ADHD: Prolonged MPH Treatment Restores Normal Response to Rewards

Attention-deficit/hyperactivity disorder (ADHD) is characterized by abnormal behavioral traits such as inattention, impulsivity and hyperactivity.

It is also associated with impaired processing of reward in the brain, meaning that patients need much greater rewards to become motivated.

One of the common treatments for ADHD, methylphenidate (MPH), is known to improve reward processing in the short term, but the long-term effects have remained unclear.

Kei Mizuno from the RIKEN Center for Life Science Technologies, in collaboration with colleagues from several other Japanese research institutions, has now demonstrated that prolonged treatment with MPH brings about stable changes in brain activity that improve reward processing with a commensurate improvement in ADHD symptoms.

ADHD is thought to affect up to 5% of children worldwide, and about half of those will go on to experience symptoms of the disorder into adulthood.

MPH treats the disorder by increasing the levels of the brain chemical dopamine, which is involved in reward processing.

To understand the effect of MPH on ADHD symptoms and specifically reward processing over the longer term, the researchers studied the reward response behavior of ADHD and healthy patients—all children or adolescents—before and after treatment with osmotic release oral system (OROS) MPH.

They used functional magnetic resonance imaging (fMRI) to measure brain activity during a task that saw participants rewarded with payment, but in two different scenarios: a high and a low monetary reward condition.

"In the high monetary reward condition, participants earned higher than the expected reward; whereas in the low monetary condition, participants earned an average reward that was consistently lower than expected," says Mizuno.

The brain images showed that before treatment with OROS-MPH, ADHD patients had lower than normal sensitivity to reward, as demonstrated by their abnormally low brain activity in two parts of the brain associated with reward processing—the nucleus accumbens and the thalamus—during testing under the low monetary reward scenario.

However, after three months of treatment with OROS-MPH, there was no difference in the activity of these brain areas in ADHD patients compared with the healthy controls under any of the reward conditions.

Their sensitivity to reward had returned to normal, and the patients' other ADHD symptoms also showed improvement.

Mizuno says that this study goes further than previous work. "We knew that acute MPH treatment improves reward processing in ADHD," he explains.

"Now we've revealed that decreased reward sensitivity and ADHD symptoms are improved by treatment for three months."

More information: Mizuno, K., et al. Osmotic release oral system-methylphenidate improves neural activity during low reward processing in children and adolescents with attention-deficit/hyperactivity disorder. NeuroImage: Clinical 2, 366–376 (2013). dx.doi.org/10.1016/j.nicl.2013.03.004

The Holy Grail: A Cure for Dyslexia | Dyslexic Brian

The Cure for Dyslexia from Dyslexic Brian

I found this interesting article debating the possibility of a 'cure' for Dyslexia. This is a very emotive discussion point and one that has been extensively explored but I believe this article has greater impact because it is written by Antonio, who is Dyslexic and is therefore eminently qualified to provide us with added insight.

Antonio says;

"I often get asked if it is possible to cure dyslexia to which I generally reply “No”. I reply “No” not because a cure for dyslexia doesn’t exist […], but simply because such a question implies that ‘dyslexia’ stems from some form of ‘deficit’, ‘abnormality’, or some other form of ‘less than normal state of functioning’ that exists within the individual.

Put in another way, such a question implies that the existence of ‘dyslexia’ is not a ‘normal’ aspect of what it is to be ‘human’. Such a question assumes that a ‘norm’ exists; a ‘norm’ that the individual would be brought back to if they were ‘cured’ of their ‘dyslexia’.

So, by me answering “No” to the question, is in my opinion, the correct answer to give, even though [as implied], I believe there to be a ‘cure’ for dyslexia.

[…] what a paradox I have created! How can I, with one breath, say that there is no cure for dyslexia and yet with another, say that there is?

To answer this we need only step into the abstract realm of our dyslexic consciousness and whilst there, in this magical, mysterious space, partially step out (as best we can) from what we have grow to know as our ‘dyslexic self’.

In this ‘in between’ state of consciousness, if the balance is just right, we can simultaneously be and not be our ‘dyslexic self’. We become, so to speak, both dyslexic and non-dyslexic within the same moment of time.

It is here, that we can rise above the ‘reality’ in which we ‘exist’ and look down at ourselves with our new found ‘in between eyes’ and see, maybe for the first time, the ‘true’ person that we have become.

Whilst holding this state we might see how the ‘reality’, to which we were born, has imposed its ‘norms’ upon us, and how it has shaped our identities using false ‘hand me down’ beliefs, views and values.

On seeing this we can, if we choose, begin to recreate our existence as neither dyslexic [nor] non-dyslexic. And, in so doing we precipitate our own ‘cure’; we liberate our thoughts and begin to recreate a new ‘self’ that becomes free with our current, actual ‘reality’."

Antonio Farruggia-Bochnak