Materiały źródłowe

• #1 Attention Deficit Hyperactivity Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441838/

  Attention hyperactivity disorder (ADHD) is a psychiatric condition that has long been recognized as affecting children’s ability to function. Individuals suffering from this disorder show patterns of developmentally inappropriate levels of inattentiveness, hyperactivity, or impulsivity. […] ADHD must be considered within the context of what is developmentally and culturally appropriate for a person. It is considered a dysfunction of executive functioning, predominantly a frontal lobe activity. Therefore, patients with ADHD show disability not only in attention and focus but also in decision making and emotional regulation. […] The etiology of ADHD is related to a variety of factors that include both a genetic and an environmental component. It is one of the most heritable conditions in terms of psychiatric disorders.

• #2 Pathophysiology of ADHD and associated problems—starting points for NF interventions?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4478393/

  Attention deficit hyperactivity disorder (ADHD) is characterized by severe and age-inappropriate levels of hyperactivity, impulsivity and inattention. […] ADHD is a heterogeneous disorder, and the majority of patients show comorbid or associated problems from other psychiatric disorders. […] ADHD is associated with cognitive and motivational problems as well as resting-state abnormalities, associated with impaired brain activity in distinct neuronal networks. […] The current manuscript describes pathophysiological characteristics of ADHD, heterogeneity of ADHD subtypes and gender differences, as well as frequently associated behavioral problems such as oppositional defiant/conduct or tic disorder. […] ADHD is currently considered as a neurodevelopmental disorder. […] ADHD is one of the most frequent problems in psychiatry.

• #3 ADHD: Symptoms, Types, Testing, and Treatment

  https://www.webmd.com/add-adhd/attention-deficit-hyperactivity-disorder-adhd

  ADHD stands for attention deficit hyperactivity disorder. Its a brain disorder that affects how you pay attention, sit still, and control your behavior. It happens in children and teens and can continue into adulthood. ADHD is one of the most commonly diagnosed mental disorders in children. Its usually spotted during the early school years, when a child begins to have problems paying attention. […] Experts arent sure what causes ADHD. Research shows a strong link between the disorder and genetics. You may be more likely to have it if it is passed down to you. […] It can be hard to diagnose ADHD, especially in children. No one test will spot it. Doctors diagnose ADHD in children and teens after discussing symptoms at length with the child, parents, and teachers and then observing the child’s behaviors.

• #4 Attention Deficit Hyperactivity Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441838/

  Attention hyperactivity disorder (ADHD) is a psychiatric condition that has long been recognized as affecting children’s ability to function. Individuals suffering from this disorder show patterns of developmentally inappropriate levels of inattentiveness, hyperactivity, or impulsivity. […] ADHD must be considered within the context of what is developmentally and culturally appropriate for a person. It is considered a dysfunction of executive functioning, predominantly a frontal lobe activity. Therefore, patients with ADHD show disability not only in attention and focus but also in decision making and emotional regulation. […] The etiology of ADHD is related to a variety of factors that include both a genetic and an environmental component. It is one of the most heritable conditions in terms of psychiatric disorders.

• #5 Attention Deficit Hyperactivity Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441838/

  Attention hyperactivity disorder (ADHD) is a psychiatric condition that has long been recognized as affecting children’s ability to function. Individuals suffering from this disorder show patterns of developmentally inappropriate levels of inattentiveness, hyperactivity, or impulsivity. […] ADHD must be considered within the context of what is developmentally and culturally appropriate for a person. It is considered a dysfunction of executive functioning, predominantly a frontal lobe activity. Therefore, patients with ADHD show disability not only in attention and focus but also in decision making and emotional regulation. […] The etiology of ADHD is related to a variety of factors that include both a genetic and an environmental component. It is one of the most heritable conditions in terms of psychiatric disorders.

• #6 ADHD in Children: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p592.html

  Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. […] The etiology of ADHD involves a complex interaction of genetic, social, and environmental factors, including prenatal and childhood exposures. […] Research among families, twins, and children who are adopted support substantial heritability (74%) for ADHD. […] The search to identify specific genes responsible for ADHD implicates a complex polygenic mechanism. […] Children born preterm (before 37 weeks’ gestation) are diagnosed with ADHD two times as often as children born at term. […] The risk of ADHD is greater for children whose mothers smoked during pregnancy and had hypertensive disorders in pregnancy.

• #7 ADHD – Pathophysiology – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/community/neurodevelopmental-disorders/adhd/

  Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioural disorder that is characterised by hyperactivity, inattention and impulsivity. The pathophysiology of ADHD is not well understood. Evidence has been found of structural and functional changes in the brains of children with ADHD, as well as changes in the levels of certain neurotransmitters, such as dopamine. It also has a genetic component, often running through families; twin studies have shown the heritability to be 88%. There is also some evidence of interplay between genetic and environmental factors. […] The aim of using medication in children with ADHD is to improve their attention and concentration to allow them to achieve their educational potential; the timing of medication is chosen to maximise its effect at school.

• #8 Attention-deficit/hyperactivity disorder (ADHD) in children – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889

  Attention-deficit/hyperactivity disorder, also called ADHD, is a long-term condition that affects millions of children. It often continues into adulthood. ADHD includes a mix of ongoing problems. These can include having a hard time paying attention, being hyperactive and being impulsive. […] While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include genetics, the environment or central nervous system conditions at key moments in development. […] Risk factors for ADHD may include: Having a blood relative, such as a parent or sibling, with ADHD or another mental health condition. […] ADHD can make life hard for children. Children with ADHD often have trouble in the classroom, which can lead to failing grades and being judged by other children and adults.

• #9

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

  Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition characterized by developmentally inappropriate symptoms of inattention and/or hyperactivity/impulsivity, which leads to impairments in the social, academic, and professional contexts. […] Despite the difficulties imposed by the high complexity of ADHD etiology, the growing body of research and technological advances provide good perspectives for understanding the neurobiology of the disorder. […] ADHD diagnosis is sometimes challenging due to the substantial heterogeneity of the disorder in terms of clinical and pathophysiological aspects, a fact that impacts research on the etiological and neurobiological specificities of ADHD. […] The understanding of the genetic architecture of ADHD has significantly evolved with the technological advances in the molecular genetics field, especially with the availability of large-scale genome-wide association studies (GWAS).

• #10 ADHD in Children: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p592.html

  Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. […] The etiology of ADHD involves a complex interaction of genetic, social, and environmental factors, including prenatal and childhood exposures. […] Research among families, twins, and children who are adopted support substantial heritability (74%) for ADHD. […] The search to identify specific genes responsible for ADHD implicates a complex polygenic mechanism. […] Children born preterm (before 37 weeks’ gestation) are diagnosed with ADHD two times as often as children born at term. […] The risk of ADHD is greater for children whose mothers smoked during pregnancy and had hypertensive disorders in pregnancy.

• #11 KEGG DISEASE: Attention deficit hyperactivity disorder (ADHD)

  https://www.genome.jp/dbget-bin/www_bget?ds:H01895

  Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder first diagnosed in childhood and frequently persistent throughout adult life. The disorder is classically characterized by symptoms of inattention, impulsivity, and hyperactivity. […] Although heritability estimates are consistently high, ADHD is a genetically complex disorder characterized by multifactorial inheritance involving numerous genes of moderate effect. Reports implicate variants of genes important for the synthesis, uptake, transport and receptor binding of dopamine in the etiology of ADHD. And interaction between the dopamine and serotonin systems has been implicated in both the pathophysiology of ADHD and the mechanism of action of widely used stimulant compounds. […] CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice.

• #12 KEGG DISEASE: Attention deficit hyperactivity disorder (ADHD)

  https://www.genome.jp/dbget-bin/www_bget?ds:H01895

  Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder first diagnosed in childhood and frequently persistent throughout adult life. The disorder is classically characterized by symptoms of inattention, impulsivity, and hyperactivity. […] Although heritability estimates are consistently high, ADHD is a genetically complex disorder characterized by multifactorial inheritance involving numerous genes of moderate effect. Reports implicate variants of genes important for the synthesis, uptake, transport and receptor binding of dopamine in the etiology of ADHD. And interaction between the dopamine and serotonin systems has been implicated in both the pathophysiology of ADHD and the mechanism of action of widely used stimulant compounds. […] CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice.

• #13 What causes attention deficit hyperactivity disorder? | Archives of Disease in Childhood

  https://adc.bmj.com/content/97/3/260

  A number of different chromosomal anomalies including abnormalities in the number of chromosomes (notably sex chromosome aneuploidies) and chromosomal structure as well as some single gene disorders have been found to be associated with higher rates of ADHD. Fragile X syndrome, tuberous sclerosis and several microdeletion syndromes including Smith Magenis and Velocardiofacial (VCFS; 22q11 microdeletion) syndromes are associated with ADHD (more commonly inattentive type). […] In summary, there is strong evidence of an inherited contribution to ADHD, although non-inherited factors that likely include environmental risks and chance events (including de novo genetic changes) are also important. There is no single cause of ADHD and the risk factors that have been identified so far appear to be non-specific. That is, risks such as chromosomal microdeletions (eg, VCFS), large, rare CNVs, extreme low birth weight and prematurity appear to affect a range of different neurodevelopmental and psychiatric phenotypes.

• #14 Reddit – The heart of the internet

  https://www.reddit.com/r/FADQ/comments/awnsxi/adhd_pathophysiology_and_pharmacological_treatment/

  ADHD is a disorder that is characterized by behavioral problems that mainly consist of inattention or hyperactivity and impulsivity. […] The underlying causes of ADHD are complex and not fully understood yet. It is known that both structural abnormalities and imbalances in neurotransmissions plays a key part. […] The pathophysiological processes that lead to the behavioral changes seen in ADHD are very complex and still not fully understood. We now know that the cause is multifactorial in nature. […] 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. […] Other brain structures in the prefrontal-striatal-cerebellar and prefrontal-striatal-thalamic circuits have also been found to show differences between people with/without ADHD.

• #15 Attention Deficit Hyperactivity Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441838/

  ADHD is associated with cognitive and functional deficits that relate to diffuse abnormalities in the brain. The anterior cingulate gyrus and dorsolateral prefrontal cortex (DLFPC) are found to be small in individuals who are suffering from ADHD. It is thought that these changes account for the deficits in goal-directed behavior. […] It is important to diagnose and treat the disorder at a young age so that the symptoms do not persist into adulthood and cause other comorbid conditions. The treatment for the disorder is mostly related to stimulants and psychotherapy. […] This review would further shed light upon the causal factors, pathophysiology, and management of ADHD.

• #16 Azthena logo with the word Azthena

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

  The frontal and prefrontal regions of the brain, as well as possibly the parietal lobe and cerebellum, are thought to be associated with ADHD. […] Deformations of the basal ganglia nuclei in children with ADHD may also be involved. […] This theory may be supported by the efficacy of stimulant drugs in treating ADHD, which may help to reduce the deformations. […] Additionally, some research has shown that children who are more hyperactive or impulsive have a slower rate of cortical thinning in the brain, which is most evident in the prefrontal regions of the brain. […] ADHD is also linked to some neurophysiological deficits and abnormalities in cognitive function. […] Abnormalities in the function of this system may be seen in patients with ADHD and lead to the symptoms characteristic of the condition.

• #17 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.

• #18 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.

• #19 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.

• #20 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.

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

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

  In a longitudinal analysis, Shaw et al used 389 neuroanatomic MRI images to compare 193 typically developing children with varying levels of symptoms of hyperactivity and impulsivity (measured with the Conners’ Parent Rating Scale) with 197 children with ADHD (using 337 imaging scans). […] Children with higher levels of hyperactivity/impulsivity had a slower rate of cortical thinning. This was most notable in prefrontal cortical regions, bilaterally in the middle frontal/premotor gyri, extending down the medial prefrontal wall to the anterior cingulate. It was also noted in the orbitofrontal cortex and the right inferior frontal gyrus. Slower cortical thinning during adolescence is characteristic of ADHD and provides neurobiological evidence for dimensionality. […] 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.

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

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

  In a longitudinal analysis, Shaw et al used 389 neuroanatomic MRI images to compare 193 typically developing children with varying levels of symptoms of hyperactivity and impulsivity (measured with the Conners’ Parent Rating Scale) with 197 children with ADHD (using 337 imaging scans). […] Children with higher levels of hyperactivity/impulsivity had a slower rate of cortical thinning. This was most notable in prefrontal cortical regions, bilaterally in the middle frontal/premotor gyri, extending down the medial prefrontal wall to the anterior cingulate. It was also noted in the orbitofrontal cortex and the right inferior frontal gyrus. Slower cortical thinning during adolescence is characteristic of ADHD and provides neurobiological evidence for dimensionality. […] 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.

• #23 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.

• #24 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.

• #25

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

  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. […] The role of the environment in ADHD has also been the focus of several studies. […] ADHD is an important impairing condition of public health due to its prevalence and persistence across the lifespan, and because it leads to a higher risk of adverse outcomes, such as academic underachievement, substance use and abuse, other psychiatric disorders, somatic diseases, risky behaviors, and premature death.

• #26 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.

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

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

  In a longitudinal analysis, Shaw et al used 389 neuroanatomic MRI images to compare 193 typically developing children with varying levels of symptoms of hyperactivity and impulsivity (measured with the Conners’ Parent Rating Scale) with 197 children with ADHD (using 337 imaging scans). […] Children with higher levels of hyperactivity/impulsivity had a slower rate of cortical thinning. This was most notable in prefrontal cortical regions, bilaterally in the middle frontal/premotor gyri, extending down the medial prefrontal wall to the anterior cingulate. It was also noted in the orbitofrontal cortex and the right inferior frontal gyrus. Slower cortical thinning during adolescence is characteristic of ADHD and provides neurobiological evidence for dimensionality. […] 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.

• #28 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.

• #29 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.

• #30 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.

• #31 Attention deficit hyperactivity disorder – ADHD symptoms, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd

  Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that begins in early childhood. ADHD affects your brains executive functioning and your ability to self-regulate and control thoughts, words, actions and emotions. […] People with ADHD have differences in their brain anatomy and function. The exact causes of ADHD arent known. Genetic studies show that ADHD is an inherited disorder. Research has shown that ADHD symptoms are related to the biology of your brain. […] The following environmental factors may contribute towards the development of ADHD: maternal smoking during pregnancy, maternal drinking during pregnancy, premature birth, low birth weight. Other environmental factors that can cause changes in your brains development and function include the following. Toxins: chemicals like lead can affect brain development. Home environment: if there is a lot of conflict in the home. Early childhood trauma: children who experience trauma in early childhood are more likely to show features consistent with ADHD. Most children with ADHD have not had early childhood trauma.

• #32 What causes attention deficit hyperactivity disorder? | Archives of Disease in Childhood

  https://adc.bmj.com/content/97/3/260

  Attention deficit hyperactivity disorder (ADHD) affects around 13% of children. There is a high level of comorbidity with developmental and learning problems as well as with a variety of psychiatric disorders. ADHD is highly heritable, although there is no single causal risk factor and non-inherited factors also contribute to its aetiology. The genetic and environmental risk factors that have been implicated appear to be associated with a range of neurodevelopmental and neuropsychiatric outcomes, not just ADHD. The evidence to date suggests that both rare and multiple common genetic variants likely contribute to ADHD and modify its phenotype. ADHD or a similar phenotype also appears to be more common in extreme low birth weight and premature children and those exposed to exceptional early adversity.

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

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

  Researchers in Denmark conducted a population-based cohort study to determine the association of prenatal exposure to antiepileptic drugs and risk of ADHD in offspring. Of more than 900,000 children, 580 were identified as having been exposed to valproate during pregnancy. Of them, 49 (8.4%) had ADHD. Among the children not exposed to the drug, approximately 30,000 (3.2%) had the disorder. This suggests that maternal use of valproate, but not other AEDs, during pregnancy is associated with an increased risk of ADHD in the offspring. […] There has been concern about the association of maternal smoking during pregnancy and the development of ADHD in offspring. In a Finnish population-based study, researchers analyzed prenatal cotinine levels and offspring ADHD. Cotinine is a product formed after the chemical nicotine enters the body. Nicotine is a chemical found in tobacco products, including cigarettes and chewing tobacco. Measuring cotinine in people’s blood is the most reliable way to determine exposure to nicotine for both smokers and nonsmokers exposed to environmental tobacco smoke (ETS). Measuring cotinine is preferred to measuring nicotine because cotinine remains in the body longer.

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

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

  The study measured maternal cotinine levels using quantitative immunoassays from maternal serum specimens collected during the first and second trimesters of pregnancy. Results showed a dose-dependent relationship between nicotine exposure during pregnancy and offspring ADHD. […] Evidence of a neurobiologic contribution to the cause of ADHD continues to grow. A 12-year historical prospective nationwide cohort study examined whether adherence to methylphenidate (MPH) during early childhood predicts the initiation of antidepressants during adolescence. Researchers looked at children enrolled in an integrated care system who were first prescribed MPH between the ages of 6 and 8 years (N=6830). They found that patients with higher adherence to MPH had a 50% higher risk of receiving antidepressants during adolescence when controlling for other comorbid psychiatric conditions and parental use of antidepressants.

• #35 ADHD in Children: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p592.html

  Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. […] The etiology of ADHD involves a complex interaction of genetic, social, and environmental factors, including prenatal and childhood exposures. […] Research among families, twins, and children who are adopted support substantial heritability (74%) for ADHD. […] The search to identify specific genes responsible for ADHD implicates a complex polygenic mechanism. […] Children born preterm (before 37 weeks’ gestation) are diagnosed with ADHD two times as often as children born at term. […] The risk of ADHD is greater for children whose mothers smoked during pregnancy and had hypertensive disorders in pregnancy.

• #36 Attention deficit hyperactivity disorder – ADHD symptoms, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd

  Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that begins in early childhood. ADHD affects your brains executive functioning and your ability to self-regulate and control thoughts, words, actions and emotions. […] People with ADHD have differences in their brain anatomy and function. The exact causes of ADHD arent known. Genetic studies show that ADHD is an inherited disorder. Research has shown that ADHD symptoms are related to the biology of your brain. […] The following environmental factors may contribute towards the development of ADHD: maternal smoking during pregnancy, maternal drinking during pregnancy, premature birth, low birth weight. Other environmental factors that can cause changes in your brains development and function include the following. Toxins: chemicals like lead can affect brain development. Home environment: if there is a lot of conflict in the home. Early childhood trauma: children who experience trauma in early childhood are more likely to show features consistent with ADHD. Most children with ADHD have not had early childhood trauma.

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

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

  Narad et al. explored the relationship between traumatic brain injury (TBI) in children and development of secondary attention-deficit/hyperactivity disorder (SADHD). […] They looked at concurrent cohort/prospective studies of children aged 3 to 7 years who were hospitalized overnight for TBI or orthopedic injury (OI; used as control group). A total of 187 children and adolescents were included in the analyses: 81 in the TBI group and 106 in the OI group. According to the results, early childhood TBI was associated with increased risk for SADHD. This finding supports the need for post-injury monitoring for attention problems. Consideration of factors that may interact with injury characteristics, such as family functioning, will be important in planning clinical follow-up of children with TBI.

• #38 Attention deficit hyperactivity disorder – ADHD symptoms, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd

  Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that begins in early childhood. ADHD affects your brains executive functioning and your ability to self-regulate and control thoughts, words, actions and emotions. […] People with ADHD have differences in their brain anatomy and function. The exact causes of ADHD arent known. Genetic studies show that ADHD is an inherited disorder. Research has shown that ADHD symptoms are related to the biology of your brain. […] The following environmental factors may contribute towards the development of ADHD: maternal smoking during pregnancy, maternal drinking during pregnancy, premature birth, low birth weight. Other environmental factors that can cause changes in your brains development and function include the following. Toxins: chemicals like lead can affect brain development. Home environment: if there is a lot of conflict in the home. Early childhood trauma: children who experience trauma in early childhood are more likely to show features consistent with ADHD. Most children with ADHD have not had early childhood trauma.

• #39 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

  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. […] 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. […] To this end, an increasing body of research indicates that inflammation, both locally and peripherally, is associated with psychiatric disorders, including ADHD. […] If the underlying mechanisms of the immune responses are known in patients whose ADHD is associated with inflammation, then inflammation may be a potential therapeutic target and treatment strategies may include immune modulation, antioxidants or anti-inflammatory agents.

• #40 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.

• #41 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. […] The inflammatory response may be local or systemic and several immune-mediated conditions such as autoimmune diseases, allergic diseases and maternal immune activation (MIA) have been linked to ADHD, which are believed to contribute to the psychopathology of ADHD. […] 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.

• #42 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. […] The inflammatory response may be local or systemic and several immune-mediated conditions such as autoimmune diseases, allergic diseases and maternal immune activation (MIA) have been linked to ADHD, which are believed to contribute to the psychopathology of ADHD. […] 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.

• #43 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. […] The inflammatory response may be local or systemic and several immune-mediated conditions such as autoimmune diseases, allergic diseases and maternal immune activation (MIA) have been linked to ADHD, which are believed to contribute to the psychopathology of ADHD. […] 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.

• #44 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

  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. […] 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. […] To this end, an increasing body of research indicates that inflammation, both locally and peripherally, is associated with psychiatric disorders, including ADHD. […] If the underlying mechanisms of the immune responses are known in patients whose ADHD is associated with inflammation, then inflammation may be a potential therapeutic target and treatment strategies may include immune modulation, antioxidants or anti-inflammatory agents.

• #45 Novel mechanism involved in attention-deficit hyperactivity disorder, study shows | ScienceDaily

  https://www.sciencedaily.com/releases/2015/04/150416084342.htm

  Researchers have found, in animal models, that the absence of a certain enzyme causes a syndrome resembling the attention-deficit hyperactivity disorder (ADHD). […] Now a group of researchers from the Neuromed Institute identified a molecular mechanism that, when dysregulated, causes the typical symptoms of children affected by ADHD. […] Animals lacking the enzyme, though, also behaved in a strange way. […] „We had seen — continues Carnevale — that these mice had overly hectic movements, troubles in concentrating and learning, and they finally showed deficits in social interactions. In short, typical ADHD characteristics.” […] At the center of their study was a particular area of the brain, the Locus Ceruleus, already known because, through its connections with the cerebral cortex, it appears involved in maintaining attention.

• #46 Novel mechanism involved in attention-deficit hyperactivity disorder, study shows | ScienceDaily

  https://www.sciencedaily.com/releases/2015/04/150416084342.htm

  Researchers have found, in animal models, that the absence of a certain enzyme causes a syndrome resembling the attention-deficit hyperactivity disorder (ADHD). […] Now a group of researchers from the Neuromed Institute identified a molecular mechanism that, when dysregulated, causes the typical symptoms of children affected by ADHD. […] Animals lacking the enzyme, though, also behaved in a strange way. […] „We had seen — continues Carnevale — that these mice had overly hectic movements, troubles in concentrating and learning, and they finally showed deficits in social interactions. In short, typical ADHD characteristics.” […] At the center of their study was a particular area of the brain, the Locus Ceruleus, already known because, through its connections with the cerebral cortex, it appears involved in maintaining attention.

• #47 Novel mechanism involved in attention-deficit hyperactivity disorder, study shows | ScienceDaily

  https://www.sciencedaily.com/releases/2015/04/150416084342.htm

  „Locus Ceruleus neurons — she explains — have what has been defined a tonic discharge, a rhythm. In other words, they are a sort of pacemaker, and the regularity of their pulse has a crucial role in maintaining attention level. When these pulses are too frequent, as we have shown in mice lacking PI3K gamma, characteristic features of Attention Deficit Hyperactivity Disorder do appear.” […] The research offers a unique and completely new understanding of the mechanisms of this neuropsychiatric disease, so far only treatable with symptomatic drugs.

• #48 Pathophysiology of ADHD and associated problems—starting points for NF interventions?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4478393/

  ADHD is associated with a number of neurophysiological deficits. […] Cognitive problems in ADHD are reported in numerous studies with different tasks. […] ADHD may be associated with a number of cognitive deficits, but these may not causes but rather consequences of the disorder, and may not provide causative therapy options. […] ADHD is probably associated with disturbances in cortico-striato-thalamo-cortical neuronal networks which may be partly compensated by increased prefrontal activity instrumental in tic suppression. […] ADHD as a neurodevelopmental disorder is associated with pathophysiological problems during cognitive demands, reward processing and during rest. […] It is further complicated by a number of heterogeneities regarding clinical characteristics, sex differences, and frequent comorbid disorders.

• #49 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 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. […] 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.

• #50 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 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. […] 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.

• #51 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 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. […] 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.

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

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

  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-naive preschoolers, aged 4-5 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. The largest effect sizes were noted for right frontal and left temporal lobe volumes. Examination of frontal lobe sub-regions revealed that the largest between group effect sizes were evident in the left orbitofrontal cortex, left primary motor cortex (M1), and left supplementary motor complex (SMC). ADHD-related reductions in specific sub-regions (left prefrontal, left premotor, left frontal eye field, left M1, and right SMC) were significantly correlated with symptom severity, such that higher ratings of hyperactive/impulsive symptoms were associated with reduced cortical volumes.

• #53

  https://scholars.duke.edu/individual/pub748424

  A core deficit in inhibitory control may account for a wide range of dysfunctional behaviors in attention-deficit/hyperactivity disorder (ADHD). […] In response to all Stop signals, control participants produced a large negative wave at 200 msec (N200) over right inferior frontal cortex, which was markedly reduced in ADHD children. […] ADHD children appear to have an abnormality in an early-latency, right inferior frontal processing component critical to the initiation of normal response-inhibition operations. […] They also appear to have a right frontal abnormality associated to the covert processing of Go stimuli preceding failed inhibitions. […] By providing timing and processing component specificity, these results extend the findings of recent functional MRI studies of inhibitory control reporting right frontal abnormalities in ADHD.

• #54

  https://scholars.duke.edu/individual/pub748424

  A core deficit in inhibitory control may account for a wide range of dysfunctional behaviors in attention-deficit/hyperactivity disorder (ADHD). […] In response to all Stop signals, control participants produced a large negative wave at 200 msec (N200) over right inferior frontal cortex, which was markedly reduced in ADHD children. […] ADHD children appear to have an abnormality in an early-latency, right inferior frontal processing component critical to the initiation of normal response-inhibition operations. […] They also appear to have a right frontal abnormality associated to the covert processing of Go stimuli preceding failed inhibitions. […] By providing timing and processing component specificity, these results extend the findings of recent functional MRI studies of inhibitory control reporting right frontal abnormalities in ADHD.

• #55 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 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. […] 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.

• #56 Attention Deficit-Hyperactivity Disorder (ADHD): From Abnormal Behavior to Impairment in Synaptic Plasticity

  https://www.mdpi.com/2079-7737/12/9/1241

  Attention deficit-hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high incidence in children and adolescents characterized by hyperactivity, impulsivity, and inattention. Neuroanatomical anomalies such as the volume reduction in the neocortex and hippocampus and the abnormal dendritic spine pruning during postnatal development are shared by several neuropsychiatric diseases such as schizophrenia, autism spectrum disorder and ADHD. […] The impairment in synaptic plasticity, working memory and spine phenotype in a murine model of ADHD are also discussed. […] ADHD is a neurodevelopmental disorder with a high incidence in children associated with decreased levels of dopamine and norepinephrine in the brain. […] ADHD is considered a neurodevelopmental disorder in a similar manner to autism spectrum disorder (ASD) and intellectual disability (ID).

• #57 Attention Deficit-Hyperactivity Disorder (ADHD): From Abnormal Behavior to Impairment in Synaptic Plasticity

  https://www.mdpi.com/2079-7737/12/9/1241

  Several neuroanatomical studies support the view that ADHD is a neurodevelopmental disorder. A significantly lower cortical thickness (most prominent in the prefrontal cortex, PFC) in children with ADHD as evaluated by brain MRI has been reported. […] The fitting of curves of thickness values obtained from sequential brain scanning in children diagnosed with ADHD and healthy controls show a delay of ≈3 years to attain the peak of cortical thickness during childhood, supporting a delay in cortical maturation in ADHD. […] ADHD is associated with a dysfunction of dopamine and noradrenergic systems involving cortical areas such as the PFC (dorsolateral and ventromedial), cingulate cortex and basal ganglia (nucleus accumbens, caudate nucleus and putamen) affecting neural networks driving executive control, motor function, reward processing and decision-making.

• #58 Attention Deficit-Hyperactivity Disorder (ADHD): From Abnormal Behavior to Impairment in Synaptic Plasticity

  https://www.mdpi.com/2079-7737/12/9/1241

  Several neuroanatomical studies support the view that ADHD is a neurodevelopmental disorder. A significantly lower cortical thickness (most prominent in the prefrontal cortex, PFC) in children with ADHD as evaluated by brain MRI has been reported. […] The fitting of curves of thickness values obtained from sequential brain scanning in children diagnosed with ADHD and healthy controls show a delay of ≈3 years to attain the peak of cortical thickness during childhood, supporting a delay in cortical maturation in ADHD. […] ADHD is associated with a dysfunction of dopamine and noradrenergic systems involving cortical areas such as the PFC (dorsolateral and ventromedial), cingulate cortex and basal ganglia (nucleus accumbens, caudate nucleus and putamen) affecting neural networks driving executive control, motor function, reward processing and decision-making.

• #59 Attention Deficit-Hyperactivity Disorder (ADHD): From Abnormal Behavior to Impairment in Synaptic Plasticity

  https://www.mdpi.com/2079-7737/12/9/1241

  Several neuroanatomical studies support the view that ADHD is a neurodevelopmental disorder. A significantly lower cortical thickness (most prominent in the prefrontal cortex, PFC) in children with ADHD as evaluated by brain MRI has been reported. […] The fitting of curves of thickness values obtained from sequential brain scanning in children diagnosed with ADHD and healthy controls show a delay of ≈3 years to attain the peak of cortical thickness during childhood, supporting a delay in cortical maturation in ADHD. […] ADHD is associated with a dysfunction of dopamine and noradrenergic systems involving cortical areas such as the PFC (dorsolateral and ventromedial), cingulate cortex and basal ganglia (nucleus accumbens, caudate nucleus and putamen) affecting neural networks driving executive control, motor function, reward processing and decision-making.

• #60 Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-overview-of-treatment-and-prognosis

  Attention deficit hyperactivity disorder (ADHD) manifests in childhood. Diagnostic criteria for ADHD include symptoms of hyperactivity, impulsivity, and/or inattention that occur in more than one setting and affect cognitive, academic, behavioral, emotional, and social functioning. […] This topic will provide an overview of the treatment and prognosis of ADHD in children. […] (See „Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis”.)

• #61 About Attention-Deficit / Hyperactivity Disorder (ADHD) | Attention-Deficit / Hyperactivity Disorder (ADHD) | CDC

  https://www.cdc.gov/adhd/about/index.html

  ADHD is one of the most common neurodevelopmental disorders of childhood. […] The causes of ADHD are unknown, but scientists have identified some possible risk factors. […] Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child. […] In most cases, ADHD is best treated with a combination of behavior therapy and medication. […] Effective treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.

• #62 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  ADHD is common in children and adolescents, and can be impairing for the individual affected in numerous aspects of their daily lives. Effective treatment of ADHD symptoms is necessary for children and adolescents to achieve full potential and performance in social, academic, and family functioning. Existing medical evidence supports pharmacologic therapy for children and adolescents with ADHD and is continuing to evolve with new research in the field. Pharmacologic treatment of children and adolescents with ADHD should begin with long acting stimulant medications in most cases.

• #63 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  Stimulants work to enhance arousal in the prefrontal cortex. Specifically, preparations of methylphenidate and amphetamine act to boost norepinephrine and dopamine neurotransmission in the prefrontal cortex. Methylphenidate exerts its effect from inhibiting presynaptic dopamine transporters of central adrenergic neurons. It also inhibits norepinephrine transporters to a much lesser degree. This increases synaptic cleft concentration of dopamine, amplifying the dopaminergic neurotransmission. Amphetamine is a competitive inhibitor of dopamine, acting directly on dopamine transporter and norepinephrine transporter binding sites as a pseudo-substrate. Amphetamines also increase catecholamine release as a primary mechanism and both, methylphenidate and amphetamine, increase dopamine release that enhances ones response to environmental stimuli.

• #64 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  Stimulants work to enhance arousal in the prefrontal cortex. Specifically, preparations of methylphenidate and amphetamine act to boost norepinephrine and dopamine neurotransmission in the prefrontal cortex. Methylphenidate exerts its effect from inhibiting presynaptic dopamine transporters of central adrenergic neurons. It also inhibits norepinephrine transporters to a much lesser degree. This increases synaptic cleft concentration of dopamine, amplifying the dopaminergic neurotransmission. Amphetamine is a competitive inhibitor of dopamine, acting directly on dopamine transporter and norepinephrine transporter binding sites as a pseudo-substrate. Amphetamines also increase catecholamine release as a primary mechanism and both, methylphenidate and amphetamine, increase dopamine release that enhances ones response to environmental stimuli.

• #65 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  Stimulants work to enhance arousal in the prefrontal cortex. Specifically, preparations of methylphenidate and amphetamine act to boost norepinephrine and dopamine neurotransmission in the prefrontal cortex. Methylphenidate exerts its effect from inhibiting presynaptic dopamine transporters of central adrenergic neurons. It also inhibits norepinephrine transporters to a much lesser degree. This increases synaptic cleft concentration of dopamine, amplifying the dopaminergic neurotransmission. Amphetamine is a competitive inhibitor of dopamine, acting directly on dopamine transporter and norepinephrine transporter binding sites as a pseudo-substrate. Amphetamines also increase catecholamine release as a primary mechanism and both, methylphenidate and amphetamine, increase dopamine release that enhances ones response to environmental stimuli.

• #66 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  Atomoxetine is a selective norepinephrine reuptake inhibitor, which causes increased concentrations of norepinephrine and dopamine in the prefrontal cortex. Atomoxetine does not cause increased norepinephrine or dopamine in the nucleus accumbens and lacks abuse potential. In children and adolescents with ADHD treated with atomoxetine, initial response may be slower than that seen with stimulant medications. ADHD symptoms may respond over the course of several weeks and after the dose is titrated up to the maximum daily dose; symptom improvement may continue over 2 months. […] Clonidine stimulates alpha-2 adrenoceptors in the brain stem activating inhibitory neurons, which results in reduced sympathetic outflow from the central nervous system. The reduced sympathetic outflow produces decreased peripheral resistance, renal vascular resistance, heart rate, and BP. In treatment of ADHD, the exact mechanism of action is unknown. There are many subtypes of alpha adrenergic receptors widely distributed in the CNS and the main theory proposes that postsynaptic alpha-2-agonist stimulation regulates subcortical activity in the prefrontal cortex, regulating symptoms of inattention, hyperactivity, and impulsivity.

• #67 Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners – Brown – Translational Pediatrics

  https://tp.amegroups.org/article/view/16230/18308

  Atomoxetine is a selective norepinephrine reuptake inhibitor, which causes increased concentrations of norepinephrine and dopamine in the prefrontal cortex. Atomoxetine does not cause increased norepinephrine or dopamine in the nucleus accumbens and lacks abuse potential. In children and adolescents with ADHD treated with atomoxetine, initial response may be slower than that seen with stimulant medications. ADHD symptoms may respond over the course of several weeks and after the dose is titrated up to the maximum daily dose; symptom improvement may continue over 2 months. […] Clonidine stimulates alpha-2 adrenoceptors in the brain stem activating inhibitory neurons, which results in reduced sympathetic outflow from the central nervous system. The reduced sympathetic outflow produces decreased peripheral resistance, renal vascular resistance, heart rate, and BP. In treatment of ADHD, the exact mechanism of action is unknown. There are many subtypes of alpha adrenergic receptors widely distributed in the CNS and the main theory proposes that postsynaptic alpha-2-agonist stimulation regulates subcortical activity in the prefrontal cortex, regulating symptoms of inattention, hyperactivity, and impulsivity.

• #68 Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/attention-deficit-hyperactivity-disorder/protocol

  Treatment strategies for ADHD are diverse and can be divided into pharmacologic and nonpharmacologic therapies. The frontline treatment for ADHD is stimulant medication, either methylphenidate or amphetamine derivatives, with or without combined psychological and behavioral therapies. The main categories of pharmacologic therapies include stimulants, selective norepinephrine reuptake inhibitors, alpha-2 agonists, and antidepressants. Nonpharmacologic therapies include psychosocial interventions, behavioral interventions, school-based interventions, cognitive training therapies, learning training, biofeedback or neurofeedback, parent behavior training, dietary supplements, elimination diets, vision training, and chiropractic treatment. […] In children over the age of 5, the American Academy of Pediatrics (AAP) recommends stimulants as the first line of therapy. It is unclear whether there is a significant benefit of combining behavioral therapy with stimulant therapy, or whether nonpharmacologic therapy may be effective. Adverse effects of pharmacologic treatment depend on the specific intervention and may include gastrointestinal symptoms, changes in appetite, and sleep disturbance. Treatment can also lead to personality changes or perceived loss of spontaneity. Individuals who are initially misdiagnosed or who have inadequate monitoring may be overtreated with stimulant medications. Overtreatment leads to the risk of treatment with little or no benefit or to unnecessary side effects.

• #69 ADHD in Children: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p592.html

  Current guidelines recommend parent training in behavior management and classroom behavior interventions as first-line therapy for preschool children who exhibit ADHD-like behaviors or have been diagnosed with ADHD. […] Medication can be offered as first-line treatment for elementary school children and adolescents with ADHD, with evidence-based psychosocial interventions encouraged as an adjunct therapy. […] Stimulants (e.g., methylphenidate, dextroamphetamine, and mixed amphetamine salts) are the most effective. […] A retrospective cohort study found that children with ADHD treated with stimulants had favorable long-term school outcomes. […] Stimulants should be started at low doses and titrated weekly to achieve a minimum effective dose. […] Common adverse effects of stimulant and nonstimulant medications for ADHD include gastrointestinal and constitutional symptoms.

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

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

  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. […] 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. […] In general, depression should be treated before ADHD is treated. Also, the combination of an antidepressant and stimulants has been shown to be safe and effective. […] Stimulants should be avoided in patients with bipolar disorder, and mood stabilizers or atypical antipsychotics should be used instead. […] For patients with comorbid anxiety disorders, stimulants are a first-line treatment, followed by selective serotonin reuptake inhibitors and cognitive behavior therapy. […] In those with intellectual disabilities, there is not enough evidence to recommend the use of stimulants for the treatment of ADHD.

• #71 Pathophysiology of ADHD and associated problems—starting points for NF interventions?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4478393/

  ADHD is associated with a number of neurophysiological deficits. […] Cognitive problems in ADHD are reported in numerous studies with different tasks. […] ADHD may be associated with a number of cognitive deficits, but these may not causes but rather consequences of the disorder, and may not provide causative therapy options. […] ADHD is probably associated with disturbances in cortico-striato-thalamo-cortical neuronal networks which may be partly compensated by increased prefrontal activity instrumental in tic suppression. […] ADHD as a neurodevelopmental disorder is associated with pathophysiological problems during cognitive demands, reward processing and during rest. […] It is further complicated by a number of heterogeneities regarding clinical characteristics, sex differences, and frequent comorbid disorders.

• #72 Attention Deficit Hyperactivity Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441838/

  ADHD is associated with cognitive and functional deficits that relate to diffuse abnormalities in the brain. The anterior cingulate gyrus and dorsolateral prefrontal cortex (DLFPC) are found to be small in individuals who are suffering from ADHD. It is thought that these changes account for the deficits in goal-directed behavior. […] It is important to diagnose and treat the disorder at a young age so that the symptoms do not persist into adulthood and cause other comorbid conditions. The treatment for the disorder is mostly related to stimulants and psychotherapy. […] This review would further shed light upon the causal factors, pathophysiology, and management of ADHD.

• #73

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

  The growing body of research and technological advances provide good perspectives for understanding the neurobiology of ADHD, refining diagnosis, and identifying new therapeutic options to optimize treatment outcomes and associated impairments, leading to improvements in all domains of patient care.

• #74 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

  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. […] 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. […] To this end, an increasing body of research indicates that inflammation, both locally and peripherally, is associated with psychiatric disorders, including ADHD. […] If the underlying mechanisms of the immune responses are known in patients whose ADHD is associated with inflammation, then inflammation may be a potential therapeutic target and treatment strategies may include immune modulation, antioxidants or anti-inflammatory agents.

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