We investigated whether adult attention-deficit/hyperactivity disorder (ADHD) predicts risky substance use and substance use disorders (SUDs), and its impact on the course of these problematic substance use patterns. Our sample included 4975 Swiss men (mean age 20 ± 1.2 years) who participated in the baseline and 15-month follow-up assessments of the Cohort Study on Substance Use Risk Factors. We examined: (1) the contribution of ADHD, as assessed at baseline, on the risky use of alcohol, nicotine and cannabis, and their corresponding use disorders (AUD, NUD, CUD) at follow-up; and (2) the association between ADHD and the course of outcomes (i.e., absence, initiation, maturing out, persistence) over 15 months. All analyses were adjusted for socio-demographics and co-morbidity. Men with ADHD were more likely to exhibit persistent risky alcohol and nicotine use, and to mature out of risky cannabis use. ADHD at baseline was positively linked to AUD and negatively to CUD at follow-up, but not to NUD. For all SUDs, ADHD had a positive association with use persistence and maturing out. Comparing these two trajectories revealed that early age of alcohol use initiation distinguished between persistence and maturing out of AUD, while the course of NUD and CUD was related to ADHD symptoms and SUD severity at baseline. Already in their early twenties, men with ADHD are especially likely to exhibit persistent problematic substance use patterns. Substance-specific prevention strategies, particularly implemented before early adulthood, may be crucial to reducing the development and persistence of pathological patterns in such individuals.

While the neurobiological basis and developmental course of attention-deficit/hyperactivity disorder (ADHD) have not yet been fully established, an imbalance between inhibitory/excitatory neurotransmitters is thought to have an important role in the pathophysiology of ADHD. This study examined the changes in cerebral levels of GABA+, glutamate and glutamine in children and adults with ADHD using edited magnetic resonance spectroscopy. We studied 89 participants (16 children with ADHD, 19 control children, 16 adults with ADHD and 38 control adults) in a subcortical voxel (children and adults) and a frontal voxel (adults only). ADHD adults showed increased GABA+ levels relative to controls ( P =0.048), while ADHD children showed no difference in GABA+ in the subcortical voxel ( P >0.1), resulting in a significant age by disorder interaction ( P =0.026). Co-varying for age in an analysis of covariance model resulted in a nonsignificant age by disorder interaction ( P =0.06). Glutamine levels were increased in children with ADHD ( P =0.041), but there was no significant difference in adults ( P >0.1). Glutamate showed no difference between controls and ADHD patients but demonstrated a strong effect of age across both groups ( P <0.001). In conclusion, patients with ADHD show altered levels of GABA+ in a subcortical voxel which change with development. Further, we found increased glutamine levels in children with ADHD, but this difference normalized in adults. These observed imbalances in neurotransmitter levels are associated with ADHD symptomatology and lend new insight in the developmental trajectory and pathophysiology of ADHD.

THE IMPACT OF PHYSIOLOGICAL ARTIFACT CORRECTION ON TASK FMRI GROUP COMPARISON Steffen Bollmann, Lars Kasper, Carmen Ghisleni, Simon-Shlomo Poil, Peter Klaver, Lars Michels, Dominique Eich-Höchli, Daniel Brandeis, and Ruth L. O'Gorman Center for MR-Research, University Children's Hospital, Zurich, Zurich, Switzerland, Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland, Institute of Psychology, University of Zurich, Zürich, Switzerland, Institute of Neuroradiology, University Hospital of Zurich, Zürich, Switzerland, Psychiatric University Hospital, Zürich, Switzerland, Department of Child & Adolescent Psychiatry, University of Zurich, Zürich, Switzerland, Central Institute of Mental Health Mannheim / Heidelberg University, Germany