Stimulants and the developing brain

Schweren, L. J. S., 2016, [Groningen]: University of Groningen. 243 p.

Research output: ThesisThesis fully internal (DIV)

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  • Title and contents

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  • Chapter 1

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  • Chapter 2

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  • Chapter 3

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  • Chapter 4

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  • Chapter 5

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  • Chapter 6

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  • Chapter 7

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  • Chapter 8

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  • Chapter 9

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  • Chapter 10

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  • References

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  • Nederlandse samenvatting

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  • Acknowledgements

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  • Curriculum vitae

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  • Complete thesis

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  • Propositions

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The past decennia have seen an increase in the use of stimulants for the treatment of ADHD. This increase frequently leads to a heated public debate and worry among parents and clinicians. Debates are intensified by the media reporting on similarities between stimulants for the treatment of ADHD and hard drugs such as cocaine and ecstasy. People ask themselves: do we want to expose our children to stimulants if we don’t know their long-term effects on brain development? In this thesis I present my research on the long-term effects of ADHD medication on the developing brain.
In most of our studies we find no association between stimulant treatment and brain development. For example, we find no effect of stimulant treatment on cortical thickness (a measure we know is often somewhat thinner in children/adolescents with ADHD), on frontal cortex volume (that is typically somewhat smaller in children/adolescents with ADHD), or on activation in the striatum during reward (that is typically somewhat increased in children/adolescents with ADHD). Also, in terms of ADHD symptoms and cognitive functioning, we find no long-term effect of treatment.
In some studies, however, we do find subtle brain changes after stimulant treatment. The frontal cortex, for example, is smaller in adolescents with ADHD, but not in those who carry the DRD4 7R allel and have been treated at young age. We also find that adolescents who have a history of intense treatment, when rewarded, activate a brain region that is important for cognitive control; adolescents with a history of little or no treatment do not activate this area. We think that this additional activation may be positive for these intensely treated adolescents, and may contribute to the lower risk of developing substance use problems in this group.
In sum: we often find no effect of stimulant treatment on the developing brain. The effects we do find are subtle, sometimes specific to certain subgroups of children/adolescents with ADHD, and appear to be beneficial rather than detrimental.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Hoekstra, Pieter, Supervisor
  • Buitelaar, Jan, Supervisor, External person
  • Hartman, Catharina, Co-supervisor
  • Aleman, Andre, Assessment committee
  • Rubia, Katya, Co-supervisor, External person
  • Cools, Roshan, Assessment committee, External person
Award date14-Dec-2016
Place of Publication[Groningen]
Print ISBNs978-­90-­367-­9055-­0
Electronic ISBNs978‐90-­367-­9054-­3
Publication statusPublished - 2016

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