responses to the selective norepinephrine reuptake inhibitor atomoxetine (ATX) vary. We sought to determine in children with Tourette Syndrome (TS) whether clinical responses correlate with changes in short interval cortical inhibition (SICI).

Methods

Fourteen children, ages 8–16, with ADHD and TS were treated open-label with ATX for one month. ADHD rating scale scores and SICI, measured with paired-pulse transcranial magnetic stimulation (pTMS), were assessed blindly and independently at treatment onset and one month later.

Results

Eleven children, mean ADHD rating scale scores 31.8 (SD 8.2) at onset, completed the study. After one month, ADHDRS changes ranged from an increase of 4 points to a decrease (improvement) of 24 points (mean change −9.6, SD 9.1). The changes in ADHDRS scores correlated with reduction in SICI (r = .74, p = .010).

Conclusions

In children with TS, one month of atomoxetine treatment appears to induce correlated improvements in ADHD and, paradoxically, further reductions in cortical inhibition.

Significance

PTMS-evoked SICI in ADHD with TS may be a biomarker of both deficiency and compensatory changes within cortical interneuronal systems. Effective atomoxetine treatment may augment compensatory processes and thereby reduce SICI.