Effects of a single low dose of methylphenidate on saccadic eye movements in adults with attention-deficit/hyperactivity disorder (ADHD)

First‐Dose Methylphenidate‐Induced Changes in the Anti‐Saccade Task Performance and Outcome in Adults with Attention‐Deficit/Hyperactivity Disorder

“…The main findings of our pilot study are as follows: (1) never-medicated adults with ADHD make more direction errors and have longer SRTs in the AST than HCs; (2) MPH administration, either acute or chronic, normalizes the AST performances; and (3) a low percentage of direction errors after the first MPH-dose (≤10%) is associated with subsequent remission. Our results of increased direction error rates, at baseline, are consistent with all previous AST published studies in unmedicated ADHD adults (5)(6)(7)(8)(9). Moreover, delayed SRTs and normal rates of express saccades have also been previously described (5,(7)(8)(9), although it has been sometimes reported normal SRTs (6) or increased anticipatory saccades (7,9).…”

“…However, the aim of our study was not to demonstrate the effectiveness of MPH in ADHD but to evaluate the oculomotor correlates of clinical response. As previously discussed (9), it seems unlikely that improvement in the AST performances with MPH may be attributed to a placebo effect or a learning effect. Second, we did not evaluate the effects of MPH on the AST performances in HCs.…”

“…At the end of the 6‐month treatment period, the final sample consisted of 97 ADHDs (12 patients did not perform the final oculomotor assessment, six took newly prescribed psychotropic treatments, five took MPH treatment irregularly); among them, 81 had a combined presentation, and 16 had inattentive presentation; 76 had, at baseline, moderate functional impairment, and the remaining 21 had marked impairment in social or occupational functioning. One may also mention that 14 patients from the final sample (i.e., 14.4%) participated in our previous study ( 9 ). The AST measures in ADHDs were compared with those of 50 healthy adult control subjects (HCs).…”

“…Given the dysregulation of prefrontal cortical/striatal and cerebellar circuits in subjects with attention‐deficit/hyperactivity disorder (ADHD) (4), the AST may be used to reveal impairments in inhibitory control and executive function in such patients. Even though there are relatively few studies, it has been found in unmedicated adults with ADHD longer saccadic reaction times and more direction errors in the AST compared to healthy volunteers (5–9).…”

“…Consistent with this mechanism of action, the AST performances are enhanced following acute and/or chronic MPH administration in children and in adolescents ( 13 , 14 ). However, in adults, such studies are lacking, although our group recently reported that a single low dose of MPH (10 mg orally) administered in drug‐naive patients normalized the AST reaction times and direction errors ( 9 ).…”