Avaliação do impacto do uso de Metilfenidato no Desenvolvimento Neuronal de crianças com Transtorno de Déficit de Atenção e Hiperatividade

Abstract

Introduction: The newborn’s brain is immature and needs stimulation for its development. This development is assessed through milestones that accompany each phase/age group. However, some children due to genetic, social and environmental factors end up developing neurodevelopmental disorders. One of the main ones is Attention Deficit Hyperactivity Disorder (ADHD), which suggests that it is caused by a dysregulation of the dopaminergic system in the central nervous system. And, therefore, its main treatment is the use of Methylphenidate, a stimulant medication that acts on the synaptic cleft, preventing the reuptake, mainly of dopamine. Objectives: Understanding how the use of Methylphenidate affects the neuronal development of children with ADHD. Methods: This study will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. An unrestricted language search will be performed in the PubMed, Scopus, and Cochrane Library databases for randomized clinical trials that investigated the impact of the use of Methylphenidate on the neuronal development of children with ADHD. Results: We included 8 studies that met the inclusion criteria of this systematic review. All the articles included had the methodology of the double-blind randomized clinical trial and the participants were children with ADHD and children with typical development, in which some children were offered short release methylphenidate and others placebo and later evaluated the effects that methylphenidate brings or does not bring to the brains of these children. Most studies indicated that methylphenidate modulated spontaneous neural activities in the nucleus accumbens, salience network, default mode network, and frontoparietal network in children with ADHD. Discussion: Methylphenidate, often used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), generates significant changes in neural functioning, especially in the developing brain. Its main function is to regulate the levels of the neurotransmitters dopamine and noradrenaline, intensifying activity in the brain regions responsible for attention, impulse control, and executive functions. Conclusion: Thus, as we can report, methylphenidate is related to neuronal transformations in the brain of a child with ADHD, regulating neural areas and leaving it close to the brain of a child with typical development. However, more studies are still needed to evaluate long-term use in children with this disorder, without gender restriction, with the aim of expanding scientific knowledge on the subject.