Evidence map›Paper›PMID 27453081›Full record

Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2016

Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder.

Sandra K Loo, Robert M Bilder, Alexander L Cho, Alexandra Sturm, Jennifer Cowen, Patricia Walshaw, Jennifer Levitt, Melissa Del'Homme, John Piacentini, James J McGough and 1 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00429273 (An Eight-Week, Randomized, Double-Blind Comparison of Guanfacine, Focalin XR, and the Combination, With a Twelve Month Open-Label Extension for the Treatment of ADHD in Pediatric Subjects Aged 7 to 14 Years), which is not on this map. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00429273 phase4completednot on this map

An Eight-Week, Randomized, Double-Blind Comparison of Guanfacine, Focalin XR, and the Combination, With a Twelve Month Open-Label Extension for the Treatment of ADHD in Pediatric Subjects Aged 7 to 14 Years

TypeinterventionalSponsorUniversity of California, Los AngelesRan2007 to 2011Enrolled212ConditionsAttention Deficit Disorder With HyperactivityArmsGuanfacine, Methylphenidate (MPH)
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.

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  19. Stuttering: A Disorder of Energy Supply to Neurons?Frontiers in human neuroscience · 2021
    Article
  20. Alpha modulation during working memory encoding predicts neurocognitive impairment in ADHD.Journal of child psychology and psychiatry, and allied disciplines · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Sandra K LooUniversity of California, Los Angeles Semel Institute, Los Angeles. Electronic address: sloo@mednet.ucla.edu.
Robert M BilderUniversity of California, Los Angeles Semel Institute, Los Angeles.
Alexander L ChoUniversity of California, Los Angeles Semel Institute, Los Angeles.
Alexandra SturmUniversity of California, Los Angeles Semel Institute, Los Angeles.
Jennifer CowenUniversity of California, Los Angeles Semel Institute, Los Angeles.
Patricia WalshawUniversity of California, Los Angeles Semel Institute, Los Angeles.
Jennifer LevittUniversity of California, Los Angeles Semel Institute, Los Angeles.
Melissa Del'HommeUniversity of California, Los Angeles Semel Institute, Los Angeles.
John PiacentiniUniversity of California, Los Angeles Semel Institute, Los Angeles.
James J McGoughUniversity of California, Los Angeles Semel Institute, Los Angeles.
James T McCrackenUniversity of California, Los Angeles Semel Institute, Los Angeles.
University of California, Los Angeles · US

Funding

Translational Research to Enhance Cognitive ControlP50MH077248 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MCCRACKEN, JAMES T. · 2006 to 2011
$9.2M
Brain Source Analysis of Existing EEG Data in Childhood ADHDR03MH092829 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LOO, SANDRA K · 2011 to 2012
$168k
NIMH NIH HHS P50 MH077248NIMH NIH HHS R03 MH092829
6 · The paper itself

Abstract

objectivePsychostimulant medications are the gold standard of treatment for attention-deficit/hyperactivity disorder (ADHD); however, a significant minority (∼30%) of individuals with ADHD fail to respond favorably. Noradrenergic agents are increasingly used as ADHD monotherapies or adjuncts for suboptimal stimulant response, yet knowledge of their cortical effects is limited. This study is the first to examine comparative effects of guanfacine (an α adrenergic 2A agonist), psychostimulant, and their combination on resting state cortical activity in ADHD.

methodThe sample comprised 179 participants aged 7 to 14 years old with ADHD (113 boys, 55 girls). Participants were randomized to 1 of 3 blinded conditions: guanfacine (GUAN), d-methylphenidate (DMPH), or the combination (COMB). Electroencephalography (EEG) was performed pre-, mid-, and post-medication titration, with concomitant assessment of behavioral and cognitive functioning.

resultsAnalyses of spectral power measures during resting EEG suggested that each medication condition displayed a distinct profile of effects on cortical activity. Significant time effects suggested that GUAN decreased global alpha band (8-12 hertz [Hz]) power, DMPH and COMB increased centro-parietal beta band (13-21 Hz) power, and COMB resulted in decreased theta band (4-7 Hz) power. Relative to other medication groups, COMB was associated with significantly lower theta band power and DMPH with higher beta band power compared with those in the GUAN group. Medication-related changes in theta power were correlated with improvements in behavioral and cognitive functioning.

conclusionThese data reveal distinct underlying medication-related effects on neural mechanisms. The COMB condition uniquely exhibited an EEG profile that was associated with improved behavioral and cognitive functioning. Clinical trial registration information-Single Versus Combination Medication Treatment for Children With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00429273.

Indexed as

AdolescentAdrenergic alpha-2 Receptor AgonistsAttention Deficit Disorder with HyperactivityBrain WavesCentral Nervous System StimulantsChildDouble-Blind MethodDrug Therapy, CombinationElectroencephalographyFemaleGuanfacineHumansMaleMethylphenidateAdrenergic alpha-2 Receptor AgonistsCentral Nervous System StimulantsGuanfacineMethylphenidatechildrenelectroencephalographymedicationstimulantstreatment

Identifiers

PMID27453081
PMCPMC5003618
OpenAlexW2407531858

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.