Effects of methylphenidate on olfaction and frontal and temporal brain oxygenation in children with ADHD

ObjectiveOlfaction and attention-deficit-/hyperactivity disorder (ADHD) are mediated by dopamine metabolism and fronto-temporal functioning converging in recent findings of increased olfactory sensitivity in children with ADHD modulated by methylphenidate (MPH) and altered frontal and temporal oxygenation in adults with ADHD.MethodWe investigated olfactory sensitivity, discrimination, and identification (Sniffin’ Sticks) in 27 children and adolescents with ADHD under chronic MPH medication and after a wash-out period of at least 14 half-lives in balanced order and 22 controls comparable for handedness, age, and intelligence. In addition, inferior frontal and temporal oxygenation was measured by means of functional near-infrared spectroscopy (fNIRS) during the presentation of 2-phenylethanol. Group differences in regard to sex distribution were statistically controlled for by analysis of covariance.ResultsPatients did not differ from controls in any olfactory domain under treatment with MPH. Cessation of medication led to a significant increase in olfactory discrimination. Controls displayed typical inferior frontal and temporal brain activity in response to passive olfactory stimulation, while brain oxygenation was diminished in the patient group when assessed without medication. Under medication ADHD patients showed a trend for a normalisation of brain activity in the temporal cortex.ConclusionsThe here reported effects of MPH cessation on olfactory discrimination and frontal and temporal oxygenation along with previous findings of increased olfactory sensitivity in medication-naïve ADHD children and its normalisation under chronic MPH treatment lead to the conclusion that MPH exerts differential chronic effects vs. acute cessation effects on altered olfactory function in ADHD. These effects are most probably mediated by modulation of the dopaminergic system.

► Prior olfactory findings: increased sensitivity and decreased oxygenation in ADHD.
► Children with ADHD showed diminished frontal and temporal oxygenation.
► Cessation of MPH led to increased sensitivity associated with oxygenation changes.
► Olfaction in ADHD has particular chronic and cessation effects.