Materiały źródłowe

• #1 Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis – UpToDate

  https://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-epidemiology-and-pathogenesis

  Attention deficit hyperactivity disorder (ADHD) is a disorder that manifests in childhood with symptoms of hyperactivity, impulsivity, and/or inattention. The symptoms affect cognitive, academic, behavioral, emotional, and social functioning. […] This topic review focuses on the epidemiology and pathogenesis of ADHD.

• #2

  https://link.springer.com/article/10.1007/s00787-021-01871-x

  The recommendations of the cited guidelines were developed by combining evidence summaries with expert opinion. […] Despite being largely reliant on the same evidence base, differences in recommendations are especially likely when high-level evidence is lacking. […] ADHD is the most common neurodevelopmental disorder in children and adolescents. […] There is a substantial evidence base, at least in the short term, for a range of pharmacological and, for non-core symptoms, some non-pharmacological treatments, with considerable consensus across different national guidelines. […] However, as in many areas of healthcare, there are significant methodological problems with much of the research underpinning these guidelines and the clinicians should be aware of these and how they may limit interpretation of the evidence.

• #3 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

  Attention-Deficit/Hyperactivity Disorder (ADHD) is the single most prevalent behavioral and mental health problem in youth. Approximately 10 percent of US children have received a clinical diagnosis of ADHD. Clinical diagnoses have increased steadily over time, though the higher rates seem attributable to changing clinical practices rather than to an increase in true population rates. The prevalence of ADHD based on rigorous diagnostic procedures is approximately 5.3 percent, a rate that has remained constant over the more than 20 years when diagnostic criteria have not changed and that is similar across geographic regions worldwide. This rate, when compared with the much higher rates of clinical diagnoses, suggests that a large number of youth may be receiving a diagnosis when they should not be, though the increasing rates of diagnosis could also represent the clinical recognition of youth who have clinically significant and functionally impairing ADHD symptoms but who may not meet full, formal diagnostic criteria. ADHD is more than twice as likely to be diagnosed in boys than in girls. It is a more prevalent diagnosis in youth from low-income families and in Caucasian compared to Black, Hispanic, and Asian youth, though diagnostic bias and cultural influences may contribute to these socioeconomic, ethnic, and racial disparities in diagnostic rates.

• #4 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

• #5 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.

• #6 Attention deficit hyperactivity disorder – Wikipedia

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

  ADHD arises from maldevelopment in brain regions such as the prefrontal cortex, basal ganglia and anterior cingulate cortex, which regulate the executive functions necessary for human self-regulation. […] ADHD symptoms arise from executive dysfunction. […] The precise causes of ADHD are unknown in most individual cases. […] Meta-analyses have shown that the disorder is primarily genetic with a heritability rate of 70-80%, where risk factors are highly accumulative. […] ADHD arises from brain maldevelopment especially in the prefrontal executive networks that can arise either from genetic factors (different gene variants and mutations for building and regulating such networks) or from acquired disruptions to the development of these networks and regions involved in executive functioning and self-regulation.

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

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

  ADHD, like other common medical and psychiatric disorders (eg, asthma, schizophrenia), is influenced by multiple genes, non-inherited factors and their interplay. There is no single cause of ADHD and exposure to a risk factor does not necessarily result in disorder. This means that any given risk factor will only be observed in a proportion of cases and will also be found in those who are unaffected. Also, risk factors that contribute to the origins of ADHD might not necessarily be the same as those that influence its course and outcomes. […] There is robust evidence from a wide range of study designs of a strong inherited contribution to ADHD. Family studies have consistently found higher rates of ADHD (twofold to eightfold increased risk) in parents and siblings of affected probands compared with relatives of unaffected controls. Twin studies have shown that monozygotic twin pairs have much higher concordance rates for ADHD than dizygotic twin pairs and adoption studies have also found increased rates of ADHD in the biological parents of ADHD adoptees compared with both the adoptive parents of the probands and with the parents of controls without ADHD. Mean heritability estimates are around 79%. However, heritability is not 100%, suggesting non-inherited factors also contribute.

• #8 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

• #9 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

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

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

  The most robust evidence of association with ADHD has been shown for a dopamine D4 receptor gene (DRD4) variant. This receptor binds both dopamine and norepinephrine and there is a functional polymorphism (variable number tandem repeat-VNTR) in exon III of the gene that has been extensively studied. The seven-repeat allele of this polymorphism has been found to be associated with ADHD in different meta-analyses. The latest meta-analysis shows significant association of small effect size, although there is also evidence of substantial heterogeneity across studies. […] ADHD is influenced by multiple genes, non-inherited factors and their interplay. There is no single cause of ADHD and exposure to a risk factor does not necessarily result in disorder.

• #11 Attention-deficit/hyperactivity disorder: diagnostic criteria, epidemiology, risk factors and evaluation in youth – Cabral – Translational Pediatrics

  https://tp.amegroups.org/article/view/30808/28327

  Attention-deficit/hyperactivity disorder (ADHD) is a complex, chronic, and heterogenous developmental disorder with typical onset in childhood and known persistence into adulthood. It is the most common neurodevelopmental disorder with significant impact on the affected individuals personal, social, academic, and occupational functioning and development. The levels of impairment are brought about by persistent displays of inattention, disorganization, and/or hyperactivity-impulsivity. […] Understanding the multifactorial risk factors associated with ADHD is necessary. Evidence-based recommendations highlight the importance of conducting a clinical interview and utilizing other approaches in aiding in diagnosis, especially if informants are not readily available or inconsistent. […] There is known increased genetic predisposition in the affected individual as observed in multiple family and twin studies. Candidate gene association studies had found dopamine D4 receptor gene (DRD4) and DRD5 variants with consistent associations with ADHD in several meta-analysis studies. There are several genome wide association studies in the early phases of discovery. One recent meta-analysis reported on 12 independent genome-wide significant loci and found that FOXP2 in chromosome 7 correlates with ADHD.

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

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

  ADHD also appears to share an inherited liability with other neurodevelopmental and psychiatric problems, notably ASDs, developmental coordination problems, reading ability, IQ, conduct and mood problems. These findings suggest the same inherited and familial risks can result in the manifestation of different clinical phenotypes. […] The high heritability of ADHD has fuelled efforts to identify susceptibility genes. As is the case for other complex disorders, molecular genetic studies of ADHD have so far mainly been based on examining common DNA variation (the common disease-common variant hypothesis). This was originally investigated using candidate gene approaches, in which assumptions about the pathophysiology of the disorder are made, and more recently with hypothesis-free genome wide association studies (GWAS), in which the frequencies of thousands of single nucleotide polymorphisms (SNPs) across the genome are compared between cases and controls. There is also emerging interest in the contribution of rare genetic variants to ADHD.

• #13 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. Despite weak evidence for deficits in these neurotransmitters, their role is substantiated by their distribution in those areas of the brain involved in ADHD and the positive response of ADHD patients to medications that modulate the neurotransmission of catecholamines. 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.

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

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

  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. […] 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.

• #15 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. Despite weak evidence for deficits in these neurotransmitters, their role is substantiated by their distribution in those areas of the brain involved in ADHD and the positive response of ADHD patients to medications that modulate the neurotransmission of catecholamines. 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.

• #16 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. […] 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. […] 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.

• #17 Attention deficit hyperactivity disorder – Wikipedia

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

  The subcortical volumes of the accumbens, amygdala, caudate, hippocampus, and putamen appears smaller in individuals with ADHD compared with controls. […] 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. […] ADHD has also been associated with motivational deficits in children.

• #18 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. […] 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).

• #19 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. Despite weak evidence for deficits in these neurotransmitters, their role is substantiated by their distribution in those areas of the brain involved in ADHD and the positive response of ADHD patients to medications that modulate the neurotransmission of catecholamines. 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.

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

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

  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. […] 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.

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

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

  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 The ADHD Brain: Neuroscience Behind Attention Deficit DisorderFooterLogo

  https://www.additudemag.com/neuroscience-of-adhd-brain/?srsltid=AfmBOoq2MvH8EPqYTkYY_PqkS3-pdqD-monSG7jpLd20fVW99fyUT3pE

  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.

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

  https://www.additudemag.com/neuroscience-of-adhd-brain/?srsltid=AfmBOoq2MvH8EPqYTkYY_PqkS3-pdqD-monSG7jpLd20fVW99fyUT3pE

  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.

• #24 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.

• #25 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. […] 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. […] 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.

• #26 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. […] 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. […] 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.

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

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

  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 Attention deficit hyperactivity disorder – Wikipedia

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

  ADHD arises from maldevelopment in brain regions such as the prefrontal cortex, basal ganglia and anterior cingulate cortex, which regulate the executive functions necessary for human self-regulation. […] ADHD symptoms arise from executive dysfunction. […] The precise causes of ADHD are unknown in most individual cases. […] Meta-analyses have shown that the disorder is primarily genetic with a heritability rate of 70-80%, where risk factors are highly accumulative. […] ADHD arises from brain maldevelopment especially in the prefrontal executive networks that can arise either from genetic factors (different gene variants and mutations for building and regulating such networks) or from acquired disruptions to the development of these networks and regions involved in executive functioning and self-regulation.

• #31 Attention deficit hyperactivity disorder – Wikipedia

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

  The subcortical volumes of the accumbens, amygdala, caudate, hippocampus, and putamen appears smaller in individuals with ADHD compared with controls. […] 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. […] ADHD has also been associated with motivational deficits in children.

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

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

  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. […] 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. […] 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. […] 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.

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

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

  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. […] 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. […] 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. […] 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.

• #34 Attention deficit hyperactivity disorder – Wikipedia

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

  The subcortical volumes of the accumbens, amygdala, caudate, hippocampus, and putamen appears smaller in individuals with ADHD compared with controls. […] 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. […] ADHD has also been associated with motivational deficits in children.

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

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

  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. […] 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.

• #36 The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children

  https://journal.psych.ac.cn/xlkxjz/EN/10.3724/SP.J.1042.2023.02106

  The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children. […] ADHD is characterized by deficits in executive functions, which include both cool (cognitive) and hot (emotional) aspects. […] The dual pathway model of ADHD suggests that both cognitive and emotional dysregulation contribute to the disorder’s symptoms. […] Emotional dysregulation is a core component of ADHD. […] The relationship between cool and hot executive functions is crucial for understanding the mechanisms underlying ADHD.

• #37 The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children

  https://journal.psych.ac.cn/xlkxjz/EN/10.3724/SP.J.1042.2023.02106

  The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children. […] ADHD is characterized by deficits in executive functions, which include both cool (cognitive) and hot (emotional) aspects. […] The dual pathway model of ADHD suggests that both cognitive and emotional dysregulation contribute to the disorder’s symptoms. […] Emotional dysregulation is a core component of ADHD. […] The relationship between cool and hot executive functions is crucial for understanding the mechanisms underlying ADHD.

• #38 The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children

  https://journal.psych.ac.cn/xlkxjz/EN/10.3724/SP.J.1042.2023.02106

  The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children. […] ADHD is characterized by deficits in executive functions, which include both cool (cognitive) and hot (emotional) aspects. […] The dual pathway model of ADHD suggests that both cognitive and emotional dysregulation contribute to the disorder’s symptoms. […] Emotional dysregulation is a core component of ADHD. […] The relationship between cool and hot executive functions is crucial for understanding the mechanisms underlying ADHD.

• #39 The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children

  https://journal.psych.ac.cn/xlkxjz/EN/10.3724/SP.J.1042.2023.02106

  The mechanism of “cool”/“hot” executive function deficit acting on the core symptoms of ADHD children. […] ADHD is characterized by deficits in executive functions, which include both cool (cognitive) and hot (emotional) aspects. […] The dual pathway model of ADHD suggests that both cognitive and emotional dysregulation contribute to the disorder’s symptoms. […] Emotional dysregulation is a core component of ADHD. […] The relationship between cool and hot executive functions is crucial for understanding the mechanisms underlying ADHD.

• #40 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

• #41 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

• #42 ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6199644/

  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. The identification of gene sets affecting neurotransmitter pathways in the brain has suggested that rare copy number variants or the accumulation of larger deletions and duplications influencing gene transcription are more commonly found in individuals with ADHD. […] 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. Hypoxicanoxic brain injury, epilepsy disorders, and traumatic brain injury also contribute to ADHD risk.

• #43 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.

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

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

  Attention-deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder. […] 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. […] Exposure to environmental toxins (specifically lead, organophosphate pesticides, and polychlorinated biphenyls) has been linked to ADHD symptoms.

• #45 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The role of genetic factors in the development of autism has been demonstrated in earlier twin studies: the prevalence of autism in the monozygotic twins is significantly higher than in the dizygotic twins. […] Most scientists believe the deformity is the result of a combination of genetic and environmental factors. […] The major toxins include mercury, lead, PVC (polyvinyl chloride) and PCBs (polychlorinated biphenyls). […] Exposure to harmful toxins above the threshold or in large doses during the early stages of pregnancy or childhood (especially during infancy) could lead to many diseases, especially neurodevelopmental diseases. […] The number of children getting autism and ADHD is increasing over the course of decades.

• #46 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The role of genetic factors in the development of autism has been demonstrated in earlier twin studies: the prevalence of autism in the monozygotic twins is significantly higher than in the dizygotic twins. […] Most scientists believe the deformity is the result of a combination of genetic and environmental factors. […] The major toxins include mercury, lead, PVC (polyvinyl chloride) and PCBs (polychlorinated biphenyls). […] Exposure to harmful toxins above the threshold or in large doses during the early stages of pregnancy or childhood (especially during infancy) could lead to many diseases, especially neurodevelopmental diseases. […] The number of children getting autism and ADHD is increasing over the course of decades.

• #47 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.

• #48 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.

• #49 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. […] 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.

• #50 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. […] 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.

• #51 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

  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. […] There is plenty of evidence that points to the role of inflammation in ADHD from various sources. 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.

• #52 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

  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. […] There is plenty of evidence that points to the role of inflammation in ADHD from various sources. 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.

• #53 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. […] More recently, Nielsen and colleagues conducted a population-based cohort study and a meta-analysis of five studies to investigate the relationship between maternal autoimmune diseases (ADs). In the cohort study, children whose mother with an AD (for example, psoriasis, type I diabetes mellitus, rheumatic fever/carditis) were more likely to be diagnosed with ADHD in comparison with the control group. […] The presence of more risk factors was related to a higher likelihood of ADHD diagnosis with a higher odds ratio observed with increasing number of biochemical risk factors.

• #54 The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials

  https://www.mdpi.com/2072-6643/13/11/4059

  Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD.

• #55 The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials

  https://www.mdpi.com/2072-6643/13/11/4059

  Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD.

• #56 The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials

  https://www.mdpi.com/2072-6643/13/11/4059

  Diet-related factors (such as vitamin and/or mineral deficiencies) have also been evidenced to contribute to the levels of ADHD and the progression of the disease. […] Studies assessing the specific role of iron and zinc on the course of ADHD have observed the deficiency of both minerals in most cases of hyperactivity. Zinc is an essential mineral involved in numerous cellular metabolic processes, required for the catalytic activity of a large number of enzymes, implied in the accurate functioning of the immune system and with a role in the protein synthesis, DNA synthesis, and cell division. Zinc also contributes to normal growth and development from pregnancy to adolescence, and harmonizes the performance of dopamine and melatonin. Iron is a cofactor mineral that systematizes the production of dopamine and norepinephrine, an essential element participating in a wide variety of metabolic processes, including oxygen transport, deoxyribonucleic acid synthesis, and electron transport.

• #57 The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials

  https://www.mdpi.com/2072-6643/13/11/4059

  The potential explanations about the paths between the zinc–iron levels and the various ADHD manifestations are discussed in a number of studies, which showed that lower levels of these elements in childhood (but also in older adults) could be related to a dopaminergic impairment, which could be the origin of the high inattentiveness–hyperactivity levels and the other correlates of the ADHD disease (like the presence of restless leg syndrome and other multiple sleep problems). Neuroimaging, genetic, and animal studies have also shown that decreases in dopamine transporter densities are related with decreased brain iron and zinc levels. […] The link between iron and zinc supplementation and the observed decrease in ADHD symptoms in the controlled clinical trials selected for this systematic review also makes sense with regard to the role of zinc and iron as dopamine reuptake inhibitors, which was precisely the core target of the stimulant medications used in the combined treatment plans for the disease.

• #58 Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis | Annals of General Psychiatry | Full Text

  https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00271-w

  Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence, affecting 2.2 to 17.8% of all school-aged children and adolescents. ADHD in children has been associated with a wide range of developmental deficits including limitations of learning or control of executive functions as well as global impairments of social skills. […] Our systematic review suggested a higher prevalence of ADHD (7.47%) in children and adolescents in Africa, indicating that ADHD is a serious public health problem in children and adolescents in Africa. The prevalence of ADHD was considerably greater in males than in females. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both males and females. […] In DSM-5, three main nominal subtypes of ADHD are identified which are mainly based on the differential elevation of two dimensions of inattention symptoms and hyperactivityimpulsivity symptoms. The first one is the predominantly inattentive type (ADHD-I) which describes individuals with maladaptive levels of inattention, but not hyperactivityimpulsivity; the second is the predominantly hyperactiveimpulsive type (ADHD-H) which is characterized by maladaptive levels of hyperactivityimpulsivity, but not inattention, and finally, the combined type (ADHD-C) which describes individuals who exhibit significant symptoms of both inattention and hyperactivityimpulsivity. […] ADHD is more prevalent among males in all three subtypes including the predominantly inattentive type (ADHD-I), hyperactiveimpulsive type (ADHD-HI), and combined (ADHD-C). This is consistent with other study findings that ADHD is more prevalent among males in all three subtypes.

• #59 Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis | Annals of General Psychiatry | Full Text

  https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00271-w

  Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence, affecting 2.2 to 17.8% of all school-aged children and adolescents. ADHD in children has been associated with a wide range of developmental deficits including limitations of learning or control of executive functions as well as global impairments of social skills. […] Our systematic review suggested a higher prevalence of ADHD (7.47%) in children and adolescents in Africa, indicating that ADHD is a serious public health problem in children and adolescents in Africa. The prevalence of ADHD was considerably greater in males than in females. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both males and females. […] In DSM-5, three main nominal subtypes of ADHD are identified which are mainly based on the differential elevation of two dimensions of inattention symptoms and hyperactivityimpulsivity symptoms. The first one is the predominantly inattentive type (ADHD-I) which describes individuals with maladaptive levels of inattention, but not hyperactivityimpulsivity; the second is the predominantly hyperactiveimpulsive type (ADHD-H) which is characterized by maladaptive levels of hyperactivityimpulsivity, but not inattention, and finally, the combined type (ADHD-C) which describes individuals who exhibit significant symptoms of both inattention and hyperactivityimpulsivity. […] ADHD is more prevalent among males in all three subtypes including the predominantly inattentive type (ADHD-I), hyperactiveimpulsive type (ADHD-HI), and combined (ADHD-C). This is consistent with other study findings that ADHD is more prevalent among males in all three subtypes.

• #60 Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis | Annals of General Psychiatry | Full Text

  https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00271-w

  Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence, affecting 2.2 to 17.8% of all school-aged children and adolescents. ADHD in children has been associated with a wide range of developmental deficits including limitations of learning or control of executive functions as well as global impairments of social skills. […] Our systematic review suggested a higher prevalence of ADHD (7.47%) in children and adolescents in Africa, indicating that ADHD is a serious public health problem in children and adolescents in Africa. The prevalence of ADHD was considerably greater in males than in females. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both males and females. […] In DSM-5, three main nominal subtypes of ADHD are identified which are mainly based on the differential elevation of two dimensions of inattention symptoms and hyperactivityimpulsivity symptoms. The first one is the predominantly inattentive type (ADHD-I) which describes individuals with maladaptive levels of inattention, but not hyperactivityimpulsivity; the second is the predominantly hyperactiveimpulsive type (ADHD-H) which is characterized by maladaptive levels of hyperactivityimpulsivity, but not inattention, and finally, the combined type (ADHD-C) which describes individuals who exhibit significant symptoms of both inattention and hyperactivityimpulsivity. […] ADHD is more prevalent among males in all three subtypes including the predominantly inattentive type (ADHD-I), hyperactiveimpulsive type (ADHD-HI), and combined (ADHD-C). This is consistent with other study findings that ADHD is more prevalent among males in all three subtypes.

• #61 Epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents in Africa: a systematic review and meta-analysis | Annals of General Psychiatry | Full Text

  https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00271-w

  Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence, affecting 2.2 to 17.8% of all school-aged children and adolescents. ADHD in children has been associated with a wide range of developmental deficits including limitations of learning or control of executive functions as well as global impairments of social skills. […] Our systematic review suggested a higher prevalence of ADHD (7.47%) in children and adolescents in Africa, indicating that ADHD is a serious public health problem in children and adolescents in Africa. The prevalence of ADHD was considerably greater in males than in females. The predominantly inattentive type (ADHD-I) was the most common type of ADHD in both males and females. […] In DSM-5, three main nominal subtypes of ADHD are identified which are mainly based on the differential elevation of two dimensions of inattention symptoms and hyperactivityimpulsivity symptoms. The first one is the predominantly inattentive type (ADHD-I) which describes individuals with maladaptive levels of inattention, but not hyperactivityimpulsivity; the second is the predominantly hyperactiveimpulsive type (ADHD-H) which is characterized by maladaptive levels of hyperactivityimpulsivity, but not inattention, and finally, the combined type (ADHD-C) which describes individuals who exhibit significant symptoms of both inattention and hyperactivityimpulsivity. […] ADHD is more prevalent among males in all three subtypes including the predominantly inattentive type (ADHD-I), hyperactiveimpulsive type (ADHD-HI), and combined (ADHD-C). This is consistent with other study findings that ADHD is more prevalent among males in all three subtypes.

• #62 Event segmentation in ADHD: neglect of social information and deviant theta activity point to a mechanism underlying ADHD | General Psychiatry

  https://gpsych.bmj.com/content/37/3/e101486

  Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed psychiatric conditions in children and adolescents. Although the symptoms appear to be well described, no coherent conceptual mechanistic framework integrates their occurrence and variance and the associated problems that people with ADHD face. […] The current study proposes that altered event segmentation processes provide a novel mechanistic framework for understanding deficits in ADHD. […] Compared with their NT peers, the ADHD group showed less dependence of their segmentation behaviour on social information, indicating that they did not consider social information to the same extent as their unaffected peers. This divergence was accompanied by differences in EEG theta band activity and a different effective connectivity network architecture at the source level.

• #63 Event segmentation in ADHD: neglect of social information and deviant theta activity point to a mechanism underlying ADHD | General Psychiatry

  https://gpsych.bmj.com/content/37/3/e101486

  Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed psychiatric conditions in children and adolescents. Although the symptoms appear to be well described, no coherent conceptual mechanistic framework integrates their occurrence and variance and the associated problems that people with ADHD face. […] The current study proposes that altered event segmentation processes provide a novel mechanistic framework for understanding deficits in ADHD. […] Compared with their NT peers, the ADHD group showed less dependence of their segmentation behaviour on social information, indicating that they did not consider social information to the same extent as their unaffected peers. This divergence was accompanied by differences in EEG theta band activity and a different effective connectivity network architecture at the source level.

• #64 Event segmentation in ADHD: neglect of social information and deviant theta activity point to a mechanism underlying ADHD | General Psychiatry

  https://gpsych.bmj.com/content/37/3/e101486

  This study shows that adolescents with ADHD perceive events differently from their NT peers, in association with a different brain network architecture that reflects less adaptation to the situation and problems in attentional sampling of environmental information. The results call for a novel conceptual view of ADHD, based on event segmentation theory. […] We hypothesised that the mechanisms described in the EST might be altered in ADHD and that these alterations would in turn be reflected at the neurophysiological level. More specifically, we posited that altered event segmentation in ADHD might be related to alterations in specific electroencephalography (EEG) frequency bands that are linked to distinct, general cognitive functions and specifically to event segmentation. […] The ADHD group appeared to consider changes in social interactions to a lesser extent for segmenting events. This comparative lack of consideration of social information in event segmentation adds to previous research indicating that people diagnosed with ADHD rely less than NT adolescents on social and affective cues for decision-making and orienting attention.

• #65 Attention deficit hyperactivity disorder – Wikipedia

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

  ADHD arises from maldevelopment in brain regions such as the prefrontal cortex, basal ganglia and anterior cingulate cortex, which regulate the executive functions necessary for human self-regulation. […] ADHD symptoms arise from executive dysfunction. […] The precise causes of ADHD are unknown in most individual cases. […] Meta-analyses have shown that the disorder is primarily genetic with a heritability rate of 70-80%, where risk factors are highly accumulative. […] ADHD arises from brain maldevelopment especially in the prefrontal executive networks that can arise either from genetic factors (different gene variants and mutations for building and regulating such networks) or from acquired disruptions to the development of these networks and regions involved in executive functioning and self-regulation.

• #66 ADHD and Complex Trauma

  https://www.childdevelopmentclinic.com.au/adhd-and-complex-trauma.html

  ADHD is a Neurobiological Developmental Disorder, meaning its related to the brain, runs in families, and impacts a childs development and ability to learn. 1 in 20 children are diagnosed with ADHD at some point in their lives. The main symptoms include impulsivity, hyperactivity, distractibility, poor concentration, racing thoughts and emotional reactivity. Interestingly, these symptoms can also be seen in chronic hyper-arousal after trauma. […] Brain development studies for ADHD and child maltreatment show significant similarities in the areas of the brain that are affected (areas responsible for emotional regulation, decision making, memory, social processing and concentration). […] Children who have a trauma history tend to have more severe ADHD symptoms than in either diagnosis alone and have poorer overall functioning.

• #67 ADHD and Complex Trauma

  https://www.childdevelopmentclinic.com.au/adhd-and-complex-trauma.html

  ADHD is a Neurobiological Developmental Disorder, meaning its related to the brain, runs in families, and impacts a childs development and ability to learn. 1 in 20 children are diagnosed with ADHD at some point in their lives. The main symptoms include impulsivity, hyperactivity, distractibility, poor concentration, racing thoughts and emotional reactivity. Interestingly, these symptoms can also be seen in chronic hyper-arousal after trauma. […] Brain development studies for ADHD and child maltreatment show significant similarities in the areas of the brain that are affected (areas responsible for emotional regulation, decision making, memory, social processing and concentration). […] Children who have a trauma history tend to have more severe ADHD symptoms than in either diagnosis alone and have poorer overall functioning.

• #68 ADHD and Complex Trauma

  https://www.childdevelopmentclinic.com.au/adhd-and-complex-trauma.html

  ADHD is a Neurobiological Developmental Disorder, meaning its related to the brain, runs in families, and impacts a childs development and ability to learn. 1 in 20 children are diagnosed with ADHD at some point in their lives. The main symptoms include impulsivity, hyperactivity, distractibility, poor concentration, racing thoughts and emotional reactivity. Interestingly, these symptoms can also be seen in chronic hyper-arousal after trauma. […] Brain development studies for ADHD and child maltreatment show significant similarities in the areas of the brain that are affected (areas responsible for emotional regulation, decision making, memory, social processing and concentration). […] Children who have a trauma history tend to have more severe ADHD symptoms than in either diagnosis alone and have poorer overall functioning.

• #69 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.

• #70 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The exact cause of ADHD is still unknown, but it is widely acknowledged that there is a strong neurobiological basis. […] Changes in brain structure are thought to be the main cause of the disease. […] Neurotransmitters, which are called brains chemical messengers, perform poorly and found with less activity in areas of the brain responsible for activity and attention in ADHD patients. […] ADHD in children can be understood as a comprehensive result of the dysfunction of information transmission between neurons in the brain and the disorder of the mutual restriction between inhibitory synapses and excitatory synapses. […] The condition is usually diagnosed in preschoolers and early elementary schoolers, which provides a structured environment that allows symptoms to become apparent.

• #71 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The exact cause of ADHD is still unknown, but it is widely acknowledged that there is a strong neurobiological basis. […] Changes in brain structure are thought to be the main cause of the disease. […] Neurotransmitters, which are called brains chemical messengers, perform poorly and found with less activity in areas of the brain responsible for activity and attention in ADHD patients. […] ADHD in children can be understood as a comprehensive result of the dysfunction of information transmission between neurons in the brain and the disorder of the mutual restriction between inhibitory synapses and excitatory synapses. […] The condition is usually diagnosed in preschoolers and early elementary schoolers, which provides a structured environment that allows symptoms to become apparent.

• #72 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The exact cause of ADHD is still unknown, but it is widely acknowledged that there is a strong neurobiological basis. […] Changes in brain structure are thought to be the main cause of the disease. […] Neurotransmitters, which are called brains chemical messengers, perform poorly and found with less activity in areas of the brain responsible for activity and attention in ADHD patients. […] ADHD in children can be understood as a comprehensive result of the dysfunction of information transmission between neurons in the brain and the disorder of the mutual restriction between inhibitory synapses and excitatory synapses. […] The condition is usually diagnosed in preschoolers and early elementary schoolers, which provides a structured environment that allows symptoms to become apparent.

• #73 Different Factors and the Occurrence of of Autism and ADHD | PRBM

  https://www.dovepress.com/a-review-on-the-mechanism-between-different-factors-and-the-occurrence-peer-reviewed-fulltext-article-PRBM

  The exact cause of ADHD is still unknown, but it is widely acknowledged that there is a strong neurobiological basis. […] Changes in brain structure are thought to be the main cause of the disease. […] Neurotransmitters, which are called brains chemical messengers, perform poorly and found with less activity in areas of the brain responsible for activity and attention in ADHD patients. […] ADHD in children can be understood as a comprehensive result of the dysfunction of information transmission between neurons in the brain and the disorder of the mutual restriction between inhibitory synapses and excitatory synapses. […] The condition is usually diagnosed in preschoolers and early elementary schoolers, which provides a structured environment that allows symptoms to become apparent.

• #74

  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.

• #75 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.

• #76 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20221208/Researchers-gain-new-insights-into-ADHD-drugs-mechanism-of-action.aspx

  Our findings demonstrate in two independent cohorts that methylphenidate changes spontaneous neural activity in reward and cognitive control systems in children with ADHD. […] Findings were replicated across two independent cohorts, providing further evidence that methylphenidate may alleviate ADHD symptoms by its actions on the NAc and the triple network cognitive system. […] The work advances researchers’ understanding of how ADHD affects cognitive control networks in the brain and how methylphenidate interacts with these networks to shift behavior.

• #77 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20221208/Researchers-gain-new-insights-into-ADHD-drugs-mechanism-of-action.aspx

  Our findings demonstrate in two independent cohorts that methylphenidate changes spontaneous neural activity in reward and cognitive control systems in children with ADHD. […] Findings were replicated across two independent cohorts, providing further evidence that methylphenidate may alleviate ADHD symptoms by its actions on the NAc and the triple network cognitive system. […] The work advances researchers’ understanding of how ADHD affects cognitive control networks in the brain and how methylphenidate interacts with these networks to shift behavior.

• #78 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20221208/Researchers-gain-new-insights-into-ADHD-drugs-mechanism-of-action.aspx

  Our findings demonstrate in two independent cohorts that methylphenidate changes spontaneous neural activity in reward and cognitive control systems in children with ADHD. […] Findings were replicated across two independent cohorts, providing further evidence that methylphenidate may alleviate ADHD symptoms by its actions on the NAc and the triple network cognitive system. […] The work advances researchers’ understanding of how ADHD affects cognitive control networks in the brain and how methylphenidate interacts with these networks to shift behavior.

• #79 Guanfacine (Intuniv) for Attention-Deficit/Hyperactivity Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0215/p468.html

  Guanfacine (Intuniv) is an extended-release, noncentral nervous system stimulant approved for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children six to 17 years of age; however, it appears to be most effective in children 12 years or younger. Similar to clonidine (Catapres), it works as a selective agonist for the 2A-adrenergic receptor, although the actual mechanism of action is not known. […] Guanfacine is effective in the short-term (i.e., eight to nine weeks) treatment of ADHD. Dosages of 1 to 4 mg per day decrease scores on the ADHD Rating Scale-IV by an average of 17 to 21 points, compared with a decrease of 9 to 12 points with placebo. […] When adjusted for age, the changes in ADHD Rating Scale-IV scores were not statistically significant compared with the placebo group in patients 13 to 17 years of age, but were for patients six to 12 years of age. […] Therefore, effectiveness in children 13 to 17 years of age is questionable.

• #80

  https://link.springer.com/article/10.1007/s00787-021-01871-x

  We will first consider some of the methodological challenges that we encountered when conducting systematic reviews and meta-analyses of ADHD interventions and highlight how these may have affected interpretation of the evidence and discuss some of the approaches that may mitigate these methodological challenges. […] While there is a wealth of data regarding the short-term efficacy of treatments for ADHD, high-quality data on longer term outcomes are still lacking and the long-term effectiveness of ADHD interventions, both pharmacological and non-pharmacological, continues to be debated. […] Despite their clear limitations, observational studies have certain advantages and can helpfully complement RCTs. […] The most recent and comprehensive appraisal of pharmacological treatments is the network meta-analysis (NMA) conducted by the EAGG, with stringent inclusion/exclusion criteria as well as including both published and unpublished data.

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