Document Detail

A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention.
MedLine Citation:
PMID:  21575934     Owner:  NLM     Status:  MEDLINE    
Attention Deficit Hyperactivity Disorder (ADHD) has long been associated with abnormalities in frontal brain regions. In this paper we review the current structural and functional imaging evidence for abnormalities in children and adults with ADHD in fronto-striatal, fronto-parieto-temporal, fronto-cerebellar and fronto-limbic regions and networks. While the imaging studies in children with ADHD are more numerous and consistent, an increasing number of studies suggests that these structural and functional abnormalities in fronto-cortical and fronto-subcortical networks persist into adulthood, despite a relative symptomatic improvement in the adult form of the disorder. We furthermore present new data that support the notion of a persistence of neurofunctional deficits in adults with ADHD during attention and motivation functions. We show that a group of medication-naïve young adults with ADHD behaviours who were followed up 20 years from a childhood ADHD diagnosis show dysfunctions in lateral fronto-striato-parietal regions relative to controls during sustained attention, as well as in ventromedial orbitofrontal regions during reward, suggesting dysfunctions in cognitive-attentional as well as motivational neural networks. The lateral fronto-striatal deficit findings, furthermore, were strikingly similar to those we have previously observed in children with ADHD during the same task, reinforcing the notion of persistence of fronto-striatal dysfunctions in adult ADHD. The ventromedial orbitofrontal deficits, however, were associated with comorbid conduct disorder (CD), highlighting the potential confound of comorbid antisocial conditions on paralimbic brain deficits in ADHD. Our review supported by the new data therefore suggest that both adult and childhood ADHD are associated with brain abnormalities in fronto-cortical and fronto-subcortical systems that mediate the control of cognition and motivation. The brain deficits in ADHD therefore appear to be multi-systemic and to persist throughout the lifespan.
Ana Cubillo; Rozmin Halari; Anna Smith; Eric Taylor; Katya Rubia
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-27
Journal Detail:
Title:  Cortex; a journal devoted to the study of the nervous system and behavior     Volume:  48     ISSN:  1973-8102     ISO Abbreviation:  Cortex     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-30     Completed Date:  2012-05-25     Revised Date:  2014-03-25    
Medline Journal Info:
Nlm Unique ID:  0100725     Medline TA:  Cortex     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  194-215     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Srl. All rights reserved.
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MeSH Terms
Attention / physiology*
Attention Deficit Disorder with Hyperactivity / pathology*,  physiopathology*
Brain Mapping
Cognition Disorders / physiopathology,  psychology
Conduct Disorder / physiopathology
Corpus Striatum / pathology*,  physiopathology*
Frontal Lobe / pathology*,  physiopathology*
Image Processing, Computer-Assisted / methods
Intelligence Tests
Magnetic Resonance Imaging
Motivation / physiology*
Nerve Net / pathology,  physiopathology
Neuropsychological Tests
Psychomotor Performance / physiology
Grant Support
053272/Z/98/Z/JRS/JP/JAT//Wellcome Trust; G9900839//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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