Materiały źródłowe

• #1 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. […] Current estimates indicate that approximately 3 to 4 percent of adults meet the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV), diagnostic criteria for ADHD, whereas approximately 16 percent of adults meet some of these criteria, but not enough for diagnosis. […] The clinical diagnosis of ADHD in adults should take a stepwise approach, including evaluating current (in the past six months) ADHD symptoms using rating scales with adult norms. […] The mainstay of ADHD treatment is pharmacotherapy. Most studies focus on medications in children, yet these medications have been shown to be safe and effective in adults as well.

• #2 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  ADHD has an estimated childhood prevalence of 4% to 7% with increasing evidence pointing to its continuation into adulthood for between 15% and 65% of individuals. […] The general population prevalence of ADHD in adults has been estimated to be 2.5%. […] ADHD is associated with educational difficulties, requiring extra help, attending special classes, repeating grades, as well as higher rates of academic suspension and drop outs. […] The detrimental effects of ADHD on overall health and safety provide additional imperative to appropriately recognize and manage this debilitating disorder. […] Adult ADHD has been associated with poorer driving and a higher incidence of traffic citations and motor vehicle accidents. […] The co-occurrence of ADHD and SUD can result in a more severe course of both substance use and psychiatric symptoms and outcomes.

• #3 Pathophysiology and Factors Affecting Attention-Deficit/Hyperacti

  https://www.longdom.org/open-access/pathophysiology-and-factors-affecting-attentiondeficithyperactivity-disorder-94576.html

  One of the most well-known neurobehavioral disorders for children being treated is Attention-Deficit/Hyperactivity Disorder (ADHD). […] In adults, an equal proportion of people with ADHD are presenting for diagnosis and treatment as compared to an uneven pace of young men and young women in adolescents being diagnosed with ADHD. […] Because of corresponding weaknesses in chief mental functioning, ADHD has been regarded as a problem effecting „front facing” hardware. Diffuse abnormalities have been documented in both children and adults with ADHD in the underlying imaging studies. […] The Anterior Cingulate Cortex (ACC) and dorsolateral prefrontal cortex of adults with and without ADHD were also shown to be smaller in a primary attractive reverberation imaging study. […] These discrepancies are recalled to represent deficiencies in ADHD-related objective coordinated and on-task behavior. […] A neurological and genetic cause for ADHD with catecholaminergic dysfunction as a key finding is supported by the combined data.

• #4 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  Their reduced size, functional connectivity, and activation contribute to the pathophysiology of ADHD, as well as imbalances in the noradrenergic and dopaminergic systems that mediate these brain regions. […] ADHD has a high heritability of 74%, meaning that 74% of the presence of ADHD in the population is due to genetic factors. […] ADHD presents with reduced size, functional connectivity and activation as well as low noradrenergic and dopaminergic functioning in brain regions and networks crucial for executive functioning and self-regulation. […] Current models of ADHD suggest that it is associated with functional impairments in some of the brain’s neurotransmitter systems, particularly those involving dopamine and norepinephrine. […] The dopamine pathways and norepinephrine pathways which project to the prefrontal cortex and striatum are directly responsible for modulating executive function (cognitive control of behaviour), motivation, reward perception, and motor function; these pathways are known to play a central role in the pathophysiology of ADHD.

• #5 Managing Adult ADHD: Diagnosis, Strategies & Treatment | Psych Scene Hub

  https://psychscenehub.com/psychinsights/diagnosis-and-management-of-adult-adhd/

  Clinicians should increase their awareness of adult ADHD given that currently less than one in five adult patients are diagnosed and treated. […] ADHD can impair psychosocial functioning and impair quality of life significantly. […] Patients with ADHD or a history of childhood ADHD have higher mortality rates than those without ADHD. […] The increased risk of mortality is multifactorial in origin. […] ADHD tends to have a high degree of heritability and twin studies show that ADHD has a heritability of 70% to 80% in both children and adults. […] Gene-Environment interactions may be the main mechanism by which environmental risk factors increase the risk of ADHD. […] 40% of the heritability of ADHD can be attributed to common genetic variants. […] Methylphenidate (MPH) non-competitively blocks the reuptake of dopamine and noradrenaline into the terminal by blocking dopamine transporter (DAT) and noradrenaline transporter (NAT), increasing levels of dopamine and noradrenaline in the synaptic cleft.

• #6

  https://link.springer.com/article/10.1007/s44192-022-00030-1

  Despite evidence demonstrating high polygenicity in ADHD, it is possible that many variants at different loci may converge on common mechanisms. A putative pathophysiological mechanism that has been long implicated in ADHD involves the dysregulation of monoaminergic neurotransmission systems, mainly dopaminergic and noradrenergic. […] Pathophysiological insights can also be inferred from neuroimaging studies, which has reported differences in structural and functional brain architecture between patients with ADHD and neurotypical individuals, especially in children. […] ADHD is substantially influenced by genetics with a polygenic architecture, there is extensive biological and phenotypic overlap between ADHD and other psychiatric traits, and the correlations observed in clinical and epidemiological studies have been confirmed by studies of genetic correlations.

• #7 Managing Adult ADHD: Diagnosis, Strategies & Treatment | Psych Scene Hub

  https://psychscenehub.com/psychinsights/diagnosis-and-management-of-adult-adhd/

  Clinicians should increase their awareness of adult ADHD given that currently less than one in five adult patients are diagnosed and treated. […] ADHD can impair psychosocial functioning and impair quality of life significantly. […] Patients with ADHD or a history of childhood ADHD have higher mortality rates than those without ADHD. […] The increased risk of mortality is multifactorial in origin. […] ADHD tends to have a high degree of heritability and twin studies show that ADHD has a heritability of 70% to 80% in both children and adults. […] Gene-Environment interactions may be the main mechanism by which environmental risk factors increase the risk of ADHD. […] 40% of the heritability of ADHD can be attributed to common genetic variants. […] Methylphenidate (MPH) non-competitively blocks the reuptake of dopamine and noradrenaline into the terminal by blocking dopamine transporter (DAT) and noradrenaline transporter (NAT), increasing levels of dopamine and noradrenaline in the synaptic cleft.

• #8 Attention-Deficit/Hyperactivity Disorder (ADHD)

  https://my.clevelandclinic.org/health/diseases/4784-attention-deficithyperactivity-disorder-adhd

  ADHD is genetic. This means your child is born with certain gene changes that cause differences in their brain development (neurodivergence). Often, the gene changes that cause ADHD are passed down within biological families. Kids with ADHD commonly have biological parents or siblings with the condition. […] Researchers continue to look into how ADHD affects the brain. Heres what we know so far. With ADHD, the frontal lobe of your childs brain is wired in a way that makes it harder for them to use directed attention. Directed attention is the ability to focus on something you dont find very interesting. […] If your child has ADHD, it takes even more energy than usual to direct their attention to things they have to do. That means after a long day at school, your child might resist doing a task that otherwise seems simple like hanging up their coat or backpack. The attention it requires to do these basic chores is simply not available to them.

• #9

  https://link.springer.com/article/10.1007/s44192-022-00030-1

  Despite evidence demonstrating high polygenicity in ADHD, it is possible that many variants at different loci may converge on common mechanisms. A putative pathophysiological mechanism that has been long implicated in ADHD involves the dysregulation of monoaminergic neurotransmission systems, mainly dopaminergic and noradrenergic. […] Pathophysiological insights can also be inferred from neuroimaging studies, which has reported differences in structural and functional brain architecture between patients with ADHD and neurotypical individuals, especially in children. […] ADHD is substantially influenced by genetics with a polygenic architecture, there is extensive biological and phenotypic overlap between ADHD and other psychiatric traits, and the correlations observed in clinical and epidemiological studies have been confirmed by studies of genetic correlations.

• #10 Neurobiology of Attention Deficit/Hyperactivity Disorder | Pediatric Research

  https://www.nature.com/articles/pr9201196

  Attention deficit/hyperactivity disorder (ADHD), a prevalent neurodevelopmental disorder, has been associated with various structural and functional CNS abnormalities but findings about neurobiological mechanisms linking genes to brain phenotypes are just beginning to emerge. […] Despite the high heritability of the disorder and its main symptom dimensions, common individual genetic variants are likely to account for a small proportion of the phenotype’s variance. […] Recent findings have drawn attention to the involvement of rare genetic variants in the pathophysiology of ADHD, some being shared with other neurodevelopmental disorders. […] However, there is still a lack of insight into the mechanisms linking genotypes, neural processes, and cognitive/behavioral symptoms. […] Recent findings point out that other neurodevelopmental disorders like autism, schizophrenia, and epilepsy share genetic variants with ADHD.

• #11 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity | Canadian Paediatric Society

  https://cps.ca/documents/position/adhd-etiology-diagnosis-and-comorbidity

  ADHD is a disorder with multiple etiologies. Combinations of genetic, neurological, and environmental factors contribute to pathogenesis and its heterogeneous phenotype. […] Evidence from family, twin, and adoption studies has suggested strongly that ADHD is a highly hereditary, polygenic disorder. Gene variants predicting risk for ADHD are important for brain development, cell migration, and encoding for catecholamine receptor and transporter genes. […] Noninherited neurological factors affecting brain development or resulting in brain injury have been implicated in ADHD pathogenesis. The contribution of pregnancy and birth complications is mixed, but strong evidence supports greater ADHD risk following in utero exposure to alcohol or tobacco and low birth weight. […] Neuroimaging studies point to ADHD as a disorder of early brain development. Based on volumetric and functional MRI studies, differences are found in the structural development and functional activation in the prefrontal cortex, basal ganglia, anterior cingulate cortex, and cerebellum. Activity among these areas depends on catecholaminergic brain circuitry. […] A delay in cortical maturation has been documented, with peak cortical thickness attained in the cerebrum at 7 years in typically developing children and at 10 years in those with ADHD.

• #12 Pathophysiology and Factors Affecting Attention-Deficit/Hyperacti

  https://www.longdom.org/open-access/pathophysiology-and-factors-affecting-attentiondeficithyperactivity-disorder-94576.html

  One of the most well-known neurobehavioral disorders for children being treated is Attention-Deficit/Hyperactivity Disorder (ADHD). […] In adults, an equal proportion of people with ADHD are presenting for diagnosis and treatment as compared to an uneven pace of young men and young women in adolescents being diagnosed with ADHD. […] Because of corresponding weaknesses in chief mental functioning, ADHD has been regarded as a problem effecting „front facing” hardware. Diffuse abnormalities have been documented in both children and adults with ADHD in the underlying imaging studies. […] The Anterior Cingulate Cortex (ACC) and dorsolateral prefrontal cortex of adults with and without ADHD were also shown to be smaller in a primary attractive reverberation imaging study. […] These discrepancies are recalled to represent deficiencies in ADHD-related objective coordinated and on-task behavior. […] A neurological and genetic cause for ADHD with catecholaminergic dysfunction as a key finding is supported by the combined data.

• #13 Attention Deficit Hyperactivity Disorder (ADHD): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/289350-overview

  Although ADHD has been associated with structural and functional alterations in the frontostriatal circuitry, recent studies have further demonstrated changes just outside that region and more specifically in the cerebellum and the parietal lobes. […] Another study using proton magnetic spectroscopy demonstrated right prefrontal neurochemical changes in adolescents with ADHD. […] Work by Sobel et al has demonstrated deformations in the basal ganglia nuclei (caudate, putamen, globus pallidus) in children with ADHD. The more prominent the deformations, the greater the severity of symptoms. Furthermore, Sobel et al have shown that stimulants may normalize the deformations. […] Adults with ADHD also have been reported to have deficits in anterior cingulate activation while performing similar tasks.

• #14 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  In children with ADHD, there is a general reduction of volume in certain brain structures, with a proportionally greater decrease in the volume in the left-sided prefrontal cortex. […] The subcortical volumes of the accumbens, amygdala, caudate, hippocampus, and putamen appears smaller in individuals with ADHD compared with controls. […] Structural MRI studies have also revealed differences in white matter, with marked differences in inter-hemispheric asymmetry between ADHD and typically developing youths. […] Functional MRI (fMRI) studies have revealed a number of differences between ADHD and control brains. […] ADHD arises from a core deficit in executive functions (e.g., attentional control, inhibitory control, and working memory), which are a set of cognitive processes that are required to successfully select and monitor behaviours that facilitate the attainment of one’s chosen goals.

• #15 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  There are strong familial links between ADHD and psychiatric comorbidities such as bipolar disorder, suggesting a genetic contribution. […] Recent studies have demonstrated that similar regions of the brain are involved in ADHD and psychiatric disorders. […] Neuroimaging studies have implicated differences in volume and activity in the frontal lobe, which is responsible for attention, behaviour selection, and emotion. […] Studies of neurotransmitters have also pointed to abnormalities in dopamine (DA) and norepinephrine (NE) signaling. […] Overlapping symptomology between ADHD and mood, anxiety, or SUDs present several barriers to diagnosis and treatment. […] It has been suggested that stress, depression, and anxiety could manifest as a consequence of undiagnosed and untreated ADHD.

• #16 Attention Deficit Hyperactivity Disorder (ADHD): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/289350-overview

  The pathology of ADHD is not clear. Psychostimulants (which facilitate dopamine release) and noradrenergic tricyclics used to treat this condition have led to speculation that certain brain areas related to attention are deficient in neural transmission. PET scan imaging indicates that methylphenidate acts to increase dopamine. The neurotransmitters dopamine and norepinephrine have been associated with ADHD. […] The underlying brain regions predominantly thought to be involved are frontal and prefrontal; the parietal lobe and cerebellum may also be involved. In one functional MRI study, children with ADHD who performed response-inhibition tasks were reported to have differing activation in frontostriatal areas compared with healthy controls. A 2010 study again indicated the presence of frontostriatal malfunctioning in the etiology of ADHD.

• #17 What are the causes of ADHD? Biology vs. environment

  https://www.medicalnewstoday.com/articles/causes-of-adhd

  The differences in brain volume were more noticeable in children with ADHD than in adults. This supports the researchers’ theory that ADHD causes a delay in the development and maturation of several brain regions. […] According to a 2018 review, functional MRI (fMRI) studies indicate that people with ADHD may have impairments in several brain networks that manage attention, cognitive control, timing, and working memory. […] Brain chemistry refers to the balance of chemicals that affect a person’s mood and nervous system. One such brain chemical is dopamine. It plays a vital role in feelings of pleasure, motivation, and reward. […] In a 2009 study, study participants with ADHD had lower dopamine levels than participants without ADHD. […] Some experts believe that lower dopamine levels may occur in people with ADHD because they have higher concentrations of proteins known as dopamine transporters, which reduce dopamine levels in the brain.

• #18

  https://link.springer.com/article/10.1007/s00406-024-01927-4

  Diffusion imaging studies in Attention-deficit/hyperactivity disorder (ADHD) have revealed alterations in anatomical brain connections, such as the fronto-parietal connection known as superior longitudinal fasciculus (SLF). […] The potential contribution of the lateralization of the SLF branches to adult ADHD pathophysiology remains to be elucidated. […] All the three SLF branches were lateralized in adults with ADHD, but not in controls. […] Thus, an altered asymmetry of the SLF, perhaps especially of the dorsal branch, may contribute to adult ADHD pathophysiology. […] Taken together, these prior findings suggest that the pattern of lateralization of the SLF branches may potentially contribute to adult ADHD pathophysiology. […] These results partly confirm prior findings in neurotypical adults, i.e. the right-lateralization of the SLF III volume

• #19

  https://link.springer.com/article/10.1007/s00406-024-01927-4

  Overall, these findings suggest that asymmetry of the SLF branches contributes to variation in neuropsychological profiles in adults with ADHD. […] These findings suggest that brain network asymmetry, including that of the SLF branches, may contribute to ADHD pathophysiology. […] The potential pathophysiological role of an asymmetry of attentive networks in ADHD is supported by the results of our correlation analyses. […] In conclusion, our and prior findings indicate that the pattern of lateralization of the SLF branches plays a role in neurocognitive performance in both ADHD and neurotypical adults; although we showed that altered asymmetry, perhaps especially of the dorsal branch (SLF I), contributes to ADHD pathophysiology.

• #20 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  Their reduced size, functional connectivity, and activation contribute to the pathophysiology of ADHD, as well as imbalances in the noradrenergic and dopaminergic systems that mediate these brain regions. […] ADHD has a high heritability of 74%, meaning that 74% of the presence of ADHD in the population is due to genetic factors. […] ADHD presents with reduced size, functional connectivity and activation as well as low noradrenergic and dopaminergic functioning in brain regions and networks crucial for executive functioning and self-regulation. […] Current models of ADHD suggest that it is associated with functional impairments in some of the brain’s neurotransmitter systems, particularly those involving dopamine and norepinephrine. […] The dopamine pathways and norepinephrine pathways which project to the prefrontal cortex and striatum are directly responsible for modulating executive function (cognitive control of behaviour), motivation, reward perception, and motor function; these pathways are known to play a central role in the pathophysiology of ADHD.

• #21 The ADHD Brain: Neuroscience Behind Attention Deficit DisorderFooterLogo

  https://www.additudemag.com/neuroscience-of-adhd-brain/?srsltid=AfmBOoqFdEMu1eXH0_DUWWXf5gbLpOlC94v8lmp_mMJT8YuQA-KSCbHM

  ADHD was the first disorder found to be the result of a deficiency of a specific neurotransmitter — in this case, norepinephrine. […] ADHD brains have low levels of a neurotransmitter called norepinephrine. Norepinephrine is linked arm-in-arm with dopamine. […] The ADHD brain has impaired activity in four functional regions of the brain. […] A deficiency here can cause inter-brain communication & information to “short-circuit.” That results in inattention or impulsivity. […] A deficiency here can cause inattention, impulsivity, or hyperactivity. […] ADHD is a complex neurological condition.

• #22 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  It’s not “all in your head.” It’s all in your brain—literally. […] An ADHD brain isn’t wired the same way as a non-ADHD one. Science suggests that specific differences in the brain’s structure, function, and chemistry may be one possible cause of ADHD. […] For instance, brain experts have found that various medical conditions are linked to lower levels of chemical messengers in the brain known as neurotransmitters. These disorders include anxiety, depression, Alzheimer’s, mood disorders, and ADHD. […] One of the most significant differences between an ADHD brain vs. a normal brain is the level of norepinephrine (a neurotransmitter). Norepinephrine is synthesized from dopamine. Since the two go hand-in-hand, experts believe that lower levels of dopamine and norepinephrine are both linked to ADHD.

• #23 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Noradrenaline plays an important role in the prefrontal cortex, and ADHD may disrupt its transmission in the brain. […] Meanwhile, dopamine helps us regulate our emotions and is linked to feelings of pleasure and reward. […] In ADHD, there might be lower levels of dopamine in the brain. This makes it harder to maintain motivation, especially when the rewards seem small or not immediate. ADHD brains tend to favor short-term, smaller rewards over long-term, more significant ones. […] Scientists have found unique differences in the structure, chemistry, and networks of the ADHD brain. These differences can explain many of the symptoms and challenges ADHDers experience.

• #24 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  It’s not “all in your head.” It’s all in your brain—literally. […] An ADHD brain isn’t wired the same way as a non-ADHD one. Science suggests that specific differences in the brain’s structure, function, and chemistry may be one possible cause of ADHD. […] For instance, brain experts have found that various medical conditions are linked to lower levels of chemical messengers in the brain known as neurotransmitters. These disorders include anxiety, depression, Alzheimer’s, mood disorders, and ADHD. […] One of the most significant differences between an ADHD brain vs. a normal brain is the level of norepinephrine (a neurotransmitter). Norepinephrine is synthesized from dopamine. Since the two go hand-in-hand, experts believe that lower levels of dopamine and norepinephrine are both linked to ADHD.

• #25 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Because of these differences, you may find it challenging to organize, plan, focus, and manage your emotions with ADHD. […] Research has found deficits in the neural networks linked to attention and executive function in children and adults with ADHD. This may affect your ability to organize, prioritize, plan, focus, remember instructions, and work toward your goals. […] In addition, ADHD may alter the network connections between your prefrontal cortex and other areas of the brain. Scientists believe this is associated with poor planning, distractibility, impulsivity, and forgetfulness in ADHD. […] Neurotransmitters are chemical messengers that transmit signals from nerve cells to other target cells in your body. […] As noted earlier, dopamine and norepinephrine are two neurotransmitters that might be associated with ADHD.

• #26 Molecular Mechanisms Underlying NMDARs Dysfunction and Their Role in ADHD Pathogenesis

  https://www.mdpi.com/1422-0067/24/16/12983

  Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, although the aetiology of ADHD is not yet understood. One proposed theory for developing ADHD is N-methyl-D-aspartate receptors (NMDARs) dysfunction. NMDARs are involved in regulating synaptic plasticity and memory function in the brain. Abnormal expression or polymorphism of some genes associated with ADHD results in NMDAR dysfunction. […] Currently, there are no drugs for ADHD that specifically target NMDARs. However, NMDAR-stabilizing drugs have shown promise in improving ADHD symptoms with fewer side effects than the currently most widely used psychostimulant in ADHD treatment, methylphenidate. […] Glutamatergic dysfunction in ACC positively correlates with core ADHD symptoms, impulsivity, and hyperactivity.

• #27 Attention Deficit Hyperactivity Disorder (ADHD): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/289350-overview

  A PET scan study by Volkow et al revealed that in adults with ADHD, depressed dopamine activity in caudate and preliminary evidence in limbic regions was associated with inattention and enhanced reinforcing responses to intravenous methylphenidate. This concludes that dopamine dysfunction may be involved with symptoms of inattention but may also contribute to substance abuse comorbidity. […] Individuals with ADHD have inhibition impairment, which is difficulty stopping their responses. […] According to a study of young children, there is evidence of early brain structural changes in pre-schoolers with ADHD. Researchers used high resolution anatomical (MPRAGE) images and cognitive and behavioral measures in a cohort of 90 medication-nave preschoolers, aged 45 years (52 with ADHD, 38 controls; 64.4% boys). Results show reductions in bilateral frontal, parietal, and temporal lobe gray matter volumes in children with ADHD relative to typically developing children.

• #28 Adult attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Adult_attention_deficit_hyperactivity_disorder

  Several lines of research based on structural and/or functional imaging techniques, stimulant drugs, and psychological interventions have identified alterations in the dopaminergic and adrenergic pathways of individuals with ADHD. In particular, areas of the prefrontal cortex appear to be the most affected. Dopamine and norepinephrine are neurotransmitters which play an important role in brain function. The uptake transporters for dopamine and norepinephrine are overly active and clear these neurotransmitters from the synapse a lot faster than in other individuals. This is thought to increase processing latency and salience, and diminish working memory.

• #29 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  Their reduced size, functional connectivity, and activation contribute to the pathophysiology of ADHD, as well as imbalances in the noradrenergic and dopaminergic systems that mediate these brain regions. […] ADHD has a high heritability of 74%, meaning that 74% of the presence of ADHD in the population is due to genetic factors. […] ADHD presents with reduced size, functional connectivity and activation as well as low noradrenergic and dopaminergic functioning in brain regions and networks crucial for executive functioning and self-regulation. […] Current models of ADHD suggest that it is associated with functional impairments in some of the brain’s neurotransmitter systems, particularly those involving dopamine and norepinephrine. […] The dopamine pathways and norepinephrine pathways which project to the prefrontal cortex and striatum are directly responsible for modulating executive function (cognitive control of behaviour), motivation, reward perception, and motor function; these pathways are known to play a central role in the pathophysiology of ADHD.

• #30 Azthena logo with the word Azthena

  https://www.news-medical.net/health/ADHD-Pathophysiology.aspx

  The exact pathophysiology of Attention Deficit Hyperactivity Disorder (ADHD) is not clear. With this said, several mechanisms have been proposed as factors associated with the condition. These include abnormalities in the functioning of neurotransmitters, brain structure and cognitive function. […] Although it remains unknown if these mechanisms cause or are consequences of the condition, they appear to be linked to the pathophysiology of ADHD and are evident in affected individuals. Their possible roles are discussed in more detail below. […] Due to the efficacy of medications such as psychostimulants and noradrenergic tricyclics in the treatment of ADHD, neurotransmitters such as dopamine and noradrenaline have been suggested as key players in the pathophysiology of ADHD. […] A deficiency in neural transmission may be linked to the pathophysiology and symptoms of ADHD.

• #31 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  In children with ADHD, there is a general reduction of volume in certain brain structures, with a proportionally greater decrease in the volume in the left-sided prefrontal cortex. […] The subcortical volumes of the accumbens, amygdala, caudate, hippocampus, and putamen appears smaller in individuals with ADHD compared with controls. […] Structural MRI studies have also revealed differences in white matter, with marked differences in inter-hemispheric asymmetry between ADHD and typically developing youths. […] Functional MRI (fMRI) studies have revealed a number of differences between ADHD and control brains. […] ADHD arises from a core deficit in executive functions (e.g., attentional control, inhibitory control, and working memory), which are a set of cognitive processes that are required to successfully select and monitor behaviours that facilitate the attainment of one’s chosen goals.

• #32 Attention deficit hyperactivity disorder in adults: Epidemiology, clinical features, assessment, and diagnosis – UpToDate

  https://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-adults-epidemiology-clinical-features-assessment-and-diagnosis

  ADHD in adults is characterized by symptoms of inattention, impulsivity, and restlessness, resulting in functional impairment. Impairment in executive function is common. Emotional dysregulation is often seen in these patients. […] This topic discusses the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of ADHD in adults.

• #33 Attention deficit hyperactivity disorder – Wikipedia

  https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder

  The executive function impairments that occur in ADHD individuals result in problems with staying organised, time keeping, procrastination control, maintaining concentration, paying attention, ignoring distractions, regulating emotions, and remembering details. […] ADHD has also been associated with motivational deficits in children.

• #34 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Because of these differences, you may find it challenging to organize, plan, focus, and manage your emotions with ADHD. […] Research has found deficits in the neural networks linked to attention and executive function in children and adults with ADHD. This may affect your ability to organize, prioritize, plan, focus, remember instructions, and work toward your goals. […] In addition, ADHD may alter the network connections between your prefrontal cortex and other areas of the brain. Scientists believe this is associated with poor planning, distractibility, impulsivity, and forgetfulness in ADHD. […] Neurotransmitters are chemical messengers that transmit signals from nerve cells to other target cells in your body. […] As noted earlier, dopamine and norepinephrine are two neurotransmitters that might be associated with ADHD.

• #35 Attention Deficit Hyperactivity Disorder (ADHD): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/289350-overview

  A PET scan study by Volkow et al revealed that in adults with ADHD, depressed dopamine activity in caudate and preliminary evidence in limbic regions was associated with inattention and enhanced reinforcing responses to intravenous methylphenidate. This concludes that dopamine dysfunction may be involved with symptoms of inattention but may also contribute to substance abuse comorbidity. […] Individuals with ADHD have inhibition impairment, which is difficulty stopping their responses. […] According to a study of young children, there is evidence of early brain structural changes in pre-schoolers with ADHD. Researchers used high resolution anatomical (MPRAGE) images and cognitive and behavioral measures in a cohort of 90 medication-nave preschoolers, aged 45 years (52 with ADHD, 38 controls; 64.4% boys). Results show reductions in bilateral frontal, parietal, and temporal lobe gray matter volumes in children with ADHD relative to typically developing children.

• #36 Neurobiology of Attention Deficit/Hyperactivity Disorder | Pediatric Research

  https://www.nature.com/articles/pr9201196

  These developments should encourage the search for relevant intermediate clinical or cognitive phenotypes that are more likely related to the underlying neurobiological mechanisms involved in ADHD symptoms than the categorical diagnosis itself. […] As neurobiology of ADHD is a rapidly evolving domain of research, this article aims to provide an update of recent findings in genetics, molecular biology, and neuroimaging and a review of the main neurocognitive and biological models of ADHD. […] The clinical and etiological complexity of ADHD as well as the small proportion of variance in ADHD symptoms explained by candidate genes has encouraged the search for endophenotypes, heritable traits thought to be more proximal to the genetic etiology of the disorder. […] Cognitive deficits have been consistently identified in ADHD and are potential markers for the neural dysfunctions of the disorder.

• #37 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  An imbalance in the transmission of dopamine in the brain may be associated with symptoms of ADHD, including inattention and impulsivity. This disruption may also interfere with the dopamine reward pathway, changing how the ADHD brain perceives reward and pleasure. […] The structure of the ADHD brain can also differ from a non-ADHD brain in certain areas, including the frontal cortex, limbic regions, and basal ganglia. […] Another significant difference involves the default mode network (DMN) of the brain. The DMN activates when you’re daydreaming or not focused (or unable to focus) on a task or activity. […] In ADHD, the DMN is more often activated. As a result, you may feel that your focus is constantly being pulled away from the task at hand toward unrelated thoughts. […] An ADHD brain differs from a neurotypical one in many ways—from the size and activity levels of certain regions to the chemical signals traveling throughout the brain.

• #38 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  An imbalance in the transmission of dopamine in the brain may be associated with symptoms of ADHD, including inattention and impulsivity. This disruption may also interfere with the dopamine reward pathway, changing how the ADHD brain perceives reward and pleasure. […] The structure of the ADHD brain can also differ from a non-ADHD brain in certain areas, including the frontal cortex, limbic regions, and basal ganglia. […] Another significant difference involves the default mode network (DMN) of the brain. The DMN activates when you’re daydreaming or not focused (or unable to focus) on a task or activity. […] In ADHD, the DMN is more often activated. As a result, you may feel that your focus is constantly being pulled away from the task at hand toward unrelated thoughts. […] An ADHD brain differs from a neurotypical one in many ways—from the size and activity levels of certain regions to the chemical signals traveling throughout the brain.

• #39 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Because of these differences, you may find it challenging to organize, plan, focus, and manage your emotions with ADHD. […] Research has found deficits in the neural networks linked to attention and executive function in children and adults with ADHD. This may affect your ability to organize, prioritize, plan, focus, remember instructions, and work toward your goals. […] In addition, ADHD may alter the network connections between your prefrontal cortex and other areas of the brain. Scientists believe this is associated with poor planning, distractibility, impulsivity, and forgetfulness in ADHD. […] Neurotransmitters are chemical messengers that transmit signals from nerve cells to other target cells in your body. […] As noted earlier, dopamine and norepinephrine are two neurotransmitters that might be associated with ADHD.

• #40 ADHD across the lifespan: What it looks like in adults | NIH MedlinePlus Magazine

  https://magazine.medlineplus.gov/article/adhd-across-the-lifespan-what-it-looks-like-in-adults

  ADHD is often diagnosed in childhood, but can continue into adulthood. […] ADHD does not magically disappear when you grow up. Even with treatment, many people with ADHD continue to have symptoms in adulthood though those symptoms may look and feel a little different. […] The responsibilities and challenges of adulthood can also trigger new symptoms and make existing ones worse. […] ADHD affects how people perceive and manage time, which can make it tough to estimate how long tasks will take and stick to schedules.

• #41 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Noradrenaline plays an important role in the prefrontal cortex, and ADHD may disrupt its transmission in the brain. […] Meanwhile, dopamine helps us regulate our emotions and is linked to feelings of pleasure and reward. […] In ADHD, there might be lower levels of dopamine in the brain. This makes it harder to maintain motivation, especially when the rewards seem small or not immediate. ADHD brains tend to favor short-term, smaller rewards over long-term, more significant ones. […] Scientists have found unique differences in the structure, chemistry, and networks of the ADHD brain. These differences can explain many of the symptoms and challenges ADHDers experience.

• #42 Inside the ADHD Brain: Structure, Function, and Chemistry – ADDA – Attention Deficit Disorder Association

  https://add.org/adhd-brain/

  Noradrenaline plays an important role in the prefrontal cortex, and ADHD may disrupt its transmission in the brain. […] Meanwhile, dopamine helps us regulate our emotions and is linked to feelings of pleasure and reward. […] In ADHD, there might be lower levels of dopamine in the brain. This makes it harder to maintain motivation, especially when the rewards seem small or not immediate. ADHD brains tend to favor short-term, smaller rewards over long-term, more significant ones. […] Scientists have found unique differences in the structure, chemistry, and networks of the ADHD brain. These differences can explain many of the symptoms and challenges ADHDers experience.

• #43 Attention-Deficit/Hyperactivity Disorder (ADHD)

  https://my.clevelandclinic.org/health/diseases/4784-attention-deficithyperactivity-disorder-adhd

  On the other hand, your child is better than most neurotypical kids at using automatic attention. This is the type of attention we use to focus on something were interested in. It allows for something called hyperfocus, or the ability to get in the zone and do something for hours on end. Your child might use hyperfocus to become really good at a hobby or game or to reach certain goals.

• #44 Managing Adult ADHD: Diagnosis, Strategies & Treatment | Psych Scene Hub

  https://psychscenehub.com/psychinsights/diagnosis-and-management-of-adult-adhd/

  Clinicians should increase their awareness of adult ADHD given that currently less than one in five adult patients are diagnosed and treated. […] ADHD can impair psychosocial functioning and impair quality of life significantly. […] Patients with ADHD or a history of childhood ADHD have higher mortality rates than those without ADHD. […] The increased risk of mortality is multifactorial in origin. […] ADHD tends to have a high degree of heritability and twin studies show that ADHD has a heritability of 70% to 80% in both children and adults. […] Gene-Environment interactions may be the main mechanism by which environmental risk factors increase the risk of ADHD. […] 40% of the heritability of ADHD can be attributed to common genetic variants. […] Methylphenidate (MPH) non-competitively blocks the reuptake of dopamine and noradrenaline into the terminal by blocking dopamine transporter (DAT) and noradrenaline transporter (NAT), increasing levels of dopamine and noradrenaline in the synaptic cleft.

• #45

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2023/05000/adult_attention_deficit_hyperactivity_disorder__a.74.aspx

  Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 23% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. A thorough review of the history, mechanism of action, pharmacokinetics and drug-drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. Several factors contribute to ADHD symptoms, including genetics, neurodevelopmental disorders, abnormal neuronal maturation, brain injury, environmental exposure and consanguinity. A recent study by Posner and colleagues reported that environmental risk factors contribute to ADHD symptoms at prenatal, perinatal, and postnatal stages. Prenatal and perinatal risk factors such as prematurity, low birth weight, maternal smoking history, stress, trauma and obesity are substantially associated with ADHD. Postnatal risk factors such as trauma, parenting style, artificial colours and fragrances, pollutants, and pesticides can exacerbate ADHD symptoms. It is clear that better long-term treatments for ADHD are urgently needed. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely used approach for diagnosing ADHD in adults and requires childhood onset. The purpose of this review is to describe the characteristics and the associated comorbidities of Adult ADHD and to depict the scope of available treatment. ADHD is recognized by the DSM-IV to fit into three different subtypes-hyperactive or impulsive, inattentive and combined. According to Wilens, 90% of individuals suffering with ADHD show inattentive symptoms, who recognized it as the most prevalent symptom domain. Literature shows that females present with far higher levels of inattentiveness leading to infrequent access to care. In contrast, the least represented domain is the hyperactive subtype. ADHD adults often feel different from others due to their inability to comprehend social cues and because they lack propriety. But there are positive aspects of ADHD. The patients are creative and thus usually prosper in the art industry. Accomplishing tasks is rewarding when it is in their interest. They develop coping strategies to overcome their deficits by keeping track of to-do lists, setting alarms. Diagnosis is essential as it helps them to come to term with their shortcomings. Two-thirds of ADHD adults present with one comorbid psychiatric disorder. Studies also show that ADHD is found in 15% of psychiatric patients. These comorbidities are responsible for masking ADHD which reduces the frequency of correct diagnosis. Comorbidity rates of 57-92% have been shown in various studies. ADHD is associated with poor academic and professional performance because it presents with reading disabilities which lead to repeating grades and attending special educational facilities hindering higher educational opportunities. ADHD is associated with increased risks of psychiatric disorders, including oppositional defiant disorder, conduct disorder, substance abuse, and possibly mood disorders, such as depression and mania. ADHD is a neurological and neurodevelopmental disorder that begins in childhood and is characterized by persistent patterns of inattention, impulsivity, restlessness and hyperactivity. The long-term efficacy of these treatments on clinical, occupational and social outcomes remains unknown.

• #46 Adult ADHD (Attention Deficit/Hyperactivity Disorder) | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/adult-adhd-attention-deficit-hyperactivity-disorder.17221/

  ADHD can run in families. […] Pregnant women who smoke, drink alcohol or use drugs are at increased risk of having children with ADHD. Likewise, women exposed to environmental poisons during pregnancy ? such as polychlorinated biphenyls (PCBs) ? may be more likely to have children with symptoms of ADHD. […] Preschool children exposed to certain toxins are at increased risk of developmental and behavioral problems. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span.

• #47 What are the causes of ADHD? Biology vs. environment

  https://www.medicalnewstoday.com/articles/causes-of-adhd

  A 2018 study with children ages 3-7 years old hospitalized overnight for TBI found that TBI correlated to an increased risk of ADHD up to 7 years after the injury. […] Some research connects ADHD to complications that affect fetal development during pregnancy, such as prenatal alcohol exposure and prenatal smoking. […] While these studies show an association between ADHD and prenatal or birth complications, they do not prove they are a direct cause. More research is necessary to understand the relationship. […] Psychological trauma may play a role in ADHD, but it is unclear how, or to what extent. […] ADHD appears to be something a person has from birth, or that develops in early childhood. […] Researchers are still learning about the causes of ADHD. However, they suspect a combination of genetic and environmental factors increases a person’s chances of developing the condition.

• #48 Adult ADHD (Attention Deficit/Hyperactivity Disorder) | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/adult-adhd-attention-deficit-hyperactivity-disorder.17221/

  ADHD can run in families. […] Pregnant women who smoke, drink alcohol or use drugs are at increased risk of having children with ADHD. Likewise, women exposed to environmental poisons during pregnancy ? such as polychlorinated biphenyls (PCBs) ? may be more likely to have children with symptoms of ADHD. […] Preschool children exposed to certain toxins are at increased risk of developmental and behavioral problems. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span.

• #49 What are the causes of ADHD? Biology vs. environment

  https://www.medicalnewstoday.com/articles/causes-of-adhd

  A 2018 study with children ages 3-7 years old hospitalized overnight for TBI found that TBI correlated to an increased risk of ADHD up to 7 years after the injury. […] Some research connects ADHD to complications that affect fetal development during pregnancy, such as prenatal alcohol exposure and prenatal smoking. […] While these studies show an association between ADHD and prenatal or birth complications, they do not prove they are a direct cause. More research is necessary to understand the relationship. […] Psychological trauma may play a role in ADHD, but it is unclear how, or to what extent. […] ADHD appears to be something a person has from birth, or that develops in early childhood. […] Researchers are still learning about the causes of ADHD. However, they suspect a combination of genetic and environmental factors increases a person’s chances of developing the condition.

• #50 ADHD—or Something Else?

  https://www.psychiatrictimes.com/view/adhd-or-something-else-

  Pre-, peri-, and postnatal environmental factors play a significant role in the development of ADHD. Prenatal factors include the mothers lifestyle during pregnancy. For example, prenatal alcohol exposure can lead to hyperactive, disruptive, and impulsive behaviors and increase the risk of psychiatric disorders. Maternal smoking during the prenatal developmental period has been linked to increased risk of ADHD and hyperactivity. Perinatal factors such as very low-birthweight children have a twofold increase in ADHD.

• #51

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2023/05000/adult_attention_deficit_hyperactivity_disorder__a.74.aspx

  Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 23% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. A thorough review of the history, mechanism of action, pharmacokinetics and drug-drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. Several factors contribute to ADHD symptoms, including genetics, neurodevelopmental disorders, abnormal neuronal maturation, brain injury, environmental exposure and consanguinity. A recent study by Posner and colleagues reported that environmental risk factors contribute to ADHD symptoms at prenatal, perinatal, and postnatal stages. Prenatal and perinatal risk factors such as prematurity, low birth weight, maternal smoking history, stress, trauma and obesity are substantially associated with ADHD. Postnatal risk factors such as trauma, parenting style, artificial colours and fragrances, pollutants, and pesticides can exacerbate ADHD symptoms. It is clear that better long-term treatments for ADHD are urgently needed. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely used approach for diagnosing ADHD in adults and requires childhood onset. The purpose of this review is to describe the characteristics and the associated comorbidities of Adult ADHD and to depict the scope of available treatment. ADHD is recognized by the DSM-IV to fit into three different subtypes-hyperactive or impulsive, inattentive and combined. According to Wilens, 90% of individuals suffering with ADHD show inattentive symptoms, who recognized it as the most prevalent symptom domain. Literature shows that females present with far higher levels of inattentiveness leading to infrequent access to care. In contrast, the least represented domain is the hyperactive subtype. ADHD adults often feel different from others due to their inability to comprehend social cues and because they lack propriety. But there are positive aspects of ADHD. The patients are creative and thus usually prosper in the art industry. Accomplishing tasks is rewarding when it is in their interest. They develop coping strategies to overcome their deficits by keeping track of to-do lists, setting alarms. Diagnosis is essential as it helps them to come to term with their shortcomings. Two-thirds of ADHD adults present with one comorbid psychiatric disorder. Studies also show that ADHD is found in 15% of psychiatric patients. These comorbidities are responsible for masking ADHD which reduces the frequency of correct diagnosis. Comorbidity rates of 57-92% have been shown in various studies. ADHD is associated with poor academic and professional performance because it presents with reading disabilities which lead to repeating grades and attending special educational facilities hindering higher educational opportunities. ADHD is associated with increased risks of psychiatric disorders, including oppositional defiant disorder, conduct disorder, substance abuse, and possibly mood disorders, such as depression and mania. ADHD is a neurological and neurodevelopmental disorder that begins in childhood and is characterized by persistent patterns of inattention, impulsivity, restlessness and hyperactivity. The long-term efficacy of these treatments on clinical, occupational and social outcomes remains unknown.

• #52 What are the causes of ADHD? Biology vs. environment

  https://www.medicalnewstoday.com/articles/causes-of-adhd

  A 2018 study with children ages 3-7 years old hospitalized overnight for TBI found that TBI correlated to an increased risk of ADHD up to 7 years after the injury. […] Some research connects ADHD to complications that affect fetal development during pregnancy, such as prenatal alcohol exposure and prenatal smoking. […] While these studies show an association between ADHD and prenatal or birth complications, they do not prove they are a direct cause. More research is necessary to understand the relationship. […] Psychological trauma may play a role in ADHD, but it is unclear how, or to what extent. […] ADHD appears to be something a person has from birth, or that develops in early childhood. […] Researchers are still learning about the causes of ADHD. However, they suspect a combination of genetic and environmental factors increases a person’s chances of developing the condition.

• #53 Adult ADHD (Attention Deficit/Hyperactivity Disorder) | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/adult-adhd-attention-deficit-hyperactivity-disorder.17221/

  ADHD can run in families. […] Pregnant women who smoke, drink alcohol or use drugs are at increased risk of having children with ADHD. Likewise, women exposed to environmental poisons during pregnancy ? such as polychlorinated biphenyls (PCBs) ? may be more likely to have children with symptoms of ADHD. […] Preschool children exposed to certain toxins are at increased risk of developmental and behavioral problems. Exposure to lead, which is found mainly in paint and pipes in older buildings, has been linked to disruptive and even violent behavior and to a short attention span.

• #54 Adult ADHD and Childhood Trauma: Is There a Link?

  https://www.webmd.com/add-adhd/adult-adhd-childhood-trauma

  If youre an adult with ADHD, youre among millions of other grownups who also live with it. Scientists know your genes play a major role in your chances of having it. They also know theres a strong association between having trauma when youre a child and then having ADHD in your adulthood. […] But childhood trauma seems to be a big predictor of long-lasting ADHD symptoms. […] Scientists think early and ongoing exposure to ACEs raise your toxic levels of stress. […] Research shows that childhood trauma can shape how certain areas of your brain form. That includes stress-sensitive structures and connections that control how you think, feel, and act. […] Early life stress may result in changes that cause you to have common ADHD symptoms, including: An ongoing sense of fear, heightened response to stress that doesnt go away easily, difficulty regulating your emotions, trouble planning or paying attention, lack of impulse control.

• #55 Adult ADHD and Childhood Trauma: Is There a Link?

  https://www.webmd.com/add-adhd/adult-adhd-childhood-trauma

  If youre an adult with ADHD, youre among millions of other grownups who also live with it. Scientists know your genes play a major role in your chances of having it. They also know theres a strong association between having trauma when youre a child and then having ADHD in your adulthood. […] But childhood trauma seems to be a big predictor of long-lasting ADHD symptoms. […] Scientists think early and ongoing exposure to ACEs raise your toxic levels of stress. […] Research shows that childhood trauma can shape how certain areas of your brain form. That includes stress-sensitive structures and connections that control how you think, feel, and act. […] Early life stress may result in changes that cause you to have common ADHD symptoms, including: An ongoing sense of fear, heightened response to stress that doesnt go away easily, difficulty regulating your emotions, trouble planning or paying attention, lack of impulse control.

• #56 Adult ADHD and Childhood Trauma: Is There a Link?

  https://www.webmd.com/add-adhd/adult-adhd-childhood-trauma

  If youre an adult with ADHD, youre among millions of other grownups who also live with it. Scientists know your genes play a major role in your chances of having it. They also know theres a strong association between having trauma when youre a child and then having ADHD in your adulthood. […] But childhood trauma seems to be a big predictor of long-lasting ADHD symptoms. […] Scientists think early and ongoing exposure to ACEs raise your toxic levels of stress. […] Research shows that childhood trauma can shape how certain areas of your brain form. That includes stress-sensitive structures and connections that control how you think, feel, and act. […] Early life stress may result in changes that cause you to have common ADHD symptoms, including: An ongoing sense of fear, heightened response to stress that doesnt go away easily, difficulty regulating your emotions, trouble planning or paying attention, lack of impulse control.

• #57 The neurobiological basis of ADHD

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3016271/

  Attention-Deficit/Hyperactivity Disorder is not a single pathophysiological entity and appears to have a complex etiology. […] A growing body of evidence supports a model in which multiple genetic and environmental factors interact during early development to create a neurobiological susceptibility to the disorder; the expression of which is mediated by alterations within different and diverse neural networks and deficits in the neuropsychological functions that these subserve. […] Recent studies have focused on the joint effects of gene variants (of DRD4 and DAT1) and prenatal substance exposures on subtypes of ADHD children, demonstrating that smoking during pregnancy is associated with the combined ADHD type in genetically susceptible children. […] Growing evidence points to the involvement of the frontostriatal network as a likely contributor to the pathophysiology of ADHD. […] Convergent data from neuroimaging, neuropsychology, genetics and neurochemical studies consistently point to the involvement of the frontostriatal network as a likely contributor to the pathophysiology of ADHD.

• #58 Complex ADHD in Adults | TEAM ADHD For HCPs

  https://www.team-adhd.com/adult/complex-adhd

  ADHD is a complex disorder in adults. Diagnosis and treatment of adult ADHD are made challenging by the neuropathology underlying the disorder, as well as the prevalence of psychiatric comorbidities. The pathogenesis of ADHD is complex, involving an interplay of genes and environment. Studies have demonstrated a multifactorial causality underlying both the expression and severity of ADHD in adults. Affected brain regions in adult ADHD include: Dorsal Anterior Cingulate Cortex, Prefrontal Cortex, and Ventromedial Prefrontal Cortex. Neurotransmitter circuits are also involved in adult ADHD, and include the dopaminergic system and noradrenergic system. In adults with ADHD, dopaminergic pathways of the frontal-striatal circuitry may be dysfunctional, particularly during cognitive tasks. Dysregulation in both brain regions and neurologic pathways is seen in adults with ADHD.

• #59 SUD and Adult ADHD | TEAM ADHD For HCPs

  https://www.team-adhd.com/adult/comorbidities/sud

  SUD is prevalent in adults with ADHD, and may relate to the core symptoms of the disorder. […] Evidence shows that patients with ADHD and SUD share similar abnormalities in brain structure and function, including smaller volumes in the frontal cortex, cerebellum, and subcortical structures. […] It has also been postulated that genetically mediated personality traits common to both ADHD and SUD (such as novelty seeking and impulsivity), may result from shared neurologic substrates. […] ADHD can significantly impact the development and course of SUD, making early diagnosis important. […] Stimulant medications, which constitute the mainstay of pharmacotherapy in adult ADHD, have been shown to decrease the risk for developing SUD, due possibly to their protective effect against impulsive decision making or to the prosocial benefits of treatment. […] Risk of abuse of stimulants is increased in patients with SUD, particularly young adults.

• #60 Complex ADHD in Adults | TEAM ADHD For HCPs

  https://www.team-adhd.com/adult/complex-adhd

  ADHD is a complex disorder in adults. Diagnosis and treatment of adult ADHD are made challenging by the neuropathology underlying the disorder, as well as the prevalence of psychiatric comorbidities. The pathogenesis of ADHD is complex, involving an interplay of genes and environment. Studies have demonstrated a multifactorial causality underlying both the expression and severity of ADHD in adults. Affected brain regions in adult ADHD include: Dorsal Anterior Cingulate Cortex, Prefrontal Cortex, and Ventromedial Prefrontal Cortex. Neurotransmitter circuits are also involved in adult ADHD, and include the dopaminergic system and noradrenergic system. In adults with ADHD, dopaminergic pathways of the frontal-striatal circuitry may be dysfunctional, particularly during cognitive tasks. Dysregulation in both brain regions and neurologic pathways is seen in adults with ADHD.

• #61 Molecular Mechanisms Underlying NMDARs Dysfunction and Their Role in ADHD Pathogenesis

  https://www.mdpi.com/1422-0067/24/16/12983

  Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, although the aetiology of ADHD is not yet understood. One proposed theory for developing ADHD is N-methyl-D-aspartate receptors (NMDARs) dysfunction. NMDARs are involved in regulating synaptic plasticity and memory function in the brain. Abnormal expression or polymorphism of some genes associated with ADHD results in NMDAR dysfunction. […] Currently, there are no drugs for ADHD that specifically target NMDARs. However, NMDAR-stabilizing drugs have shown promise in improving ADHD symptoms with fewer side effects than the currently most widely used psychostimulant in ADHD treatment, methylphenidate. […] Glutamatergic dysfunction in ACC positively correlates with core ADHD symptoms, impulsivity, and hyperactivity.

• #62 Attention Deficit Hyperactivity Disorder (ADHD): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/289350-overview

  Although ADHD has been associated with structural and functional alterations in the frontostriatal circuitry, recent studies have further demonstrated changes just outside that region and more specifically in the cerebellum and the parietal lobes. […] Another study using proton magnetic spectroscopy demonstrated right prefrontal neurochemical changes in adolescents with ADHD. […] Work by Sobel et al has demonstrated deformations in the basal ganglia nuclei (caudate, putamen, globus pallidus) in children with ADHD. The more prominent the deformations, the greater the severity of symptoms. Furthermore, Sobel et al have shown that stimulants may normalize the deformations. […] Adults with ADHD also have been reported to have deficits in anterior cingulate activation while performing similar tasks.

• #63 Psychopathology of attention deficit/hyperactivity disorder: from an inflammatory perspective | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00561-y

  Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattentiveness, hyperactivity and impulsivity, which may affect ones cognitive and psychosocial functioning. […] The exact cause of ADHD remains unknown, and the aetiology of the disorder is believed to be multifactorial. Numerous genetic and environmental factors have been linked to the development of ADHD. Like many psychiatric disorders, ADHD has been associated with inflammation that occurs locally and peripherally. […] The underlying inflammatory processes and mechanisms in ADHD are not clearly understood. Therefore, further exploration is warranted in future research. This has clinical implications as inflammation may be a potential target in the treatment of ADHD. […] An understanding of the immune basis of neurological and psychiatric conditions leads to a better appreciation of the role of inflammation and immune system in the pathogenesis of these diseases.

• #64 Psychopathology of attention deficit/hyperactivity disorder: from an inflammatory perspective | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00561-y

  Despite the conventional belief that the central nervous system (CNS) was immunologically inert and privileged, it is now evident that neuroimmune communications exist between the CNS and peripheral immune cells of the innate and adaptive immune system. […] Neuroinflammation has been implicated in various neurological conditions including traumatic brain injuries, neurodegenerative disorders and movement disorders. […] Although, there is no direct evidence of neuroinflammation in ADHD, there is indirect evidence that indicates neuroinflammation may play a role in ADHD. […] Maternal immune activation refers to immune response to infections or stimuli resembling infections in the mother during pregnancy. The resultant cytokines and immune alterations may exert their adverse effects on the developing foetus, particularly in the CNS and leads to adverse neurodevelopment and behaviour phenotypes.

• #65 Psychopathology of attention deficit/hyperactivity disorder: from an inflammatory perspective | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00561-y

  Current literature cannot pinpoint the exact cause of ADHD but suggests that an interplay of genetic and environmental factors plays a role in the pathogenesis and psychopathology of ADHD. […] It is also increasingly evident that factors such as oxidative stress, neuroinflammation, autoimmune diseases, maternal immune activation, allergic diseases and other immune-mediated conditions are linked to ADHD. […] However, the underlying mechanisms are not clearly understood, which warrant further exploration. This has clinical significance in terms of treatment of ADHD.

• #66 Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder

  https://www.psychiatrist.com/jcp/mechanism-action-stimulants-attention-deficit-hyperactivity/

  Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder […] Stimulants hypothetically increase the availability of both dopamine and norepinephrine in prefrontal cortex, which enhances the efficiency of information processing at pyramidal neurons, resulting in the improvement of symptoms in attention-deficit/hyperactivity disorder (ADHD). […] Symptoms of ADHD are theoretically linked to inefficient information processing by pyramidal neurons in PFC, perhaps due in part to imbalances in the neurotransmitters DA and NE. […] Stimulants such as methylphenidate and amphetamine hypothetically act at these pyramidal neurons to enhance signal strength by increasing NE and to reduce noise by increasing DA, thereby reducing symptoms of inattention, hyperactivity, and impulsivity in ADHD.

• #67 Attention deficit hyperactivity disorder – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/attention-deficit-hyperactivity-disorder/

  ADHD is a multifactorial disorder; pathogenesis is thought to be related to altered catecholamine metabolism. […] Mechanism of action: indirect and central sympathomimetic activity increased release and blocked reuptake of norepinephrine and dopamine (minor effect on serotonin) increased concentration of norepinephrine and dopamine in the synaptic cleft increased mental performance (e.g., improved concentration, cognition; , short-term memory).

• #68 Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder

  https://www.psychiatrist.com/jcp/mechanism-action-stimulants-attention-deficit-hyperactivity/

  Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder […] Stimulants hypothetically increase the availability of both dopamine and norepinephrine in prefrontal cortex, which enhances the efficiency of information processing at pyramidal neurons, resulting in the improvement of symptoms in attention-deficit/hyperactivity disorder (ADHD). […] Symptoms of ADHD are theoretically linked to inefficient information processing by pyramidal neurons in PFC, perhaps due in part to imbalances in the neurotransmitters DA and NE. […] Stimulants such as methylphenidate and amphetamine hypothetically act at these pyramidal neurons to enhance signal strength by increasing NE and to reduce noise by increasing DA, thereby reducing symptoms of inattention, hyperactivity, and impulsivity in ADHD.

• #69 Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder

  https://www.psychiatrist.com/jcp/mechanism-action-stimulants-attention-deficit-hyperactivity/

  Mechanism of Action of Stimulants in Attention-Deficit/Hyperactivity Disorder […] Stimulants hypothetically increase the availability of both dopamine and norepinephrine in prefrontal cortex, which enhances the efficiency of information processing at pyramidal neurons, resulting in the improvement of symptoms in attention-deficit/hyperactivity disorder (ADHD). […] Symptoms of ADHD are theoretically linked to inefficient information processing by pyramidal neurons in PFC, perhaps due in part to imbalances in the neurotransmitters DA and NE. […] Stimulants such as methylphenidate and amphetamine hypothetically act at these pyramidal neurons to enhance signal strength by increasing NE and to reduce noise by increasing DA, thereby reducing symptoms of inattention, hyperactivity, and impulsivity in ADHD.

• #70

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2023/05000/adult_attention_deficit_hyperactivity_disorder__a.74.aspx

  Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 23% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. A thorough review of the history, mechanism of action, pharmacokinetics and drug-drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. Several factors contribute to ADHD symptoms, including genetics, neurodevelopmental disorders, abnormal neuronal maturation, brain injury, environmental exposure and consanguinity. A recent study by Posner and colleagues reported that environmental risk factors contribute to ADHD symptoms at prenatal, perinatal, and postnatal stages. Prenatal and perinatal risk factors such as prematurity, low birth weight, maternal smoking history, stress, trauma and obesity are substantially associated with ADHD. Postnatal risk factors such as trauma, parenting style, artificial colours and fragrances, pollutants, and pesticides can exacerbate ADHD symptoms. It is clear that better long-term treatments for ADHD are urgently needed. The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely used approach for diagnosing ADHD in adults and requires childhood onset. The purpose of this review is to describe the characteristics and the associated comorbidities of Adult ADHD and to depict the scope of available treatment. ADHD is recognized by the DSM-IV to fit into three different subtypes-hyperactive or impulsive, inattentive and combined. According to Wilens, 90% of individuals suffering with ADHD show inattentive symptoms, who recognized it as the most prevalent symptom domain. Literature shows that females present with far higher levels of inattentiveness leading to infrequent access to care. In contrast, the least represented domain is the hyperactive subtype. ADHD adults often feel different from others due to their inability to comprehend social cues and because they lack propriety. But there are positive aspects of ADHD. The patients are creative and thus usually prosper in the art industry. Accomplishing tasks is rewarding when it is in their interest. They develop coping strategies to overcome their deficits by keeping track of to-do lists, setting alarms. Diagnosis is essential as it helps them to come to term with their shortcomings. Two-thirds of ADHD adults present with one comorbid psychiatric disorder. Studies also show that ADHD is found in 15% of psychiatric patients. These comorbidities are responsible for masking ADHD which reduces the frequency of correct diagnosis. Comorbidity rates of 57-92% have been shown in various studies. ADHD is associated with poor academic and professional performance because it presents with reading disabilities which lead to repeating grades and attending special educational facilities hindering higher educational opportunities. ADHD is associated with increased risks of psychiatric disorders, including oppositional defiant disorder, conduct disorder, substance abuse, and possibly mood disorders, such as depression and mania. ADHD is a neurological and neurodevelopmental disorder that begins in childhood and is characterized by persistent patterns of inattention, impulsivity, restlessness and hyperactivity. The long-term efficacy of these treatments on clinical, occupational and social outcomes remains unknown.

• #71 Managing Adult ADHD: Diagnosis, Strategies & Treatment | Psych Scene Hub

  https://psychscenehub.com/psychinsights/diagnosis-and-management-of-adult-adhd/

  Atomoxetine is a selective norepinephrine reuptake inhibitor or NARI, resulting in increased noradrenaline or dopamine levels in the prefrontal cortex. […] ADHD is a treatable condition that begins in childhood and adolescence which in many cases can persist during adulthood. […] Cases of Adult ADHD are and undertreated which can have a significant impact on the individual and societal level. […] Clinicians are advised to have a high index of suspicion for Adult ADHD as part of routine assessment of patients presenting with psychological distress.

• #72 Attention-Deficit/Hyperactivity Disorder (ADHD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/attention-deficit-hyperactivity-disorder-adhd

  Studies have shown growth in height slows over 2 years of stimulant medication use, and adult height potential may be diminished with chronic stimulant use. […] Atomoxetine, a selective norepinephrine reuptake inhibitor, is also used. The medication is effective, but data are mixed regarding its efficacy compared with stimulants.

• #73 Solriamfetol (Sunosi): Another Option for the Treatment of Adult ADHD? – MGH Psychiatry News

  https://mghpsychnews.org/solriamfetol-sunosi-another-option-for-adhd/

  Solriamfetol may be a safe and effective treatment for ADHD in adults. […] Solriamfetol is thought to promote wakefulness by increasing levels of dopamine and norepinephrine; more specifically, solriamfetol is a selective dopamine-norepinephrine reuptake inhibitor that binds to dopamine and norepinephrine transporters at the synapse and prevents the reuptake of these neurotransmitters. […] The current study indicates that the wakefulness-promoting medication solriamfetol may be a safe and effective alternative for the treatment of ADHD in adults. […] Solriamfetol is not considered a traditional stimulant, but does block reuptake of dopamine and norepinephrine, which is a core mechanism of action of stimulants. […] Non-stimulant alternatives like solriamfetol may have certain advantages, offering treatment options with a lower potential for abuse and pharmacologic properties that may help to address comorbid psychiatric illness in adults.

• #74 Molecular Mechanisms Underlying NMDARs Dysfunction and Their Role in ADHD Pathogenesis

  https://www.mdpi.com/1422-0067/24/16/12983

  Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, although the aetiology of ADHD is not yet understood. One proposed theory for developing ADHD is N-methyl-D-aspartate receptors (NMDARs) dysfunction. NMDARs are involved in regulating synaptic plasticity and memory function in the brain. Abnormal expression or polymorphism of some genes associated with ADHD results in NMDAR dysfunction. […] Currently, there are no drugs for ADHD that specifically target NMDARs. However, NMDAR-stabilizing drugs have shown promise in improving ADHD symptoms with fewer side effects than the currently most widely used psychostimulant in ADHD treatment, methylphenidate. […] Glutamatergic dysfunction in ACC positively correlates with core ADHD symptoms, impulsivity, and hyperactivity.

• #75 Molecular Mechanisms Underlying NMDARs Dysfunction and Their Role in ADHD Pathogenesis

  https://www.mdpi.com/1422-0067/24/16/12983

  The potential causal role of NMDAR dysfunction in the pathogenesis of ADHD has become a new area of research interest. For this reason, this review paper is aimed to focus on the role of NMDAR dysregulation in ADHD pathophysiology, which to date has not been studied extensively and is not well-understood. NMDAR dysfunction is one of the suggested mechanisms underlying ADHD pathogenesis in humans, as the role of NMDAR dysregulation has been well-established in a rat model of ADHD. […] Research regarding NMDAR role in ADHD might be useful in the development of novel treatment strategies, as currently most effective drugs, atomoxetine and methylphenidate, beside inhibiting monoamine reuptake, also influence NMDAR function. […] A better understanding of the role of NMDAR in the disease pathogenesis may lead to the development of novel, targeted therapies that could bring relief to ADHD patients.

• #76 Molecular Mechanisms Underlying NMDARs Dysfunction and Their Role in ADHD Pathogenesis

  https://www.mdpi.com/1422-0067/24/16/12983

  The potential causal role of NMDAR dysfunction in the pathogenesis of ADHD has become a new area of research interest. For this reason, this review paper is aimed to focus on the role of NMDAR dysregulation in ADHD pathophysiology, which to date has not been studied extensively and is not well-understood. NMDAR dysfunction is one of the suggested mechanisms underlying ADHD pathogenesis in humans, as the role of NMDAR dysregulation has been well-established in a rat model of ADHD. […] Research regarding NMDAR role in ADHD might be useful in the development of novel treatment strategies, as currently most effective drugs, atomoxetine and methylphenidate, beside inhibiting monoamine reuptake, also influence NMDAR function. […] A better understanding of the role of NMDAR in the disease pathogenesis may lead to the development of novel, targeted therapies that could bring relief to ADHD patients.

• #77

  https://www.acofp.org/news-and-publications/journal/article-detail/vol-16-no-3-fall-2024/adhd-family-medicine-setting

  Diagnosis of ADHD in adults is also made clinically, after excluding other possible causes of inattention, hyperactivity, and impulsivity. In addition to the clinical evaluation in adults is the reliance on self-report assessments rather than informant accounts by parents and teachers. There are two important criteria to assess adults. First, that the symptoms of adult ADHD have persisted since childhood. Second, the symptoms impair their quality of life. Future research aims to develop biologic correlates to diagnose ADHD in the clinical setting through EEG, fMRI, hemodynamics, or genetics.

• #78 Attention deficit hyperactivity disorder – adults | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/attention-deficit-hyperactivity-disorder-adults

  Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder that affects around one in 20 Australians, mainly men. […] It is now recognised that seven out of 10 children will experience ADHD symptoms as adults. […] Many potential causes affecting the structure and chemistry of the brain are being investigated. The leading theory is that ADHD is a neurodevelopmental disorder. […] Contributing factors to ADHD may include: genetics some research suggests possible gene changes may be present […] exposure during pregnancy and early years – a variety of infectious and metabolic factors have been identified […] environment – lack of early attachment if a baby does not bond with their parent or caregiver, or has traumatic experiences related to the attachment, this can contribute to their inattention and hyperactivity. […] Brain imaging techniques and function measures of how your brain solves problems hold current promise for being able to better understand and personalise treatments.

• #79

  https://www.acofp.org/news-and-publications/journal/article-detail/vol-16-no-3-fall-2024/adhd-family-medicine-setting

  Diagnosis of ADHD in adults is also made clinically, after excluding other possible causes of inattention, hyperactivity, and impulsivity. In addition to the clinical evaluation in adults is the reliance on self-report assessments rather than informant accounts by parents and teachers. There are two important criteria to assess adults. First, that the symptoms of adult ADHD have persisted since childhood. Second, the symptoms impair their quality of life. Future research aims to develop biologic correlates to diagnose ADHD in the clinical setting through EEG, fMRI, hemodynamics, or genetics.

• #80

  https://www.acofp.org/news-and-publications/journal/article-detail/vol-16-no-3-fall-2024/adhd-family-medicine-setting

  Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental syndrome caused by the cumulative effects of various genetic and environmental risk factors. ADHD manifests as lifelong patterns of inattentiveness, hyperactivity, and impulsivity that are severe enough to impair daily functioning. The etiology of ADHD is a complex interaction of genetic, social, and environmental factors. There is evidence that the genes responsible for ADHD development work through a complex polygenic mechanism. Despite this, ADHD has a 74% heritability from parent to offspring. In addition to genetics, prenatal factors appear to determine the development of ADHD. The core etiology of ADHD is impaired neurodevelopment resulting in arousal dysregulation in the brain. Recent data show that ADHD correlates with biomarkers on electroencephalogram (EEG), functional magnetic resonance imaging (fMRI), hemodynamics, and genetics. Biomarkers typically show significant differences in the anatomy and physiology of cerebral structures such as the prefrontal cortex and amygdala. The major symptoms of ADHD: inattention, hyperactivity, and impulsivity are primarily attributed to abnormalities of the prefrontal cortex principally involving the neurotransmitters dopamine and norepinephrine. ADHD is associated with different etiologies and variable changes in brain development, leading to a spectrum of symptomatology. Medical literature typically describes ADHD through the lens of the dopamine hypothesis, which attributes symptoms to dysregulation of dopaminergic pathways. Further evidence from genetic studies suggests that variation in genes that are responsible for norepinephrine production can disrupt the prefrontal cortex and disrupt the regulation of attention and behavior. It is likely that a combination of both dopaminergic and noradrenergic disruptions explains the heterogeneity of ADHD among different individuals. Alpha-2 adrenergic agonists are effective pharmacotherapies for ADHD and are believed to modulate both dopaminergic and noradrenergic neurotransmission to alleviate ADHD symptoms.

• #81

  https://www.acofp.org/news-and-publications/journal/article-detail/vol-16-no-3-fall-2024/adhd-family-medicine-setting

  Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental syndrome caused by the cumulative effects of various genetic and environmental risk factors. ADHD manifests as lifelong patterns of inattentiveness, hyperactivity, and impulsivity that are severe enough to impair daily functioning. The etiology of ADHD is a complex interaction of genetic, social, and environmental factors. There is evidence that the genes responsible for ADHD development work through a complex polygenic mechanism. Despite this, ADHD has a 74% heritability from parent to offspring. In addition to genetics, prenatal factors appear to determine the development of ADHD. The core etiology of ADHD is impaired neurodevelopment resulting in arousal dysregulation in the brain. Recent data show that ADHD correlates with biomarkers on electroencephalogram (EEG), functional magnetic resonance imaging (fMRI), hemodynamics, and genetics. Biomarkers typically show significant differences in the anatomy and physiology of cerebral structures such as the prefrontal cortex and amygdala. The major symptoms of ADHD: inattention, hyperactivity, and impulsivity are primarily attributed to abnormalities of the prefrontal cortex principally involving the neurotransmitters dopamine and norepinephrine. ADHD is associated with different etiologies and variable changes in brain development, leading to a spectrum of symptomatology. Medical literature typically describes ADHD through the lens of the dopamine hypothesis, which attributes symptoms to dysregulation of dopaminergic pathways. Further evidence from genetic studies suggests that variation in genes that are responsible for norepinephrine production can disrupt the prefrontal cortex and disrupt the regulation of attention and behavior. It is likely that a combination of both dopaminergic and noradrenergic disruptions explains the heterogeneity of ADHD among different individuals. Alpha-2 adrenergic agonists are effective pharmacotherapies for ADHD and are believed to modulate both dopaminergic and noradrenergic neurotransmission to alleviate ADHD symptoms.

• #82 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management. […] There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. […] Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. […] As our diagnostic systems are evolving towards a more dimensional approach to the classification of mental disorders, so too is our understanding of adult ADHD. […] It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs.

• #83 Attention-deficit/hyperactivity disorder | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-024-00495-0

  Attention-deficit/hyperactivity disorder (ADHD; also known as hyperkinetic disorder) is a common neurodevelopmental condition that affects children and adults worldwide. ADHD has a predominantly genetic aetiology that involves common and rare genetic variants. […] The heterogeneity of the condition is evident in the diverse presentation of symptoms and levels of impairment, the numerous co-occurring mental and physical conditions, the various domains of neurocognitive impairment, and extensive minor structural and functional brain differences. […] Clinical and neurobiological research is ongoing and could lead to the creation of personalized diagnostic and therapeutic approaches for this disorder.

• #84 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Stimulants and antidepressants (e.g., bupropion [Wellbutrin], desipramine [Norpramin]) have similar effectiveness, although no direct comparison trials have been conducted. […] In a recent meta-analysis, stimulant and nonstimulant medications showed clinically significant improvements compared with placebo. […] Small studies have found that cognitive behavior therapy is helpful as an adjunct to medication in the treatment of ADHD in adults. The mechanism of how cognitive behavior therapy helps treat ADHD is uncertain, but it may help improve daily life skills affected by ADHD.

• #85 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management. […] There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. […] Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. […] As our diagnostic systems are evolving towards a more dimensional approach to the classification of mental disorders, so too is our understanding of adult ADHD. […] It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs.

• #86 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  Overall, these challenges have contributed to an under-diagnosis and under-treatment of adult ADHD. […] ADHD is a prevalent psychiatric disorder in the adult population that is frequently unrecognized, under-diagnosed, and under-treated. […] Early and optimal treatment of ADHD has the potential to change the trajectory of psychiatric morbidity later in life and to substantially improve functional outcomes across the spectrum of psychiatric comorbidities.

• #87 ADHD Research | Icahn School of Medicine

  https://icahn.mssm.edu/research/adhd/research

  The Center of Excellence in ADHD and Related Disorders supports both medical and laboratory studies which represent a critical link between basic and clinical science, often referred to as „translational research.” Translational research is that which can be quickly applied to practical patient treatment. […] Our recent study of Methylphenidate and Atomoxetine in ADHD: fMRI Measures of Mechanisms and Response produced exciting findings, offering a window into the common and unique neurophysiological mechanisms of response to stimulant and non-stimulant treatments. […] Our prior research suggests that effective non-stimulant treatments for ADHD act through key prefrontal regions that subserve inhibitory and executive functions, although different medications may achieve these effects via distinct mechanisms. […] By examining differences in the processes used in decision-making and impulse control, we gain insight into the mechanisms of ADHD and the ways in which ADHD treatments affect the brain.

• #88 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management. […] There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. […] Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. […] As our diagnostic systems are evolving towards a more dimensional approach to the classification of mental disorders, so too is our understanding of adult ADHD. […] It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs.

• #89 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management. […] There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. […] Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. […] As our diagnostic systems are evolving towards a more dimensional approach to the classification of mental disorders, so too is our understanding of adult ADHD. […] It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs.

• #90 Adult ADHD and comorbid disorders: clinical implications of a dimensional approach | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1463-3

  There are strong familial links between ADHD and psychiatric comorbidities such as bipolar disorder, suggesting a genetic contribution. […] Recent studies have demonstrated that similar regions of the brain are involved in ADHD and psychiatric disorders. […] Neuroimaging studies have implicated differences in volume and activity in the frontal lobe, which is responsible for attention, behaviour selection, and emotion. […] Studies of neurotransmitters have also pointed to abnormalities in dopamine (DA) and norepinephrine (NE) signaling. […] Overlapping symptomology between ADHD and mood, anxiety, or SUDs present several barriers to diagnosis and treatment. […] It has been suggested that stress, depression, and anxiety could manifest as a consequence of undiagnosed and untreated ADHD.

• #91 SUD and Adult ADHD | TEAM ADHD For HCPs

  https://www.team-adhd.com/adult/comorbidities/sud

  SUD is prevalent in adults with ADHD, and may relate to the core symptoms of the disorder. […] Evidence shows that patients with ADHD and SUD share similar abnormalities in brain structure and function, including smaller volumes in the frontal cortex, cerebellum, and subcortical structures. […] It has also been postulated that genetically mediated personality traits common to both ADHD and SUD (such as novelty seeking and impulsivity), may result from shared neurologic substrates. […] ADHD can significantly impact the development and course of SUD, making early diagnosis important. […] Stimulant medications, which constitute the mainstay of pharmacotherapy in adult ADHD, have been shown to decrease the risk for developing SUD, due possibly to their protective effect against impulsive decision making or to the prosocial benefits of treatment. […] Risk of abuse of stimulants is increased in patients with SUD, particularly young adults.

• #92 SUD and Adult ADHD | TEAM ADHD For HCPs

  https://www.team-adhd.com/adult/comorbidities/sud

  SUD is prevalent in adults with ADHD, and may relate to the core symptoms of the disorder. […] Evidence shows that patients with ADHD and SUD share similar abnormalities in brain structure and function, including smaller volumes in the frontal cortex, cerebellum, and subcortical structures. […] It has also been postulated that genetically mediated personality traits common to both ADHD and SUD (such as novelty seeking and impulsivity), may result from shared neurologic substrates. […] ADHD can significantly impact the development and course of SUD, making early diagnosis important. […] Stimulant medications, which constitute the mainstay of pharmacotherapy in adult ADHD, have been shown to decrease the risk for developing SUD, due possibly to their protective effect against impulsive decision making or to the prosocial benefits of treatment. […] Risk of abuse of stimulants is increased in patients with SUD, particularly young adults.

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