Yonsei Med J.  2009 Oct;50(5):650-655. 10.3349/ymj.2009.50.5.650.

Variability of Response Time as a Predictor of Methylphenidate Treatment Response in Korean Children with Attention Deficit Hyperactivity Disorder

• Lee SH
• Song DH
• Kim BN
• Joung YS
• Ha EH
• Cheon KA
• Shin YJ
• Yoo HJ
• Shin DW

• KMID: 1103818
• DOI: http://doi.org/10.3349/ymj.2009.50.5.650

Abstract

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.

Keyword

ADHD; methylphenidate; response time variability

MeSH Terms

Adolescent
Attention Deficit Disorder with Hyperactivity/*drug therapy
Child
Female
Humans
Korea
Male
Methylphenidate/*therapeutic use
*Reaction Time
Treatment Outcome

Figure

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  Fig. 1 ADHD diagnostic system scores of the responders. Baseline and week 12 scores were compared by paired T-test analyses. ADHD, attention deficit hyperactivity disorder. *p < 0.05, †p < 0.01.

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  Fig. 2 ADHD diagnostic system scores of the non-responders. Comparison of baseline and week 12 scores were made by paired T-test analyses. ADHD, attention deficit hyperactivity disorder. *p < 0.05.

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