ADHD, Smoking Withdrawal, and Inhibitory Control: Results of a Neuroimaging Study with Methylphenidate Challenge

Neuropsychopharmacology. 2018 Mar;43(4):851-858. doi: 10.1038/npp.2017.248. Epub 2017 Oct 20.

Abstract

Smoking withdrawal negatively impacts inhibitory control, and these effects are greater for smokers with preexisting attention problems, such as attention deficit/hyperactivity disorder (ADHD). The current study preliminarily evaluated changes in inhibitory control-related behavior and brain activation during smoking withdrawal among smokers with ADHD. Moreover, we investigated the role of catecholamine transmission in these changes by examining the effects of 40 mg methylphenidate (MPH) administration. Adult daily smokers with (n=17) and without (n=20) ADHD completed fMRI scanning under each of three conditions: (a) smoking as usual+placebo; (b) 24 h smoking abstinence+placebo and (c) 24 h smoking abstinence+MPH. Scan order was randomized and counterbalanced. Participants completed a modified Go/No-Go task to assess both sustained and transient inhibitory control. Voxelwise analysis of task-related BOLD signal revealed a significant group-by-abstinence interaction in occipital/parietal cortex during sustained inhibition, with greater abstinence-induced decreases in activation observed among ADHD smokers compared with non-ADHD smokers. Changes in behavioral performance during abstinence were associated with changes in activation in regions of occipital and parietal cortex and bilateral insula during sustained inhibition in both groups. MPH administration improved behavioral performance and increased sustained inhibitory control-related activation for both groups. During transient inhibition, MPH increased prefrontal activation for both groups and increased striatal activation only among ADHD smokers. These preliminary findings suggest that abstinence-induced changes in catecholamine transmission in visual attention areas (eg, occipital and superior parietal cortex) may be associated with inhibitory control deficits and contribute to smoking vulnerability among individuals with ADHD.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / diagnostic imaging*
  • Attention Deficit Disorder with Hyperactivity / drug therapy
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Central Nervous System Stimulants / administration & dosage*
  • Female
  • Humans
  • Inhibition, Psychological*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Methylphenidate / administration & dosage*
  • Neuroimaging / methods
  • Photic Stimulation / methods
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology
  • Smoking / drug therapy
  • Smoking / psychology
  • Smoking Cessation / methods
  • Smoking Cessation / psychology
  • Substance Withdrawal Syndrome / diagnostic imaging*
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / psychology
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate