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Advances in the Neurobiology of ADHD

Published online by Cambridge University Press:  07 November 2014

Joseph Biederman
Joseph Biederman*
Affiliation:
Dr. Biederman is professor of psychiatry in the Department of Psychiatry at Massachusetts General Hospital and, Harvard Medical School in Boston
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Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a lifelong condition that begins in childhood and continues with adult manifestations related to the core symptoms. Approximately 50% to 75% of children with ADHD continue to meet criteria for the disorder as adolescents and adults. Adults with the disorder increasingly present to primary care physicians, psychiatrists, and other practitioners for diagnosis and treatment. Understanding the diagnosis of ADHD in adults requires knowledge of age-dependent decline of symptoms over time. Retrospective recall of symptoms and impairment are valid methods of diagnosing the disorder. ADHD is also a brain disorder with a strong neurobiologic basis, complex etiology, and genetic component. Genetic and environmental vulnerabilities give rise to abnormalities in the brain and subsequent behavioral and cognitive deficits, which may produce the symptoms associated with ADHD. Magnetic resonance imaging studies of ADHD have provided evidence that abnormalities in the brain are caused by the disorder itself rather than treatment of the disorder. Psychiatric comorbidity is common among patients with ADHD and tends to complicate treatment. Acute and long-term use of long-acting stimulant formulations (methylphenidate and amphetamine compounds) have shown robust efficacy and tolerability consistent with the treatment response established in children with ADHD. Non-stimulant medications have demonstrated efficacy as well, and may be preferred in patients with tic and substance use disorders.

In this expert roundtable supplement, Timothy E. Wilens, MD, reviews the epidemiology and clinical presentation of adult ADHD. Next, Joseph Biederman, MD, provides an overview of recent advances in the neurobiology of ADHD. Thomas J. Spencer, MD, reviews stimulant treatment of adult ADHD, and Lenard A. Adler concludes with a discussion of non-stimulant trials in adult ADHD.

Type
Research Article
Information
CNS Spectrums , Volume 12 , Issue S6 , 2007 , pp. 6 - 7
Copyright
Copyright © Cambridge University Press 2007

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References

1.Posner, MJ, Raichle, ME. Images of Mind. Scientific American Books; 1996.Google Scholar
2.Huang-Pollock, CL, Nigg, JT, Halperin, JM. Single dissociation findings of ADHD deficits in vigilance but not anterior or posterior attention systems. Neuropsychology. 2006;20(4):420–429.CrossRefGoogle ScholarPubMed
3.Frazier, TW, Demaree, HA, Youngstrom, EA. A meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology. 2004;18;543–555.CrossRefGoogle ScholarPubMed
4.Castellanos, FX, Lee, PP, Sharp, W, et al.Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA. 2002;288(14):1740–1748.CrossRefGoogle ScholarPubMed
5.Seidman, LJ, Valera, EM, Makris, N, et al.Dorsolateral prefrontal and anterior cingulate cortex volumetric abnormalities in adults with attention-deficit/hyperactivity disorder identified by magnetic resonance imaging. Biol Psychiatry. 2006;60(10):1071–1080.CrossRefGoogle ScholarPubMed
6.Bush, G, Frazier, JA, Rauch, SL. Anterior cingulate cortex dysfunction in attention-deficit/hyperactivity disorder revealed by fMRI and the Counting Stroop. Biol Psychiatry. 1999;45(12):1542–1552.CrossRefGoogle ScholarPubMed
7.Bush, G, Valera, EM, Seidman, LJ. Functional neuroimaging of attention-deficit/hyperactivity disorder: a review and suggested future directions. Biol Psychiatry. 2005;57(11):1273–1284.CrossRefGoogle ScholarPubMed
8.Seidman, LJ, Valera, EM, Makris, N. Structural brain imaging of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1263–1272.CrossRefGoogle ScholarPubMed
9.Valera, EM, Faraone, SV, Murray, KE, Seidman, LJ. Meta-analysis of structural imaging findings in attention-deficit/hyperactivity disorder. Biol Psychiatry. 2006 Aug 31; [Epub ahead of print].Google Scholar
10.Faraone, SV. Genetics of adult attention deficit hyperactivity disorder. Psychiatr Clin North Am. 2004;27(2):303–321.CrossRefGoogle ScholarPubMed
11.Faraone, SV, Doyle, AE. The nature and heritability of attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin North Am. 2001;10: 299–316.CrossRefGoogle ScholarPubMed
12.Faraone, SV, Perlis, RH, Doyle, AE, et al.Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57:1313–1323.CrossRefGoogle ScholarPubMed
13.Spencer, TJ, Biederman, J, Ciccone, PE, et al.PET study examining pharmacokinetics, detection and likeability, and dopamine transporter receptor occupancy of short- and long-acting oral methylphenidate. Am J Psychiatry. 2006;163(3):387–395.CrossRefGoogle Scholar
14.Swanson, J, Castellanos, FX. National Institutes of Health Consensus Development Conference; 1998.Google Scholar
15.Volkow, ND, Wang, GJ, Fowler, JS, et al.Gender differences in cerebellar metabolism: test-retest reproducibility. Am J Psychiatry. 1997;154(1):119–121.Google ScholarPubMed